If you’re currently covered by Marketplace health insurance, now’s the time to be thinking about 2020 coverage. You may have heard about auto-enroll and be thinking perfect, I don’t have to do anything to keep my health insurance. In a world full of subscription services set to auto-pay and frequent information overload, that sounds pretty tempting. Unfortunately, it’s not quite that simple.
With auto re-enroll, you either get re-enrolled in to your current plan or the next most similar plan, if your plan is no longer offered. But, according to the Center for Medicare and Medicaid Services (CMS), “in some cases, you won’t be automatically enrolled.” Given that, we highly recommend doing a little homework and looking into the different plans available for you. Then you can actively renew your current plan or enrolling in a new one for next year. This will also help make sure you’re getting the right tax credits and cost savings for 2020.
It’s important to shop around because marketplace offerings and your personal situation change from year to year. Here are some ways that things can change and how those changes impact the health insurance that you choose to enroll in for next year.
Carriers may enter and leave markets
Sometimes health insurance companies decide to leave the individual market or specific geographies. We saw Humana discontinue individual medical plans in 2018. On the flipside, new carriers may enter the individual marketplace or expand into new geographies. For example, Oscar is expanding to 12 new metro areas for 2020 plans (enrolling during November 1 - December 15 open enrollment). Bright Health is another carrier that is serving new markets this year. For you, this means that there may be new carriers that may better serve your needs.
Plans change year-over-year
It’s not just about the insurance company. Carriers typically offer multiple plans. The plan details can change year-over-year. While EHB (essential health benefits) are guaranteed with ACA compliant plans, it’s possible other coverage details may change. If you plan to renew or auto-reenroll, you should double check that the plan still meets your individual needs.
Rates go up and down
Plan prices don’t stay the same from one year to the next. Some carriers increase rates, while others may decrease rates. What was the best value plan for your individual needs this year may not necessarily be the best value for next year. For example, initial indication for plans in Texas shows that some rates could go up by more than 13% while others could decrease by more than 8%.
Individual financial situation changes
Things may be looking very different for you than they were a year ago (hopefully for the better!). If money is tight and it’s looking like you may not earn as much in 2020, you may qualify for additional premium tax credits. It’s worth checking! Keep in mind, tax credits are based on expected earnings for the coverage year (2020), not what you earned this year. You may also want to change metal tiers, shifting the balance between premiums and cost of care when needed.
Overall health and medical needs change
Let’s not forget health insurance is meant to take care of you and your loved ones. Health changes. You may have been diagnosed with something, plan to be on different medications, or have appointments with new doctors. You’ll want to make sure your insurance meets your needs - whether that means coverage of a specific medicine or in-network status for a particular doctor.
We know that choosing the right plan isn’t always simple, so we want to help make sure you are able to make the right decisions for you.
Here are a few of the key things to keep in mind when you choose your plan for 2020:
- Tax credits: you may be eligible to qualify for government assistance
- Metal tier: the general tradeoff between premium cost and cost of coverage when it is needed (lower premium typically means a higher cost of care for medical services used). Also, thanks to “silver loading” (give it a Google if you’re curious to learn the full details), a Gold plan may be not too much more expensive than a Silver plan, or a Bronze plan may be much cheaper than a Silver plan
- Monthly premium: the amount you pay each month for your insurance
- Deductible and out of pocket max: this will help you get a sense of the most you’ll need to pay if you need to use your insurance
- Network: if possible, you’ll want a plan with your doctors in-network (you’ll pay more for out-of-network doctors)
- Medicine: check to make sure you understand how your plan will cover your medicine
Now is the time to be sure you have the right insurance for 2020. We have licensed insurance agents available to help. Don't forget, Open Enrollment closes on December 15, 2019.