6 Ways to Make the Most of Obamacare Open Enrollment for 2015
If you buy your health coverage on the exchanges, take these steps to make sure you get the best possible policy in 2015.
Open enrollment for the Obamacare health insurance exchanges opens on November 15. This can be a great opportunity to fix problems with your current policy or take advantage of new options available in your area. Here are six things you need to do as you prepare to sign up for individual health insurance for 2015.
1. Don’t stay on autopilot. If you bought a policy from your state health insurance exchange in 2014, you generally don’t have to do anything during open enrollment this year: You’ll automatically be reenrolled unless your policy was discontinued or you choose another policy (you should have received a letter from your insurer letting you know about any changes to your plan for next year). But inaction can be a mistake, even if you’ve been happy with your coverage. Most people will have more insurers to choose from for 2015 and a wider range of prices, networks and options.
Most state exchanges are adding one or two new insurers in 2015, and some are adding even more. In Missouri, for example, the number of insurers selling on the state exchange is rising from three in 2014 to eight in 2015. New Hampshire, which had only one company selling on the exchange in 2014, will have five insurers in 2015. Ohio and Pennsylvania are also seeing big increases. And some of the new insurers are major players. United Healthcare, for example, sold on only four state exchanges in 2014 but will be selling on 23 exchanges in 2015.
Go to your state exchange Web site (you can find links at www.healthcare.gov) to get price quotes for the policies available in your area. Most states have improved their tools to make it easier to get quotes on their Web sites, and they are hiring many more people in their call centers and working with more navigators and agents. Click on the Find Local Help link at Healthcare.gov for contact information. Some state exchanges, like Covered California, even have storefronts where you can buy health insurance.
2. Look beyond premiums. Now that you’ve had almost a year to use your current policy, you have a better idea of your actual costs. Some people who chose policies with low premiums had a hard time budgeting for their high deductibles and ended up with big out-of-pocket expenses for prescription drugs and health care throughout the year. Look through your records to see how much you spent for health care and drugs; many insurers have tools that itemize your expenses. Also consider any special care you may need in 2015. If you plan to have surgery or another procedure, you may want to pay more for a policy with a lower deductible and fewer out-of-pocket costs (such as a gold-level policy) just for this year, then switch back to a silver or bronze policy the following year.
3. Make sure your providers are still included. The biggest surprise many people had as they started to use their policies in 2014 was that their doctors weren’t included in the plan’s network – even if they were covered by the insurer in the past. Many insurers had several versions of their policies on the exchanges, some with lower premiums in exchange for smaller provider networks, a trend that is likely to continue for 2015. After you’ve narrowed your options, contact both the insurer and your doctors to make sure they’re in the plan’s network. And ask what happens if you go to an out-of-network provider. Some policies make you pay more out of pocket; others only cover out-of-network care in emergencies.
4. Find out whether your policy is HSA-eligible. If your health insurance policy has a deductible of at least $1,300 for individual coverage and $2,600 for family coverage in 2015, you may be able to contribute to a health savings account. That can give you a triple tax break: Your contributions are tax-deductible, they grow tax-deferred, and they can be used tax-free for out-of-pocket medical expenses in any year. But your policy must meet a few other criteria to be HSA-eligible; for example, everything (except preventive care) must be subject to the same deductible. It isn’t always obvious on the exchanges which policies are HSA-eligible; ask the insurer before you sign up. The insurance company may have a relationship with an HSA provider, or you can pick one yourself (you can compare plans and prices at HSASearch.com). See FAQs About Health Savings Accounts for more information.
5. Update your income information. Even if you don’t plan to switch policies, it’s a good idea to go to your state exchange Web site to update your income information, especially if you’ll earn a lot more or less than you did in 2014 or if you had any life changes, such as getting married or divorced. Otherwise, your income from 2014 may be used to determine how much of a subsidy you can get to help with your health insurance premiums. If you earn more in 2015, you may have to pay back some of the extra subsidy when you file your 2015 tax return; if you earn less, you may qualify for a larger subsidy. The size of your subsidy is likely to change anyway because it’s based on the premiums for the second-lowest-cost silver plan in your area, which is generally a bit different than it was in 2014. You can use the calculator at the Kaiser Family Foundation to estimate your after-subsidy costs based on your age, zip code, family size and income. But you’ll need to go to your state’s site to change the income you report to the marketplace.
6. Act fast. Open enrollment for individual insurance – whether you buy a policy on or off the exchanges – runs from November 15, 2014, to February 15, 2015, for 2015 coverage. If you already have a policy and don’t do anything, you’ll generally be reenrolled in your current policy. But if you want to switch policies and have the new one start on January 1, you’ll need to sign up by December 15. (If you sign up by January 15, your policy will take effect by February 1; if you sign up by February 15, your policy will take effect by March 1.) You won’t be able to sign up for a new policy at all after February 15 unless you qualify for a special enrollment period -- for example, if you move or get married. This deadline applies whether you get coverage through your state exchange or you buy an off-exchange policy. See Your Options Outside Open Enrollment at Healthcare.gov for details.
For more information about your options during open enrollment, whether you get insurance on your own or through your employer, see our Guide to Picking the Best Health Insurance for 2015.