Open enrollment for next year starts on Tuesday for insurance on HealthCare.gov, the marketplace for those who don’t get coverage through their job, and runs through Jan. 15. Here are five things to keep in mind.
1. More people are eligible for more subsidies
During the pandemic, subsidies were increased and expanded for those using the exchange, and Congress locked in the enhancements until 2025. Four out of five customers on HealthCare.gov will be able to find a plan for $10 a month or less after subsidies, according to the Centers for Medicare and Medicaid Services.
They include some high-earners who previously were ineligible for assistance because they earned over 400% of the federal poverty level.
There’s also been a recent rule change to fix the so-called family glitch. The glitch occurs when a breadwinner gets coverage from work but cannot afford to add a spouse and kids. Those family members will be eligible for subsidies.
2. Review HealthCare.gov coverage even if you’re satisfied with your plan
Open enrollment is a chance to compare offers on the exchange and make changes if you find a better fit.
Those who don’t sign up for a new plan can be automatically re-enrolled in the same plan for next year — and that can lead to surprises.
Daniel Bouton, senior director of family and community health at United Way of Metropolitan Dallas, said his father had to deal with sticker shock.
“He didn’t do anything because he was keeping the same plan, but that didn’t mean the price was staying the same,” Bouton said. “It was higher than what he had paid throughout the year.”
3. Update financial and family information to get the correct subsidies and assistance
The net costs of coverage on HealthCare.gov is based on family income and other factors, such as the number of people living in the household. Those details affect subsidies that reduce monthly premiums and can reduce deductibles and copayments.
To get an accurate read of the actual price, you must enter key information and compare plans on the exchange. There’s a checklist of items that may be needed for the application, including Social Security numbers, wage information from W-2 forms or pay stubs, unemployment compensation and income from gig work.
One more tip from Bouton: If you participated in the exchange this year, be sure to have log-in information. That speeds up the re-enrollment process.
4. Free help and advice is widely available, and there are several ways to enroll
To help people evaluate and apply for offers, the federal government spends millions to train and certify assisters, often known as navigators.
Independent brokers and agents for insurance companies also sign up customers and provide advice. Go to localhelp.healthcare.gov and enter your ZIP code.
There’s a link for certified enrollment partners. For those wanting to enroll by phone or mail, HealthCare.gov has phone numbers and applications.
5. Be aware of deadlines and crunch times on HealthCare.gov
Open enrollment runs from Nov. 1 to Jan. 15, but you must sign up by Dec. 15 for coverage to take effect Jan. 1. For those enrolling after Dec. 15, coverage starts in February.
“Why not get covered for the entire year?” Bouton said.
One expert suggested applicants wait a day or two to avoid the crowds on the Nov. 1 opening. Bouton was more concerned about people waiting too long and facing delays on Dec. 15. If they run into long waits when calling someone at the exchange, they can reach out to local navigators through the United Way website or its phone lines.
“We may be able to see you within a couple of hours in person or through a virtual visit over the phone,” Bouton said.
