Whether it’s Medicare, Medicaid, ACA or employer-based, clock is ticking on health care sign-ups – Omaha World-Herald

Now is the time to enroll in health insurance for 2018, whether you’re looking for Medicare, Medicaid, Affordable Care Act plans or — like more than half of Nebraskans and Iowans — employer-based coverage.

Although health insurance details and sign-up dates vary, there’s one thing in common, even for TriCare, the government health system for military families: It’s up to you to find the best plan to fit your needs — and most people have only a few weeks to do that.

“It’s real interesting to have three open enrollments going on at the same time,” said Stefanie Torres, patient financial services manager for the Charles Drew Health Center. For the north Omaha clinic’s clients, that’s Medicare, Medicaid and plans under the Affordable Care Act.

Enrollment for the newest kid in the health insurance neighborhood — the five-year-old ACA, also known as Obamacare — starts Wednesday and goes through Dec. 15, ending six weeks earlier than last year’s open enrollment period.

Issa Issa, a translator and Uber driver, made an appointment for Thursday to sign up for an ACA plan that would continue coverage for himself and his three children. Looking at his options at HealthCare.gov on Tuesday, Torres found a plan that, with subsidies, would cost him less than $2 a month.

So far the health center at 2915 Grace St. has five appointments to help people find ACA plans, but Torres expects a rush as the Dec. 15 deadline approaches.

“It’s very short, only 45 days,” Torres said. “And there’s only one insurance company instead of three like last year.”

All Care Health Center at 902 S. Sixth St. in Council Bluffs will be open 8:30 a.m. to 12:30 p.m. on Saturdays and until 7 p.m. on Mondays and Tuesdays because of the shortened enrollment period, said Kristen Hendershot, director of access services. Iowans and Nebraskans can enroll at the Bluffs center.

Only Minnesota-based Medica will offer health plans through the ACA for next year in Nebraska and Iowa. It’s part of a national trend of insurers dropping out of the marketplaces operated by the federal government because of past losses.

Premium increases have drawn headlines when it comes to ACA plans: The increases will average 57 percent in Iowa and 36 percent in Nebraska, not counting government subsidies.

While those higher premiums will hit people whose incomes exclude them from tax subsidies, more lower-income people will qualify for low-premium or even zero-premium health plans in 2018, the Kaiser Family Foundation said.

Actions taken by the Trump administration raised the underlying cost of insurance, leading to higher federal subsidies for premiums, Kaiser said.

In Nebraska and Iowa, state insurance authorities encourage people who need individual health plans to go to HealthCare.gov and look at their options. People who didn’t qualify for subsidies this year may be able to qualify for 2018.

But all that doesn’t apply to the 55 percent of Nebraskans and Iowans who get their insurance through their employers.

Because Jan. 1 is the most common date to renew job-related plans, open enrollment for most of those people is already underway or will start soon.

According to a national survey by the consulting firm Mercer, employers expect to spend an average of 4.3 percent more on employee health insurance in 2018 than 2017. The biggest factor is an expected 7 percent increase in pharmaceutical costs.

Company spending would have gone up an average of 6 percent, the Mercer survey showed, except that employers plan to hold costs down by cutting benefits and taking steps such as pushing high-deductible plans.

Mike Bojanski, president-elect of the Human Resources Association of the Midlands, said that by this time of year, businesses have decided how much of the cost increases they will pay and how much will fall on their employees through higher monthly premiums or out-of-pocket costs such as deductibles and co-payments.

Bojanski, who is chief human resources officer for 250-employee Finley Engineering of Omaha, said enrollment periods for most employers last three weeks or less, giving employees time to learn about changes for the coming year and to sign up for the plans they want.

Bojanski said technology has made open enrollment easier, letting people choose among options from home or on the job. “It’s pretty slick,” he said, although in larger companies it may be difficult to talk to a personnel expert directly about health benefits.

Members of the HR association compare notes and find that health care is typically the second-largest expense for businesses, behind wages, he said. “Insurance goes up, costs go up, and that means everything else is going to go up.”

Last year, employers spent an average for health care of $6,435 per single person and $18,142 per family, the Kaiser Foundation said.

Many companies help control costs by encouraging healthy living by their employees, Bojanski said, but often find that most of the health claims involve only a few employees. Of the 174 people covered by Finley Engineering’s health plan, he said, nine people accounted for 85 percent of claims expenses.

“How do you mitigate or control that?” he said. “If you have a child with cancer, not having a lifetime maximum (dollar amount of claims) is a huge benefit for you. That’s what insurance is, everybody paying for the misfortunes of a few.”

Controlling costs isn’t just the job of insurance companies, employers or health care providers, he said.

“We need to point the fingers at ourselves and eat healthier and exercise,” Bojanski said. “That’s really the driving force in lowering health care costs.”

Meanwhile, the enrollment period for Medicare plans, which ends Dec. 7, is a time when people should compare plans, which can change prescription drug networks, doctor networks and other features. New plans may offer better options, too.

The government’s medicare.gov website has a “plan finder” that helps people compare costs and benefits among dozens of available plans.

steve.jordon@owh.com, 402-444-1080
, twitter.com/buffettOWH

Open enrollment dates for 2018 health plans, with websites and phone numbers for information and help:


Open through Dec. 7

Medicare.gov, 800-633-4227

Affordable Care Act

Open through Dec. 15

HealthCare.gov, 800-318-2596



Medicaid.gov, 816-426-5925



tricare.mil, 877-988-9378 for Nebraska and Iowa


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