The health law’s open enrollment season is just around the corner. Are you ready?
Here’s a quick checklist for people who don’t get their health insurance at work and plan to shop for coverage on the health law’s online exchanges, or marketplaces, starting Nov. 15. You can compare plans and prices at healthcare.gov or, if your state has its own exchange, shop there to find out which coverage is best for you. And you may be eligible for subsidies to help pay your premium.
Keep these five things in mind as the three-month open enrollment period begins.
1. Shop Around. Just because you’re enrolled in a policy now doesn’t means it’s the best deal for you next year. If you’re currently in the federal marketplace and don’t take any action, you’ll be re-enrolled in the same plan you’re in now. Federal officials, as well as many analysts, are urging consumers to go back to the exchanges to compare plans and prices. You might discover that you have more—or different—choices than you had a year ago.
2. Don’t Get Billed Twice. Insurers have expressed concerns that if a consumer changes plans, problems with the federal website might keep insurers from learning of the change and consumers could get billed for both plans. “It’s an issue we’re aware of and we’re working with exchange officials to make sure there’s a solution for consumers,” said Clare Krusing, a spokeswoman for America’s Health Insurance Plans, an industry trade group. Aaron Albright, a spokesman for the Centers for Medicare & Medicaid Services, said insurers will get lists of individuals who have been automatically enrolled into their current plan as well as those who chose to re-enroll. He also said that the agency is “examining options” on how to provide insurers the names of people who picked another plan during open enrollment.
Just in case, keep proof of payment to answer any billing questions and once you’ve cancelled the old policy watch your credit card statements or, if the payment was deducted directly from a bank account, watch those charges to make sure you aren’t paying for two policies. And don’t cancel your current insurance until you have confirmation from your new carrier that you’re covered.
3. Find Out If You Qualify For Financial Help. Enter your most up-to-date income information on healthcare.gov or with your state exchange to see if you are entitled to receive a tax credit toward the cost of your health insurance. Even if you are like the majority of those enrolling in marketplace plans who receive a subsidy, update your income to make sure you get the correct amount next year. This is important because if you get too much of a subsidy, you’ll have to repay it when you file your taxes the following year.
4. Know All Costs. It’s not just the monthly premium that will cost you. Understand a policy’s out-of-pocket costs, things like co-pays, co-insurance and deductibles, before you enroll. The health law allows out-of-pocket maximum caps of $6,600 for an individual policy and $13,200 for a family policy in 2015 but some of your health care expenses—including out-of-network care—might not be included in that cap.
5. Get Help If You Need It. Confused? There are several ways to get help. Work with a local insurance agent or broker. Find one of the law’s trained navigators or assistors. Or call the federal consumer assistance center at 800-318-2596 for extra help or to find out if you eligible for a subsidy. Folks there can also help you enroll in a health plan or if you qualify, Medicaid, the federal-state program for low-income people.
Kaiser Health News is an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health policy research and communication organization not affiliated with Kaiser Permanente.