Minneapolis, MN – Nov. 1 marks the beginning of open enrollment – an annual window when consumers can enroll in an Affordable Care Act (ACA) health plan – and healthinsurance.org released tips today to help people save money.
Open enrollment for ACA plans, which cover essential health benefits, starts Nov. 1, 2022, and ends Jan. 15, 2023, in most states.
“It makes sense for consumers to shop around for health insurance, especially since this is an area with so many opportunities for savings,” said Louise Norris, a health policy analyst for healthinsurance.org. “It’s always a good idea for consumers to evaluate their options, but this year, it’s particularly important for budget-conscious consumers to ensure they’re not leaving anything on the table.”
Here are some strategies to keep in mind for this year’s open enrollment period:
Start early, plan ahead
Although open enrollment continues through at least mid-January in most states, enrolling early has its advantages.
Enrolling or making plan changes by Dec. 15 will ensure your coverage takes effect Jan. 1. If you enroll after Dec. 15, you will not have coverage in force until February, which could leave you temporarily uninsured and put you behind on meeting your plan’s annual deductible.
Early enrollment also gives you time to compare your options and get your questions answered. It can even make it easier to get the help you need if you are working with an insurance broker or navigator.
Learn whether you qualify for savings
The recently passed Inflation Reduction Act (IRA) extended subsidy enhancements from the American Rescue Plan through 2025. Just like last year, subsidies for 2023 plans will be larger – and more people will qualify – compared with previous years.
The Internal Revenue Service also recently finalized a rule change that fixes the “family glitch.” Under the old rules, a family with an offer of employer-sponsored coverage could not qualify for premium subsidies in the exchange if the employee’s self-only coverage under the employer’s plan was considered affordable, even if it wasn’t affordable to cover all the family members. The new IRS rule creates a separate affordability determination for family members, meaning premium subsidies may be newly available this year to those family members.
Based on your income, you may qualify for a cost-sharing reduction (CSR) to lower your out-of-pocket costs. The exchange will alert you if you’re eligible for the reduction based on the income you project. But you can only get the reduction if you select a silver health insurance plan. Keep in mind that if you view the plans ordered from lowest to highest premium – the default in most states – you’ll generally see bronze plans first, with very low or $0 premiums. Use the exchange site’s filter to look at silver plans first. Then look at the other options, checking to see how out-of-pocket costs and premiums compare with the silver-level plans.
“Unfortunately, many consumers don’t look past the cost of the premium when they’re selecting a plan and they bypass the option that would actually save them the most money,” said Norris. “If you’re eligible for the CSR benefit, a silver plan might save you a significant amount of money if and when you need medical care. You have to look beyond the premium and also consider out-of-pocket expenses like the deductible, copays, and coinsurance.
“This is a great year to do that. You could end up with a better plan, and with a premium that’s lower than you thought possible.”
Different plans cost consumers in different ways – through higher premiums or a higher deductible, for example – so it’s important to look at the full cost of a plan when comparing your options.
Understand this year’s cost and benefit changes
Health insurance plan offerings change from year to year, and from area to area. 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.
“The bottom line is, you have to check your options every year if you want to optimize your savings and understand the benefits your plan will include next year,” said Norris. “Sometimes plan changes are obvious and well publicized, but sometimes they’re more subtle – such as changes in covered prescriptions, networks of providers, or cost-sharing provisions. You won’t know if you don’t look.”
If you allow your health plan to auto-renew instead of exploring other options during open enrollment, the coverage that starts on Jan. 1 may not be the plan you expected to have.
Consumers who have experienced any major changes during the year – either to their health or their family situations – may also have different needs for the coming year that could require different coverage.
Find additional tips and information about open enrollment in healthinsurance.org’s ACA Open Enrollment 2023 Guide.
Healthinsurance.org provides free, online resources for consumers, including information about individual health insurance, major medical insurance and affordable medical insurance.
Amy Fletcher Faircloth [email protected]