Open enrollment starts Monday for health plans under the Affordable Care Act (ACA), and the lineup of low-cost options for next year will come as welcome news for consumers who have — or want — coverage.
If you buy individual or family health insurance through healthcare.gov or your state’s marketplace, you have from Nov. 1 through Jan. 15, 2022 to buy a plan for 2022. New customers can also buy coverage during this time.
If you do nothing, you’ll be automatically re-enrolled into your current plan, but this isn't the year to sit out open enrollment, experts say. The American Rescue Plan that became law in March includes a broad expansion of premium subsidies that makes coverage more affordable for all consumers, including those who made too much to previously qualify for any assistance.
The American Rescue Plan removed income caps for subsidies, so people whose incomes used to be too high to qualify will be eligible for reduced premiums through 2022, thanks to this temporary expansion. In 2020, eligibility for premium assistance was capped at $49,960 for an individual and $85,320 for a family of three, and coverage above those income levels was generally much more expensive.
If you previously thought coverage was out of reach, it’s time to revisit your options. “People who haven’t looked since last fall, or even a few years ago, are going to be really impressed how affordable it is,” says Louise Norris, a licensed broker and health policy analyst for healthinsurance.org.
Here’s what you need to know — and if you think you might need help enrolling, find market-certified assistance here.
When is Obamacare open enrollment for 2022?
Open enrollment for the ACA, also known as “Obamacare,” runs from Nov. 1, 2021 through Jan. 15, 2022.
About 17 states and Washington, D.C. operate their own marketplaces, and some of them have different deadlines. For example, California and New York are two states with Jan. 31 deadlines, while Idaho and Maryland have Dec. 15 deadlines. See the full list here.
If you want your coverage to start Jan. 1, 2022, you must enroll by Dec. 15.
Where is the health insurance marketplace?
Most states use the federal marketplace at healthcare.gov, and you can buy your policy directly on that site. If your state operates its own marketplace, you can still get there from healthcare.gov: Enter your zip code and the site will provide a link to your state’s health insurance hub.
All of the plans on healthcare.gov and the state-run exchanges are comprehensive plans that must cover essential health benefits such as maternity care, hospitalizations, prescription medications and any pre-existing conditions of the policyholder.
You can buy coverage through a broker as well, and a knowledgeable one can help you compare your many options and decide what's best for you. Just make sure you're clear on the fine print. In addition to selling ACA plans, outside websites may sell plans that are not comprehensive health insurance, such as skimpy short-term plans that are cheaper but often come with a host of exclusions for pre-existing conditions.
How to get affordable health insurance
The American Rescue Plan increased the number of people eligible for a premium subsidy by 20%, to 21.8 million from 18.1 million, according to an analysis from the Kaiser Family Foundation. People with incomes between 400% and 600% of the federal poverty level, who previously made too much to qualify for subsidies, will save an average of $213 a month, according to the analysis, while those with incomes under 150% of the poverty level will save an average of $33 per month, the analysis found. These lower-income consumers will have access to benchmark "silver-tier" plans for $0 a month.
Four out of five consumers will be able to find health coverage for $10 or less per month thanks to the American Rescue Plan, the U.S. Department of Health & Human Services said in a statement.
While that’s a great deal, it’s important to look beyond the monthly premium cost. Many of the cheapest plans come with the highest deductibles — the amount of money you have to pay out-of-pocket for covered services before your health insurance kicks in. So if you have a health condition that requires regular management, or if you get into a serious accident, you could potentially be on the hook for thousands of dollars. (Many plans do cover some preventive services 100% before you hit the deductible.)
Also, if you see regular doctors, make sure they take the plan you’re considering. A good way to do this is to call each doctor and give the billing office the full name of the plan, Norris says. Most carriers have provider networks online, but those could be out of date.