Deadlines near for Medicare, Marketplace insurance

The nurses station in the family clinic at The Rocking Horse Center Tuesday. BILL LACKEY/STAFF

caption arrowCaption
The nurses station in the family clinic at The Rocking Horse Center Tuesday. BILL LACKEY/STAFF

The end of open enrollment season is nearing, with deadlines of Dec. 7 for Medicare and Dec. 15 for marketplace enrollees that want health insurance to start the beginning of 2022.

Insurance plans can change each year what they cover and cost. So for the more than 200,000 Ohioans with marketplace insurance and 2.3 million with Medicare, passively keeping the same plan can mean leaving money on the table or losing access to medications and providers.

We sorted through what you need to know if you still need to make a decision.

ExploreMedicare open enrollment here for 2.3M Ohioans

Deadlines are approaching

Medicare open enrollment is from Oct. 15 to Dec. 7, or one week from today.

Marketplace open enrollment will last until Jan 15. However, people need to sign up by Dec. 15 if they want coverage effective by Jan. 1. Also, starting in 2022, people who make less than 150% of the federal poverty level will be allowed to open enroll throughout the year.

But don’t wait until the last minute

Marisa O’Neill, CEO with RetireMEDiQ, which brokers Medicare plans in the region, said her organization still has appointments.

But phone lines can get tied up and appointments booked, so experts advise people plan ahead to avoid a last minute crunch.

Dawn Byers, director of billing with Rocking Horse Community Health Center in Springfield, said the organization has availability to help people with one-on-one assistance enrolling in marketplace coverage. She also said it is a good idea to not wait until the last minute when many others are all trying to enroll.

Help is available

Sorting through options can be overwhelming, but free professional help is available whether you’re selecting a marketplace or Medicare plan.

For Medicare, free independent help is available through the Ohio Senior Health Insurance Information Program at 1-800-686-1578.

Several ways exist to apply and enroll into a plan with the marketplace created by the Affordable Care Act. While you can apply at healthcare.gov or 1-800-318-2596, local individual help is also available. To find personal help understanding options, search by city, state or zip code at localhelp.healthcare.gov.

Some of the options for enrollment help in the region include Rocking Horse Community Health Center, based in Springfield at 937-324-1111 ext. 143; Primary Health Solutions, which serves in Butler and Montgomery County, at 513-454-1111 ext. 1432, 1019 or 1540; and Five Rivers Health Centers at 937-734-4141.

“It’s not only patients, anyone in the community can call for assistance with applications,” said Byers, with Rocking Horse.

ExploreOhioans urged to get mental health help during pandemic. But what if insurance doesn’t cover it?

Prepare for some sticker shock with Medicare Part B

Medicare’s Part B monthly premium for 2022 will increase by $21.60, the largest dollar increase in the health insurance program’s history, the Centers for Medicare & Medicaid Services announced on Nov. 12.

Standard monthly premiums for Part B will cost $170.10 in 2022, up from $148.50 in 2021.

This comes from a range of factors such as setting aside funds in case Medicare agrees to cover a new $56,000 Alzheimer’s drug, rising prices overall, COVID-19 care costs, and the repayment owed for a pandemic program subsidizing some of the cost of Part B in 2021.

AARP reported that federal Medicare officials stressed that while it’s a stiff increase, the Social Security cost-of-living adjustment is also 5.9%, which is the largest in 30 years.

ExploreAverage health insurance family premiums grew 4% to $22K this year

Changes also coming for marketplace

Higher subsidies are available through temporary changes made by the American Rescue Plan Act, according to the Kaiser Family Foundation.

People who didn’t take advantage of special enrollment seasons earlier in the year are advised to examine their options and see if they can get a better premium subsidy.

Also, premium costs could bump up next year for people who let their 2021 plans get passively renewed for 2022. And some people who have been in “bronze” high deductible plans could get a better deal by switching to a midlevel “silver” plan because of the ARPA changes.

Some counties also have more options available next year, because some health insurers are expanding for 2022.

About the Author