Many writers I know have 9-to-5 jobs that provide health coverage through a standard group insurance plan. That said, other writers I know work hourly jobs, part-time jobs, in the service industry, freelance, or in some other profession that doesn’t provide health insurance.
If the latter describes you, listen up.
In 2018, healthcare premiums are expected to increase up to 50% in states like Florida and Georgia (source). Reasons for this premium hike are legion, including the uncertain future of the Affordable Care Act, the underlying growth in healthcare costs, and the composition of the risk pool for each plan.
Basically, if you have individual health insurance, you'll want to make sure that your monthly premium hasn’t changed from 2017 to 2018. If you don’t check, you could be automatically re-enrolled in your existing plan, resulting in some unpleasant budget crunching.
My Personal Experience with 2018 Health Insurance Enrollment
As an editor in business for herself, I’m enrolled in an individual insurance plan through a nationally recognized provider. When I learned that the monthly premium on my insurance would jump by $150 next year, even with the tax credit I receive through Healthcare.gov, I set aside time to research more affordable plans.
Thanks to my “always be prepared” attitude, I’d previously enrolled in a silver-level plan. (No, I was never a Girl Scout. Why do you ask?)
This level of coverage is described on Healthcare.gov as a plan for those needing regular doctor appointments, regular prescriptions, etc. I enrolled in it as a woman who goes in for her annual physical, an annual dermatology skin check, and not much else; who has one regular prescription. After a year of this, I’ve realized that if my health remains the same, I probably won't need such intensive health insurance. A bronze-level plan, which is for occasional doctor visits at a lower premium and a higher deductible, may work for me instead.
At the start of my search, I identified a few bronze-level plans that met my needs and that showed my doctors as “in network.” This meant I wouldn’t have to pay out of pocket for my medical appointments, as can happen when a doctor is “out of network."
Then, I called the billing departments at my doctors’ offices to confirm that they did indeed accept the new plans I’d found. I asked the operator for billing specifically. Unlike the front desk, which usually just handles patients’ insurance cards, billing deals directly with insurance providers — getting authorizations for procedures, providing evidence of medical necessity for coverage, etc. In other words, they could tell you the plans your doctor participates in with their eyes closed. In the end, I found a great plan that results in a price cut for me.
If you learn anything from this story, I hope it’s that you shouldn't let insurers give you the run-around. Remember that they’re treating healthcare like a business, so they’re not going to give you straight answers. If you want direct answers (or what counts for “direct" in a field where the point of sale can’t tell you exactly how much a service will cost), call your doctors’ offices and ask for billing.
What to Expect When You Apply for Individual Health Insurance
You may have heard horrible things about Healthcare.gov: that it’s unruly, difficult to navigate, frustrating, that you’ll need a representative to walk you through it. While this was all true back in 2014 when it first launched, the website has mercifully made some changes in the past few years so that it’s a bit more user-friendly.
That said, you may not even need to interact with Healthcare.gov to enroll in an individual insurance plan. In fact, I spent most of my time on my insurance provider’s website until I was prompted to go to Healthcare.gov to apply for my tax credit.
In this instance, a tax credit is a subsidized, needs-based stipend you receive from the federal government that is essentially applied as a discount to your monthly premium.
If you want to see what sort of tax credit you could get, then you can start by applying on your preferred insurance provider’s website. At some point, you’ll be redirected to Healthcare.gov to fill out the tax credit application.
Your credit is based on factors such as age, smoking status, and projected household income for the year the subsidy is in effect. You will also be required to file a federal tax return for the year the subsidy is in effect.
You may also be given homework by Healthcare.gov. For example, I will need to upload proof of my income level (e.g., Form 1099s) by February of next year. Make sure to make down any enrollment requirements you’re given and speak with a tax professional if you have any questions.
What If I Don’t Want to Get Health Insurance?
If you’re still not convinced that you need health insurance — maybe you’re young, healthy, and/or you don’t visit the doctor that often — then you could of course elect not to get health insurance. However, as the federal law stands, there is a tax penalty for not being enrolled in health insurance for more than three consecutive months. This means that when you file your tax return in April 2019 (for tax year 2018), you may owe the government or get a lower refund as a result of this.
The tax penalty rates for 2018 and beyond haven’t been announced yet, but they are expected to increase from 2017’s rates. For 2017, the tax penalty is either 2.5% of your adjusted gross income (AGI) or $695/adult, $347.50/child dependent, with up to $2,085 per household permitted (source).
Of course, paying this penalty could “make sense” if you have a superhuman immune system that never lets you get sick. After all, $695/adult could very easily be what you pay for just two months of unsubsidized silver plan premiums. But the instant you have an emergency or something unexpected sends you to the hospital as an uninsured citizen, this could mean a major loss over time, and even include medical bills that will affect your credit score.
Considerations to Make When Choosing a Plan
If you do elect to choose a plan or to switch from your current one, then...
Do you use your health insurance benefits sparingly, regularly, or often? (You may want to choose a bronze, silver, or gold/platinum plan based on your answer.)
Are there certain types of care (e.g., outpatient mental healthcare) that you definitely need? What about dental or vision?
Are you making any healthcare changes or planning any major procedures for the next year (e.g., pregnancy and birth, LASIK eye surgery, cosmetic surgery)?
How horrible would it be if you changed doctors because your current health care providers aren't in network?
Do you need a Health Savings Account (HSA)?
Resources for Individual Insurance Open Enrollment
Of course, this post is just the tip of the iceberg. There are some great resources out there for you to review as you explore open enrollment. Here’s a list of resources to keep in mind.
December 15: Open Enrollment Deadline
Healthcare.gov
(800) 318-2596
TTY: (855) 889-4325
Find local, in-person help through their search by zip code feature: https://localhelp.healthcare.gov/#/
If you’re a freelancer, you could get benefits through Freelancers Union and its health benefit partners: https://www.freelancersunion.org/benefits/.