The Affordable Care Act open enrollment period is about to begin. If you’re currently uninsured or buy coverage on your own, here are some things to keep in mind as you weigh your options.
The open enrollment period has changed. Open enrollment runs between November 15, 2014 and February 15, 2015, but if you want a plan in place by the first of the year, you’ll have to make your selection by December 15, 2014.
Shop plan options. Those who bought insurance through Healthcare.gov during last open enrollment will be automatically re-enrolled in their current health plan (not including small employers). However, health plan rates are changing this year, and more insurers are selling policies for 2015. There may be new options that better suit your needs and your budget. Even if you’re happy with the plan you currently have, your best bet is to shop your options to make sure you’re getting the best coverage available for you and your family.
Examine the costs. In addition to the price you’ll pay in premiums for your health plan each month, you want to take a close look at the out-of-pocket costs that come with each plan – the copayments, coinsurance and deductibles — you’ll have to pay when you go for care.
For 2015, the maximum out-of-pocket costs are capped at $6,600 for an individual policy and $13,200 for a family plan. But that’s only for services provided within your health plan’s network. Keep in mind that the higher the deductible, the lower the monthly premium tends to be. However, this does mean you’ll have to spend more out of pocket before your co-insurance kicks in to cover a percentage of medical costs.
Check that your doctors and medications are covered by your plan. Don’t assume that if you stick with the same policy you had this year all of those important features will remain the same for 2015. Changes are quite common from year to year.
Don’t overlap your coverage. If you decide to switch to a new health plan for 2015, be sure to to cancel your current policy. The federal exchange, Healthcare.gov, doesn’t send health plans termination notices when consumers enroll in a different policy.
Don’t leave it up to the exchange to tell your insurance company that you no longer want your current policy. To avoid being double billed, cancel your current plan. Keep all documents showing you’ve paid for your new policy and proof you’ve canceled your old one. Obviously, your cancellation effective date should bump up to the starting date of your new plan, so you don’t go a period of time uninsured.
Check or confirm your eligibility for a subsidy or Medicaid. If you’re currently uninsured, you can check to see if you qualify for a tax subsidy to help lower your costs by logging onto Healthcare.gov or your state’s insurance exchange. You might also qualify for Medicaid.
If you’re already enrolled in an exchange plan, you’ll need to update information about your income and any changes to your family situation, such as a new baby, divorce or marriage. You may be eligible for more subsidy than you’re getting. Conversely, if you earned more than you anticipated this year, you may be getting more of a subsidy than you’re entitled to. In that case, you could get hit with a bill for repayment when you file for taxes the following year.
Also, if on your application last open enrollment you didn’t give permission for Healthcare.gov to confirm your income, you’ll need to reapply for a subsidy for 2015. If you don’t, you’ll be cut off by December 31, 2014, and receive a bill for the full cost of your health plan starting January 1, 2015.
Tax penalties for going uninsured will be steeper. If you’ve been uninsured for 2014, you may be subject to a $95 penalty per adult, ($47.50 per child) to a maximum of $285 per family or 1% of your household’s taxable income– whichever is higher.
Next year, costs for going uninsured go up – $325 per adult and a family maximum of $975 or 2% of household taxable income. This means if you make $50,000 per year salary, your penalty will double from $500 for 2014 to a $1000 penalty for being uninsured in 2015.
For more information on enrollment, be sure to go to Healthcare.gov. You can also search for a local broker or agent to help you find the coverage that best suits your needs.
