eHealth Describes Risks of Missing Obamacare’s Dec. 15 Health Insurance Deadline: Gaps in Coverage, Unexpected Price Hikes & Loss of Subsidies
December 15 is the last day to apply for health insurance coverage that begins January 1, 2016
MOUNTAIN VIEW, CA – December 14, 2015 – Today eHealth, Inc. (NASDAQ: EHTH – eHealth.com), the nation’s first and largest private online health insurance exchange, warned consumers about the risks of missing the December 15 deadline if they want to be insured on January 1, 2016.
The Affordable Care Act (ACA/Obamacare) created nationwide open enrollment periods when anyone can apply for major medical health insurance. The current open enrollment period is scheduled to end on January 31, 2016. December 15 is the last date on which to enroll in plans with coverage beginning January 1, 2016.
Uninsured Americans who miss the December 15 deadline may not be able to get coverage until February 1, 2016 at earliest, and may run the risk of incurring a penalty on their federal tax returns. However, even those who already have health insurance are at risk.
Many Americans who signed up for health insurance under Obamacare may not be aware that their health plans could be going away, their prices could be going up, and their subsidies could be at risk if they ignore the December 15 application deadline.
5 Big Risks of Missing the December 15 Obamacare Deadline
- You may find yourself uninsured on January 1. Insurers across the country will be shutting down certain 2015 health insurance plans on January 1. If your plan is on the chopping block and you miss the December 15 deadline, you could find yourself among the uninsured on New Year’s Day. Going uninsured for more than two consecutive months may leave you open to a hefty penalty on your federal taxes.
- Your monthly premiums may increase significantly. Even if your 2015 plan doesn’t disappear on January 1, you may face big increases in your monthly health insurance premiums. In a recent eHealth survey of open enrollment shoppers, more than half (58%) said their rates were scheduled to go up on January 1, but 49% were able to find a 2016 health insurance plan with a lower premium by shopping through eHealth1.
- You may no longer get subsidies on January 1. If you’re currently receiving subsidies and didn’t authorize your 2015 subsidy to be automatically recalculated for 2016, you may stop getting government help with your premiums on January 1. Without subsidies, the amount of money you are required to pay toward your monthly premium for January could be twice, or even three times, more than you paid for December.
- Your prescription drugs and preferred doctors may no longer be covered. Health insurance companies often introduce changes to plan benefits and provider networks at the start of the year. Even if your 2015 plan is still available on January 1, you may find that it no longer covers your prescription drugs at an affordable copayment, or that your favorite doctor is no longer a network provider.
- You may have to wait until February 1 (at earliest) for coverage to begin. Open enrollment for 2016 health plans is scheduled to continue through January 31, 2016. However, if you miss the December 15 deadline, the earliest your coverage under a new plan could start may be February 1, 2016. Shoppers submitting applications later than January 15 will need to wait until at least March 1, 2016 for new coverage to begin.
5 Tips for Shoppers Approaching the December 15 Deadline
To help health insurance shoppers avoid the risks of missing the December 15 deadline and assist them in finding the right health plan for their personal needs and budget, eHealth offers the following tips:
- Review your medical care and prescription drug usage from 2015. It’s important to understand the kind of medical coverage you may need in the new year. Do you have any chronic conditions? Do you use prescription drugs on a regular basis? How often do you see the doctor? Do you plan on scheduling any major medical procedures in 2016? Review these questions before you start comparing your coverage options online.
- Look beyond premiums when considering new plans. It’s understandable that monthly premiums loom large in shoppers’ eyes, but you’re not going to be happy with a plan that saddles you with unaffordable out-of-pocket expenses when you actually need to see the doctor. Make sure that in a worst-case scenario you can afford the deductibles, copayments, and coinsurance requirements of any new plan you’re considering.
