If you’re thinking of leaving employed medicine in 2019 then you should consider signing up for health insurance during open enrollment 2019. Even though it’s still 2018, open enrollment for the following year takes place in a short window of time, from November 1st through December 15th.

There are some exceptions to this depending on your state. But it’s also worth noting that this window is much shorter than previous years. And, to make it even more complicated, once you sign up, you still have to wait a couple of month before being able to use your health insurance.

I started paying for my own health insurance in 2016 at $230/month and had the price jump to $280/month in 2017 even though my health didn’t change.

I ended up cancelling my health insurance middle of 2017 after getting a $200 bill for getting some blood draws. I have decided to rely on my health insurance in Spain which costs me <$70/month for a Cadillac plan.

Mandatory Coverage

Next year, 2019, will be the first year (once again) when health insurance is no longer mandatory by federal standards. That means you won’t have to pay a tax penalty for not having health insurance coverage.

However, some states will continue their own mandates, so find out if your state will force health insurance on you.

Because I didn’t have health insurance most of 2017, I will end up paying a tax penalty to the IRS. I would much rather do that than pad the pockets of a health insurance company.

Catastrophic Plans

Catastrophic health insurance policies have very high deductibles but will protect you against massive bills. The monthly premiums for these are much lower so they are great for those who are comfortable self-insuring most of the way.

For 2019, you can only enroll in a catastrophic policy if you are <30 years. If you’re 30+ then you must meet a hardship exemption:

you were homeless (can I live on the street for a week? And AirBnb my place while at it?)
facing eviction/foreclosure
received a shut-off notice from utility company (skip paying my bills for a month?)
experienced domestic violence (my cat pawed at my face!)
experienced a death of a family member
experienced a fire/flood/other disaster
filed for bankruptcy
unpaid medical expenses
high expenses taking care of a family member
ineligible for Medicaid because your state didn’t expand eligibility

Deadlines

Again, this time the open enrollment 2019 will be much shorter so many will miss it. You will only have 45 days to sign up for, re-enroll, or change your health insurance plan through the marketplace.

November 1st, 2018 is when open enrollment begins and it will close December 15th, 2018.

There are some exception which are state-specific. California, for example, will start their open enrollment October 15th, 2018 and close it January 15th, 2019.

How to Buy Health Insurance

Now that you’re all grown up and shopping around for your own health insurance plan for the first time, where should you look?

healthcare.gov
a private health insurance website
from aggregate websites like insure.com
an agent who shops around for you

Or… Alternatively:

overseas healthcare
self-insurance (telemedicine and cash)

Ironically, the CDC, trying to protect the health of the US population, warns against medical tourism even though the quality of healthcare in other countries is higher.

Locked into a Plan?

Just like the previous years, we get to choose between a few precious metal plans which mean nothing to me.

In fact, last time I shopped around for my own health insurance, the whole thing was stupidly confusing – and I have an MD.

If you buy the most expensive plan – platinum – and you start having financial difficulties then you might not be able to switch to a less expensive plan. That’s something to consider.

But, fortunately, you can cancel your insurance anytime. There is no minimum period of time that you have to have it and there are no contracts.

2019 Prices

Let me try and predict what the prices will be for 2019.

The young and the healthy had to carry the financial burden for those with pre-existing conditions so far. This stunted young entrepreneurship since few want to carry that kind of financial burden.

8% of the US still went without health insurance. This number will rise for next year and I expect catastrophic policies being available for around $150/month for those <30.

Those with pre-existing conditions will still be covered because the ACA wasn’t appealed, only amended and modified. But the premiums for those who are older should spike up quite a bit.

In order to draw the young and healthy back into the market, health insurance premiums will have to drop quite a bit.

Pre-existing Conditions

The more you go to your doctor, the more diseases you’re diagnosed with. Asthma, seasonal allergies, hypertension, migraines, chronic pain, TMD, anxiety, major depression, or PMDD.

Those who have been dropping their guard since 2014 will be carrying a few new diagnosis in their charts. These will eventually bite them in the ass when the pre-existing clause is modified.

The pay gap should increase for those who are older and it should be a little cheaper for Bronze plans for those of us who are younger. I’m guessing somewhere in the $200 range for a Bronze plan for someone in their 40’s.

New Alternatives

Because of these new changes, I expect that there will be some new health insurance alternatives.

One that I’m excited about is Oscar. It’s a telemedicine company and health insurance company all-in-one.

Even now, their insurance premiums are quite reasonable and competitive.