What’s New, What’s Worth Noting and How to Optimize Your Experience
Last October, the Affordable Care Act’s Health Insurance Marketplace opened for business and Americans participated in the nation’s first individual open-enrollment period. More than 7 million Americans enrolled in private health insurance plans between Oct. 1, 2013, and March 31, 2014. As with most new things, there were a few bumps. Not surprisingly, the state-based and federally facilitated health insurance exchanges received mixed reviews amid political tension and website issues.
We all learned from the experience. As open enrollment 2.0 gets underway and millions return to the Health Insurance Marketplace, there are several improvements, changes and reminders which consumers should be aware.
In 2015, open enrollment will feature the following:
1. A shorter open enrollment period
The Affordable Care Act’s inaugural open-enrollment period lasted six months. This time around, it will last three. Americans can buy qualified health insurance plans on and away from the Health Insurance Marketplace, as well as in the private marketplace, from Nov. 15, 2014, through Feb. 15, 2015.
Optimize your experience: Enroll by Dec. 15, 2014, to ensure you have coverage effective Jan.1, 2015. You have through Feb. 15, 2015, to change your mind. That means if you get through the holidays and realize you should have traded your bronze plan for a silver plan or do more research and realize your preferred health care provider is no longer in-network, you can switch. Just be sure you do it by Feb. 15. Once open enrollment concludes, you must qualify for a special-enrollment period to change plans.
2. Automatic plan renewal
Most 2014 health insurance plans purchased through the Health Insurance Marketplace will be automatically renewed for 2015. This is meant to make 2015 open enrollment simple and convenient, but it also means you could miss out on better coverage or rates if you simply let your plan roll over from one year to the next.
By now, if you purchased 2014 coverage from an exchange, you should have received notices from both your health insurance company and health insurance exchange. Be sure to open them to learn about any changes to your coverage and costs for 2015, as well as whether or not you will be automatically re-enrolled in the plan effective Jan. 1. If you will not be re-enrolled or want to change plans, you will need to enroll in a new plan by Dec. 15 to ensure you have health insurance on Jan. 1.
Optimize your experience: Even if you think you want to keep the same plan in 2015, spend a little time comparison shopping. Be sure your current benefits will continue to meet your health and financial situation. Plan rates, networks, drug formularies and benefits often change.
3. More health insurance issuers
The Health Insurance Marketplace boasts 25 percent more issuers in 2015, according to a Department of Health and Human Services press release. HHS reported a total of 77 new issuers in the 44 states for which it had data—57 of these new carriers will be in the federal marketplace. In four federally facilitated marketplaces, the number doubled. Essentially, these increases mean consumers will have more companies and plans from which to choose.
Optimize your experience: Again, even if you are relatively satisfied with your current plan, see what else is available in 2015. With insurance companies entering and exiting the marketplace, your options will change and rates and subsidy amounts will be impacted.
4. Improved window shopping
Previously, visitors to the health exchanges had to answer nine questions to view plan options and prices. This time around a ZIP code alone will grant you access to health insurance plans—and, if available, dental plans—in your region. Furthermore, the window shopping tool is now ready for high volumes of traffic and optimized for smart phones and tablets.
Optimize your experience: With the ease of window shopping, you can more easily look at your monthly estimated premiums, deductibles and out-of-pocket maximums; search provider directories for your preferred doctors and hospitals; look at benefits summaries and see how they compare. Think beyond monthly rate; carefully consider what best accommodates your medical care and budgetary needs in the year ahead. If you need help deciding, contact an exchange-based helper or a licensed insurance agent or broker. Don’t wait until the last minute and risk an overloaded system or rushed mentality.
5. More accurate subsidy estimates
When window shopping, provide a household income estimate as well as age, smoking status, pregnancy status and access to other coverage for household members and receive even more accurate plan rate estimates.
Optimize your experience: Notify your state-based or federally facilitated exchange of any changes income or household size to ensure you continue receiving the right subsidy amount. Failure to report fluctuations may result in receiving too much subsidy and owing the IRS money at tax time or missing out on additional subsidy funds that would help make coverage more affordable. Changes should be reported throughout the year.
In general the federal Marketplace looks a bit more streamlined this time around. It has been widely reported that applications are shorter and security has been strengthened, too. The Spanish-language version of HealthCare.gov, www.CuidadoDeSalud.gov, has also undergone improvements.
Do not be dissuaded from last year’s glitches and website bottlenecks, get online and do your research. Health insurance is one of the biggest purchases we make, and having the right coverage can help ensure we have access to and can afford medical care when we need it.
Remember: Marketplace websites and application processes may vary. To find local assistance, consult your state’s exchange or visit localhelp.healthcare.gov. You may also shop private online health insurance websites to buy qualified health plans away from the state-based and federally facilitated exchanges.
This article was a contributed to Vitals by healthcare.com.