- Know the pluses and minuses of subsidy eligibility. The Affordable Care Act makes government subsidies available to qualifying consumers with income between 100%-400% of the federal poverty level (up to about $47,000 for a single person or $97,000 for a family of four). Subsidies really can make coverage more affordable. However, if you accidentally earn a bit more than expected during the year, you may find yourself no longer eligible for subsidies and required to pay them back when you file your federal tax return for 2016.
- Find out if new plans will cover your drugs and preferred doctors. Some of us have favorite doctors or local hospitals that we prefer to visit. Others have prescription drugs that we take on a regular basis. Make sure that any new health insurance plan you’re considering includes your preferred doctor or hospital in its network of providers, and that the drugs you need are covered at an affordable copayment.
- Look beyond government-run exchanges for more coverage options. The government-run exchange in your state is not your only resource during open enrollment. Private online marketplaces like eHealth can offer many shoppers access to the exact same health insurance plans (and government subsidies) in many states, plus access to additional Obamacare-compliant plans that aren’t available on government-run exchanges.
1 See eHealth’s December 1, 2015 Early Obamacare Open Enrollment Report.
eHealth, Inc. (NASDAQ: EHTH) owns eHealth.com, the nation's first and largest private health insurance exchange where individuals, families and small businesses can compare health insurance products from leading insurers side by side and purchase and enroll in coverage online. eHealth offers thousands of individual, family and small business health plans underwritten by many of the nation's leading health insurance companies. eHealth (through its subsidiaries) is licensed to sell health insurance in all 50 states and the District of Columbia. eHealth also offers educational resources and powerful online and pharmacy-based tools to help Medicare beneficiaries navigate Medicare health insurance options, choose the right plan and enroll in select plans online through PlanPrescriber.com (www.PlanPrescriber.com), eHealthMedicare.com (www.eHealthMedicare.com) and Medicare.com (www.Medicare.com).
For more health insurance news and information, visit the eHealth consumer blog: Get Smart - Get Covered or visit eHealth's Consumer Resource Center.
Forward Looking Statements
This press release contains forward-looking statements, including statements regarding the deadline to apply for health insurance coverage that begins January 1, 2016, January 31 as the end date for the open enrollment period, termination of health plans January 1, health insurance and application deadlines for certain effectiveness dates and eHealth’s ability to offer access for many shoppers to the same health insurance plans and government subsidies as government-run exchanges in many states and additional plans that are not available on government-run exchanges. These forward-looking statements involve certain risks and uncertainties that could cause actual results to differ materially from those indicated in such forward-looking statements, including, but not limited to, potential changes in laws, regulations and regulatory guidance, the company’s ability to enroll individuals in qualified health plans through government-run exchanges, particularly the federal government exchange; the company’s ability to satisfy the conditions and requirements contained in agreements with the federal government exchanges, applicable laws, regulations and regulatory guidance; government and federal government exchange permission for the company to use the online process it has developed to assist individuals in applying for subsidies and enrolling individuals into subsidy eligible health plans, the company’s ability to maintain a compliant web platform incorporating the requirements of agreements with the federal government exchange and applicable laws, regulations and regulatory guidance; the company’s ability to obtain qualified health plan information from the company’s health insurance carrier partners and the federal government exchange and incorporate it into its web platform; the company’s ability to successfully integrate with the federal government exchange so that information may be passed to and from the company relating to qualified health plan and subsidy eligibility; the federal government allowing enrollment from the company through the federal government-run exchange; the availability and reliability of the federal government-run exchange website and systems; and the company’s ability to timely meet applicable requirements to be able to sell subsidy-eligible health insurance through the federal government-run exchange. Other risks and uncertainties that can affect actual results are included under the captions “Risk Factors” and “Management’s Discussion and Analysis of Financial Condition and Results of Operations” in our Annual Report on Form 10-K for the year ended December 31, 2014 and our most recent Quarterly Report on Form 10-Q, which are on file with the SEC and are available on the investor relations page of the company’s website at http://www.ehealthinsurance.com and on the Securities and Exchange Commission’s website at www.sec.gov . All information provided in this press release is as of the date of this press release, and the company undertakes no duty to update this information unless required by law.