By Sarah Dugan, supervisor of Sheridan Memorial Hospital’s financial advocate and medical assistance program
No one plans to need it, but health insurance becomes a vital asset when the unexpected occurs. Eventually, nearly all of us require medical care and insurance can help defray the costs.
Open enrollment for many types of health insurance is currently underway. While Medicare open enrollment ended Dec. 7, the timeframe to apply through the health insurance Marketplace is open and runs through Jan. 15. Though, if you want coverage to begin by Jan. 1, you must enroll by Dec. 15. In addition, if you currently have Medicare Part A but not Part B, you can enroll in Part B from Jan. 1 through March 31, 2025.
If you need — or want — to make changes to your health care coverage, now is the time.
For most individuals, this is the only time you can access the marketplace and see if you qualify for additional savings. Even if you think you don’t qualify, it’s often worth the time to examine your options. According to the federal government, new data shows that nearly 50 million Americans, or one in seven U.S. residents, have chosen coverage through the Affordable Care Act Marketplaces since January 2014. Most of those individuals qualify for lower premiums or even no monthly premium.
While cost typically plays the biggest role in choosing a health insurance policy, it should not be the only factor. Consider which plans cover your doctors and medications, and which plan’s deductibles and cost-sharing amounts won’t deter you from accessing care.
Also, while plans through the Marketplace have some consumer protections in place, plans offered outside the marketplace aren’t subject to the same rules and regulations. So, if you are considering a different kind of plan, check for gaps in coverage. Unilateral pricing plans, limited benefit plans and health sharing plans all present challenges for health care consumers.
If you’re unsure where to start or how to choose, you aren’t alone. Luckily there is help available.
Enroll Wyoming offers Navigators who can help you understand what Marketplace insurance is and why it may be a good option for you and your family. Navigators can also help you get quotes on health insurance costs and assist with your application on the Marketplace itself. To connect with a local navigator, see enrollwyo.org.
In addition, Sheridan Memorial Hospital’s financial advocates offer similar services. The advocates assist underinsured and uninsured patients in navigating federal and state health insurance programs and help enroll those patients in the programs for which they are eligible. The patient financial advocates provide financial counselors who assist patients to determine eligibility and to complete the application process. The convenient and patient-friendly process maximizes enrollment in certain government-sponsored health insurance programs, including Medicaid.
With help available and options to explore, now is the time to find a health care coverage option that works for you.
To learn more about our Sheridan Memorial Hospital Patient Advocates, visit https://www.sheridanhospital.org/billing-services/patient-financial-advocate/, or to speak with a patient financial advocate at SMH, call 307.675.4620.Â