WBTV | Open enrollment for health insurance on the public marketplace begins Friday

CHARLOTTE, N.C. (WBTV) – Open enrollment for health insurance on the public marketplace begins Friday, Nov. 1.

Americans will have until Dec. 15 to enroll for coverage in 2020.

Sandy Newton is an insurance broker in Rock Hill. He’s been certified by the Marketplace since it became available in 2014. He helps guide people through enrolling in coverage on the public exchange.

Newton says people should go to the Marketplace if they do not get health insurance through their workplace. He says people who will benefit most are people who qualify for subsidies.

Subsidies help drive the cost of your health insurance down. It’s determined by a person’s income and the number of people in their household. If their income falls within 400 percent of the poverty line, they will qualify for a subsidy.

Click here to find out if you qualify for a subsidy.

“Right around 50 percent of people in South Carolina qualify for a subsidy right now,” Insurance Broker Jake Newton said.

The Newtons say they get many calls from people who don’t like the insurance offered to them at their workplace, so they want to know if they can get insurance on the public exchange instead. They say your work plan will likely be cheaper than the public exchange.

“If your insurance at the workplace is deemed affordable by the government and you go to the marketplace, you are not going to get a subsidy. Regardless of what your income is,” Newton said.

Some people will qualify for a subsidy and cost-sharing. Newton says cost-sharing can drive the price of your insurance down even further. To qualify for cost-sharing, your income must fall within 250 percent of the federal poverty line.

“I’ve had people that make say $15,000 a year, not only are they paying very little for their insurance, but the plan that they selected may have a $6,400 deductible but with cost-sharing, they’re down to a $200 deductible. That’s significant. And most people don’t even know about that part,” Newton said.

Cost-sharing only applies if you select a silver plan through the exchange.

If you do not get healthcare coverage through your workplace and you do not qualify for subsidies, you can expect to pay full price for insurance offered on the exchange.

“Which is typically a pretty scary number,” Jake Newton said.

If you cannot pay full price for the coverage, there are some off-exchange options you could consider.

Newton says some people get short-term major medical insurance. He says it is low-cost, but it does not cover pre-existing conditions. At most, you will only be covered under the plan for one year which could be problematic depending on your health.

“You can go out and you buy short term major medical, and in the 10th month you find out you have cancer. That policy is going to end in 12 months. If you go and buy another short-term major medical your cancer is now a pre-existing condition and will not be covered,” Sandy Newton said.

Others have become members of Medi-Share. According to Medi-Share’s website, it is made up of a community of Christians who agree to share each other’s eligible medical bills.

According to the website, each member pays a monthly share that could be matched to another person’s eligible medical bills. Each family must meet a limit before other members help pay for the family’s bills.

Newton says consumers should know that Medi-Share is not insurance.

“That’s very important to know because there is no contractual agreement to pay a claim,” Newton said.