Health Care Plans
Health Care Discount Plans
Our healthcare discount plans are available to members only and are handled for us by third-party administrators. The administrators are very efficient, and new members are generally enrolled quickly. Please contact the third-party administrators for details of coverage provided or discounts offered. The EFA office does not have this information.
If you belong to the Freelancers Union, you can access information on health care at Shop for Health Plans.
ACA Insurance Update 2019
ACA Open Enrollment: Open enrollment for ACA Marketplace plans opened November 1 and closes at midnight on December 15. Plans sold during open enrollment start January 1, 2019. All plans cover essential health benefits, pre-existing conditions, and preventive services.
Depending on income, you may qualify for an insurance plan with tax credits or for Medicaid/Children’s Health Insurance Program (CHIP). See where your income falls.
Most people in most US states can get coverage through the national marketplace (healthcare.gov). Some states have their own exchanges:
Medicare and Medicaid 2019
Medicare: Open enrollment began October 15 and will close December 7 at midnight for Medicare supplemental health plans.
2019 Changes in Medicare include the following:
- The donut hole is being eliminated in 2019 for brand-name drugs, one year ahead of schedule. The gap in prescription drug coverage (the donut hole) starts when someone reaches the initial coverage limit ($3,820 in 2019), and ends when they have spent $5,100 (these thresholds are each slightly higher than they were in 2018). Before 2011, Medicare Part D enrollees paid the full cost of their medications while in the donut hole. But the ACA has been steadily closing the donut hole, and it will be fully closed by 2020, when enrollees in standard Part D plans will pay just 25 percent of the cost of their drugs all the way up to the catastrophic coverage threshold. But the Bipartisan Budget Act of 2018 (BBA 2018) closes the donut hole one year early for brand name drugs. As a result of the BBA, enrollees will pay 25 percent of the cost of brand-name drugs (down from the 30 percent that was originally scheduled) and 37 percent of the cost of generic drugs (down from 44 percent in 2018). The Medicare Part D maximum deductible is $415 in 2018, up slightly from $405 in 2018.
- There’s a new premium bracket for the highest-income Part B and Part D enrollees. Under the terms of the Bipartisan Budget Act of 2018, enrollees with income of $500,000 or more ($750,000 or more for a married couple) will pay a new, higher premium for Part B and Part D coverage in 2019 and future years. For reference, in 2018, the highest income bracket starts at $160,000 ($320,000 for a married couple). The Medicare Trustees’ report projected a Part B premium of $460.70/month for Part B enrollees in the new highest bracket in 2019, and an additional $82.90/month added to the Part D premiums charged by the insurer that provides the Part D coverage.
- Medicare Part B premiums likely to increase slightly for 2019. Medicare Part B premiums for the coming year aren’t finalized until the fall, but the Medicare Trustees Report that was issued in June 2018 projected an estimated standard Part B premium of $135.50/month in 2019. Even if that premium is finalized, the actual amounts that people pay for Medicare Part B in 2019 will depend on the cost of living adjustment (COLA) that applies to Social Security benefits in 2019.
Enrollment in Medicare Advantage has changed:
Between January 1 and March 31 each year, if you are enrolled in a Medicare Advantage plan, you can leave your plan and return to Original Medicare and buy a Part D prescription drug plan to supplement your Original Medicare. Starting in 2019, you also have the option to switch to a different Medicare Advantage plan during this time. From 2011 through 2018, there wasn’t an option to switch to a different Medicare Advantage plan outside of the fall open enrollment period unless you had a circumstance that allowed you a Special Enrollment Period. But the 21st Century Cures Act (Section 17005) expanded the timeframe of the window (from one and a half months to three months) starting in 2019, and allows people to switch from one Medicare Advantage plan to another.
Only one switch during this time frame is allowed each year—you can change your mind multiple times during the enrollment period in the fall, but can only switch to a different Medicare Advantage plan (or back to Original Medicare) once in the first quarter of the new year. But if you sign up for a Medicare Advantage plan in the fall and then decide you don’t like it once it takes effect in January, you have until the end of March to make a change.
State Medicaid expansion
Some states have expanded their Medicaid programs to cover more people. Choose your state and household size to see if your state has expanded and if you may qualify.
Health Insurance Marketplace Calculator
FAQs on the Health Care Insurance Marketplace
Confused about it all? See FAQs from Kaiser Family Foundation.