Open enrollment is a time for you to make an important health care decision — finding a plan that meets your medical needs and budget. Here are four things you need to know to do just that.
1. When and Where to Enroll
This year’s open enrollment period for Obamacare (formally called ACA) begins on November 1 st. The period ending date depends on the state in which you live.
States using their own exchange have various ending dates. Here is a list of those states and their open enrollment ending dates (open enrollment for all states begins November 1, 2021):
- California — January 31, 2022
- Colorado — January 15, 2022
- Connecticut — January 15, 2022
- Idaho — December 15, 2021
- Kentucky — January 15, 2022
- Maine — January 15, 2022
- Maryland — December 15, 2021
- Massachusetts — January 23, 2022
- Minnesota — January 15, 2022
- Nevada — January 15, 2022
- New Jersey — January 31, 2022
- New Mexico — January 15, 2022
- New York — December 31, 2021
- Pennsylvania — January 15, 2022
- Rhode Island — January 31, 2022
- Vermont — December 15, 2021
- Washington, DC — January 31, 2022
- Washington — December 15, 2021
Links to these states’ websites with additional enrollment information can be found here.
All other states use the federal exchange. Their open enrollment period ends on January 15th. More information about those states’ plans and enrollment information can be found here.
2. How to Save Money
In my March post I explained how the American Rescue Plan could reduce the cost of your Obamacare plans through increased federal health insurance subsidies.
The great news is these increased subsidies are still in effect for this year’s open enrollment. That means you save money on your premiums for 2022! Here’s a recap of those savings:
- Families earning between 100% and 150% of the Federal Poverty Level (FPL) will pay no premiums for a benchmark Silver plan.
- Beginning with incomes at 150% of the FPL, subsidies gradually decrease as your income increases. But unlike prior years, subsidies won’t be capped for people whose adjusted gross income is more than 400% of the FPL.
- No one who buys a marketplace plan will pay more than 8.5% of their household income.
Do you want to know how much you can save? Beginning November 1st use this calculator to estimate your 2022 premium savings. To use the calculator, you’ll need to estimate your 2022 net income.
What happens if you overestimate or underestimate your earnings when you enroll? The difference will be corrected when you include IRS Form 8962, Premium Tax Credit, with your year-end tax filing. You may have to pay back a portion of your subsidy if you underestimated your income. Or you may receive a refund if you overestimated your income and didn’t receive a large enough subsidy.
3. Who Should Participate in Obamacare Open Enrollment
If you are uninsured or underinsured, now is the time to look at your plan options. If you have Medicare or an employer-sponsored plan, you aren’t eligible for an ACA plan
Already have an ACA plan? Don’t let it just automatically renew. Review and compare your available plans. Increased subsidies might make a plan with lower out-of-pocket costs cheaper than your current plan. Or your medical needs may have changed, causing you to need more, less, or different types of coverage.
4. What to Look For
Even if your medical needs haven’t changed, look over the plans being offered. Here are key things to consider when reviewing and comparing plans:
In-network providers: If you already have a doctor or hospital you trust, make sure they are in-network. Using an out-of-network provider is far more costly and often results in surprise bills.
Out-of-Pocket costs: Plans with lower out-of-pocket costs (deductibles, co-pays, and co-insurance) usually have higher monthly premiums and vice-versa. The best plan for you depends in part on how often you think you’ll use the coverage. For example, if you don’t plan to see the doctor often or be hospitalized, consider a plan with higher out-of-pocket costs and lower premiums. Consider the premium amount after your subsidy has been deducted from the original cost.
Drug costs: First, make sure your medications are covered. Second, find out what tier or level they are in. The higher the tier, the more money you’ll have to pay.
Specialty drugs: Not all insurance plans cover the same drugs. If you’re taking a specialty drug (high-cost drug used to treat a complex, chronic condition) that’s covered under your current plan, make sure it’s also covered in any new plan you’re considering.
Utilization: While no one can predict the future, estimate how often you think you’ll need to get medical care next year. How many office visits? Any potential hospital stays? If you’re likely to use your insurance often, look for plans with lower co-pays or co-insurance rates.
For more detailed information on these important factors, read my post, “5 Insurance Words You Need to Know to Avoid Surprise Bills.”
Take your time reviewing all of your medical needs, cost savings, and budget. Choosing the right plan can help you have a physically and financially healthy, happy New Year.