Open enrollment for individual health insurance for 2016 through Obamacare, or the Affordable Care Act, begins Nov. 1. That means anyone buying their own plan can start shopping (and you should shop around) on the federal and state insurance exchanges. Confused? We have the answers to your most common questions.
What is Obamacare open enrollment?
Among many reforms, the Affordable Care Act created insurance marketplaces (also called exchanges), where anyone without coverage can buy a health plan from a private insurer. You can’t be turned away because of pre-existing conditions (including pregnancy) or face dollar limits on your benefits. Here’s more on the nitty-gritty details of the law. Go to healthcare.gov to find your state’s exchange.
Open enrollment is typically the only time during the year when you can select a new health insurance plan for the following year (exceptions include a job loss or new baby.).
When is open enrollment?
Open enrollment for individual insurance coverage begins Nov. 1, 2015 and ends Jan. 31, 2016. (At your company, it runs for a few weeks in the fall.)
When should I buy coverage?
If you want Obamacare coverage on Jan. 1, 2016, sign up for a plan by Dec. 15, 2015. If you wait until the end of open enrollment (Jan. 31), you won’t get coverage until March 1 (though you will still avoid a tax penalty for going without insurance).
How much can I expect to pay in premiums?
Last year, the average monthly premium was $364, according to the Department of Health and Human Services. That sounds like a lot, but 87% of Americans qualified for a subsidy to help them pay the premiums. After the subsidy, the average monthly cost was only $101.
For 2016, premiums appear to be increasing. The government just reported that the cost of the most popular marketplace plan will rise by an average of 7.5% next year, though depending on where you live you could see big hikes or even small declines..
Will I qualify for a subsidy?
People who make between 100% and 400% of the poverty level—$11,770 to $47,080 for individuals and $24,250 to $97,000 for a family of four—can receive a subsidy, or tax credit, to help defray the cost of health insurance. To find out how big of a subsidy you’ll qualify for, use this calculator.
Make sure to check if you’re eligible. Last year more than 9 million people missed out on subsidies, according to the Kaiser Family Foundation.
Do I have to shop on a government exchange?
If you won’t qualify for a subsidy, you don’t have to stick to a government-run exchange. You may find more options off the exchange, including plans with larger doctor networks. On average, though, premiums tend to be higher in the private marketplace.
How do I actually enroll?
Here’s what you need to know about signing up through an exchange, even if you have in past years.
How to do I shop for health insurance in the first place?
In addition to comparing premiums, you need to focus on three critical variables: Is your doctor in your insurer’s network, how much will you have to spend before insurance kicks in (or your deductible), and what’s the maximum you could pay if you got sick. Check out Money’s primer for picking a health care plan in 15 minutes or less.
For more basic information on buying insurance, watch Money’s informational video.