July 2, 2014

Special Enrollment Periods for ‘Cares’: Obamacare & Medicare

By Richard J. Schillig, CLU, ChFC, LUTCF
Independent Insurance and Financial Advisor

Special Enrollment Periods allow individuals to sign up for a plan of insurance outside of the normal enrollment periods.

Health Care costs continue to be one of the risks to our retirement nest-egg. Average overnight room and board
in a hospital nationwide is $1,600. Other services; lab tests and X-Rays are well over $100 each. Doctor office visits, especially when we are talking about specialists, are exorbitant. Surgeries, whether outpatient or inpatient, major or minor, are all available at a huge cost. Health care costs are a risk. These costs can really put a hole in our valued retirement assets. That’s why we have insurance. Medicare insurance for the 65 plus age group and, prior to Medicare, individual or group major Medical insurance for ourselves and dependents.

However, open enrollment periods for all insurance is over. Normally that means consumers are not able to acquire insurance coverage. The Medicare enrollment period ended December 7. Persons on Medicare can no longer acquire new insurance or change their plan until the next annual enrollment period on October 15, 2014 – UNLESS ONE IS JUST NOW AGING INTO MEDICARE – then you have an initial enrollment period. Persons wanting to enroll in an Obamacare plan to take advantage of premium subsidies normally must wait until the next annual enrollment period for Obamacare on Nov. 15, 2014. But persons eligible for either Obamacare OR Medicare may qualify for a Special Enrollment Periods if life changing events occur such as marriage, divorce, death in the family, loss of employer or retirees insurance, relocation, and other events. Special Enrollment Periods allow individuals to sign up for a plan of insurance outside of the normal enrollment periods.

Our experience with these enrollment periods – especially the ones for Obamacare – we have observed a lack of participation in Obamacare especially among the millennium generation – those born after 1964 to 1983. This generation does not seem to be interested in enrolling. The feeling of “invincible” along with the cost of premium associated with major medical insurance is the major reason behind this lack of interest.

Several millennia’s we enrolled recently ended up very pleased with their cost of major medical insurance. A 32 year old single person enrolled in an Obama Plan with less than $30 monthly premium. Regular premium would have been in excess of $300 monthly. Premium subsidies brought the cost down to a very affordable cost. In another very similar case, the cost of insurance after subsidy ended up less than $16 monthly. That’s the reality of Obamacare. Premium subsidies make what was at one time almost cost prohibitive now actually affordable. That was the original intent of the Affordable Care Act.

Recall the “Individual Mandate” for major medical insurance is effective this year. When we file 2014 income tax returns, the question will be there. Are you in compliance with the Affordable Care Act? Fines (tax) will be added to the tax return for those not in compliance.

Medicare folks have a chance to acquire a similar cost effective major medical insurance plan with the availability of the very popular Advantage Plans……Medicare Part C. Insurance companies offering Medicare Advantage Plan continue with a $0 monthly premium or a minimal monthly premium compared to that required with the components of Original Medicare. Our monthly Community Meeting addresses the options, pros and cons of these choices. Thursday July 17 is our scheduled meeting. Joint us for a very informative session.

We continue our retirement explorer service. If your plans for retirement income that you believe to be true, turned out not to be true – when would you want to know? Encourage you to take advantage of our retirement income analysis to have the assurance of knowing your retirement plan is on track. See our ad on this page.

Filed Under: Finance, Health & Wellness