Minneapolis, MN – As the Affordable Care Act (also called ACA or Obamacare) open enrollment period nears, healthinsurance.org released tips today to help people compare plans and potentially save money.
Open enrollment for ACA plans starts Nov. 1, 2023, and ends Jan. 15, 2024, in most states. ACA health insurance plans cover treatment for pre-existing conditions, provide coverage for preventive care with no cost-sharing, include coverage of 10 essential health benefits, and don’t have annual or lifetime benefit caps.
“Open enrollment is an important time to review plans and see what’s best for you and your family,” said Louise Norris, a health policy analyst for healthinsurance.org. “Plans – and your needs – change every year, so take a look at the cost, as well as which benefits and providers are included.”
Here are three important things to keep in mind for this year’s open enrollment period:
Understand your plan’s network
Marketplace plans are labeled either an HMO, PPO, EPO, or POS. Historically, these managed care labels held great meaning, indicating, for example, whether you need a referral to see a specialist. But these plans have evolved over time, and the old “rules” don’t necessarily apply today.
But it’s important for consumers to understand that each type of managed care has variations. For example, many POS and HMO plans require a referral to see a specialist, but some POS and HMO plans don’t. And while employer-sponsored HMOs often have lower deductibles and premiums and potentially smaller networks, that’s generally not the case for self-purchased individual/family plans.
Also keep in mind, not all types of managed care plans insurance may be offered in your state.
Norris says consumers need to ask questions about a plan’s provider network:
- How will your plan cover services from a provider outside the plan’s network?
- How narrow is the plan’s network? Are your particular providers included?
- Will your plan require you to get a referral if you need to see a specialist?
“Look at the details of the plan and try not to make assumptions,” Norris said. “You can always turn to a broker or navigator if you need help comparing coverage and picking the plan that’s best for you.”
See if you qualify for savings
Subsidies lower the monthly cost of insurance for millions of people. In fact, Last year, 90 percent of Marketplace buyers had their premiums reduced by ACA subsidies.
The Inflation Reduction Act (IRA) extended subsidy enhancements from the American Rescue Plan through 2025. So like last year, subsidies for 2024 plans will be larger – and more people will qualify – compared with previous years. Some states also offer their own health insurance subsidies.
Consider this year’s changes
Your needs, as well as health insurance plan offerings, change from year to year. You may have been diagnosed with a new medical condition or prescribed new medications. Insurance carriers may enter or exit different markets from year to year. They may also adjust plan costs or benefits in a variety of ways.
“If you want to optimize your savings and understand the benefits your plan will include next year, you have to review your options every year,” said Norris. “Some plan changes are obvious and well-publicized, but sometimes they’re more subtle. You won’t know if you don’t look.”
Find more detailed information about open enrollment in healthinsurance.org’s ACA Open Enrollment 2024 Guide.
Healthinsurance.org provides online resources for consumers about individual and family health insurance. Healthinsurance.org has been providing consumer information about health insurance and health reform for over 25 years.
Amy Fletcher Faircloth [email protected]