Minneapolis, MN – The Jan. 15 deadline is looming for consumers to purchase ACA-compliant health insurance for 2023. Today, healthinsurance.org offered tips to simplify the enrollment process and explained the risks of delaying – or skipping – open enrollment.
“Missing the open enrollment deadline can be emotionally and financially damaging if it results in inadequate health insurance coverage,” said Louise Norris, health policy analyst for healthinsurance.org. “If you’ve put off enrolling, now is the time to roll up your sleeves and get it done.”
Open enrollment is the annual window during which consumers can enroll in Affordable Care Act (ACA) health insurance – comprehensive coverage that includes ACA’s essential health benefits, regardless of pre-existing medical conditions. Open enrollment ends Jan. 15, 2023 in most states. However, there are some exceptions, so consumers should check the deadline for their state.
Why explore coverage options during open enrollment
“It’s important to review your coverage options during open enrollment each year, even if you’re already insured and have been happy with your coverage,” Norris said. “Some plans that were available in 2022 are no longer available this year, and there may be new plans available that better fit your needs.”
The American Rescue Plan expanded access to the ACA’s health insurance premium subsidies and made the subsidies larger for millions of Americans; and recent legislation has extended that financial help into 2023. In 2022, federal rulemaking also addressed the family glitch, making subsidies newly available to many families in 2023.
Simple steps to enroll
Wondering how to get started with open enrollment? Healthinsurance.org offered these simple steps:
- Gather some basic information. You will be asked to provide basic information about yourself and other members of your family who will be covered by your plan. So, make sure you have information like birth dates and social security numbers on hand.
- Know your income. You can check for available subsidies and other cost savings by providing your household size and income. Here’s how household income is calculated.
- Compare plans. Once you have entered all of your information, you will be able to shop for health plan options available in your area.
How to compare plans
When reviewing health insurance options, healthinsurance.org suggests considering the following:
- Premium. The premium is the amount you pay (typically monthly) for your health plan. A plan with a lower premium can be an attractive choice, but you’ll want to be sure you understand how much your total costs would be, including the amount you pay when you need medical care. Be sure to see whether you’re eligible for money-saving premium subsidies when you review plans.
- Out-of-pocket costs. You may pay deductibles, copays, and coinsurance when you use your insurance. Keep in mind that your total costs for the year will include both your monthly premiums and the out-of-pocket costs you incur when you receive medical care. If your income is modest, be sure to consider Silver plans, which will have lower out-of-pocket costs if you’re eligible for cost-sharing reductions (eligibility is based on income).
- Prescription drug benefits. Health plans have formularies, which are lists of prescriptions covered by the plan, and these formularies can vary a lot from plan to plan. If there are prescription medications that are important to you, choosing a plan that includes those prescriptions in the formulary could help save you money.
- Network. Have a list of your doctors and their zip codes so you can check if they are in-network with the health plans you consider.
How to get free help
There are resources available at no cost to consumers who have questions about the open enrollment process, or need help with their enrollment.
Here are some ways you can get help:
- Find a trained and certified enrollment assister required to provide fair, impartial, and accurate information. Or work with a health insurance agent or broker trained and registered by the marketplace and licensed in your state.
- Find assisters and licensed agents at localhelp.healthcare.gov.
If you are certain that you won’t be eligible for financial assistance, an ACA-compliant plan obtained outside the marketplace might be the right choice in some circumstances. But for most people, a marketplace plan is the right choice. A marketplace-certified agent or broker will be able to help you determine the best ACA-compliant plan to meet your needs.
The risks of missing the open enrollment deadline
After open enrollment ends, consumers can typically only purchase an ACA-compliant health plan if they have a special enrollment period triggered by a qualifying life event. The list of qualifying life events includes marriage, change in citizenship status, birth or adoption, involuntary loss of other health coverage or a permanent move. But in many cases, qualifying events only allow a person to enroll if they already had minimum essential coverage prior to the qualifying event.
“You don’t want to spend this year wishing you hadn’t missed this important deadline,” Norris said. “Health and finances top the list of priorities for most consumers, and open enrollment is an opportunity to make sure you are tending to those priorities. The deadline is just around the corner – now is the time to get this checked off of your list.”
Additional tips and information about open enrollment are available in healthinsurance.org’s ACA Open Enrollment 2023 Guide.
Healthinsurance.org is a free online source of consumer health resources, including information about individual health insurance, major medical insurance and affordable medical insurance.
Amy Fletcher Faircloth [email protected]