The October 20 Local 20/20 column in the Port Townsend Leader by Angela Gyurko highlighted the key dates coming up for health care enrollment.
Have You Reviewed Your Health Insurance Plan?
By Angela Gyurko
Autumn isn’t just about changing weather, it’s also your chance to change your healthcare plan, as most insurance plans have an open enrollment period underway. Jefferson County Citizens for Healthcare Access, part of Local 20/20’s Health & Wellness Action Group, wants everyone to have the accurate information they need to choose their healthcare plan without falling prey to scams.
Affordable Care Act/Obamacare Healthcare Plans: Open enrollment runs from November 1, 2024 – January 15, 2025 and anyone can sign up during this time. In Washington, wahealthplanfinder.org is the official state website. Don’t be fooled by social media ads promising cash gift cards for enrolling. Too often those ads are sponsored by unscrupulous brokers who are switching people from plan-to-plan and collecting fees to do it. There is no fee to sign up for an ACA plan. If you are currently enrolled and like your current plan, you will be automatically re-enrolled, but we recommend taking a look at the details of your plan to make sure nothing has changed.
Medicare: For those over age 65, Medicare open enrollment runs October 15 – December 7, and medicare.gov is the only place you want to go to sign up. The open enrollment period is when you can:
Join, drop, or switch to another Medicare Advantage Plan (or add or drop drug coverage);
Switch from Original Medicare to a Medicare Advantage Plan or from a Medicare Advantage Plan to Original Medicare;
Join, drop, or switch to another Medicare drug plan if you’re in Original Medicare.
Medicare Advantage (MA) plans are heavily marketed and include options not covered by Original Medicare, but MA plans require more pre-approvals and pre-authorizations, have higher care denial rates, and charge more for care obtained out-of-network. There have been MA plans sold in Jefferson County that only included doctors on Whidbey Island or in Kitsap County, so be sure to read the details carefully. And if an MA plan says, “It’s easy to add your doctor to our list,” don’t believe them; all their contracts undergo a lengthy negotiation process that it isn’t easy on anyone. If all of this seems overwhelming, the Office of the Insurance Commission has the SHIBA program to help you navigate your Medicare options. You can reach them at 1-800-562-6900.
TRICARE: For active duty military, retirees, and their families, TRICARE Open season runs November 11 – December 10. This year’s open season is complicated a bit by the change in the TRICARE West Region contract, which goes into effect on January 1, 2025. If you’re currently in TRICARE, and need to make an enrollment change, you’ll need to contact TriWest Healthcare Alliance. You’ll also need to update your payment information, as there will not be an automatic transfer between the old contractor and the new. tricare.mil/west has all the information, and be sure to watch for any notifications from the new TriWest contractor.
Apple Health: The official name for Washington’s Medicaid Expansion, Apple Health doesn’t have an open enrollment, which means any person who qualifies can sign up at any time. Eligibility and enrollment is done on the same www.wahealthplanfinder.org official website for Washington.
Bio: Angela Gyurko has been part of Local 20/20’s Health & Wellness Action Group since 2016, and is also on Local 20/20’s Steering Council.
