By Bob Moos/Southwest public affairs officer for the U.S. Centers for Medicare & Medicaid Services
If you don’t have health insurance through your job or a government program like Medicare or Medicaid, you’ll want to read on. You have until Feb. 15 to shop for health care coverage for 2015 through the federal health insurance marketplace or your state’s exchange.
The marketplace’s open enrollment period got off to a strong start in mid-November, with tens of thousands of people now signing up every day. Here are five things to know about it:
This is comprehensive health insurance, with benefits similar to what many employers offer their workers.
Insurance protects you from unexpected medical expenses. With it, you’ll have peace of mind. Without it, you’d bear the full brunt of any bills. Fixing a broken leg can cost you up to $7,500. A three-day stay in the hospital runs, on average, $30,000.
The health plans sold through the marketplace cover a broad range of medical services, including emergency care, hospital stays, doctor visits and prescription drugs.
Insurers can’t deny you coverage, or charge you higher premiums, because you have a pre-existing medical condition such as diabetes or high blood pressure. The price you pay for insurance is based only on where you live, how old you are and whether you smoke.
Even if you signed up during the marketplace’s first enrollment period a year ago, you’ll want to update your personal information and shop around again to make sure you get the best deal.
It’s true that you’ll be automatically re-enrolled in your current health plan if you do nothing. But you could end up cheating yourself. The plan that was your best choice for 2014 may not be for 2015. It may be changing its benefits, its cost sharing or its network of hospitals and doctors.
You also may have more choices. Nationally, there are 25 percent more health plans than last year. The increased competition among insurers is reining in prices in many cases. If you don’t compare all your options for 2015, you could miss out on a plan that would save you money.
It’s also important to review your application from last year and update any personal information that’s changed. If you’ve had a drop in income, for example, that could boost any financial help you’re receiving for your premiums or out-of-pocket costs.
Look beyond the monthly premiums in comparing health plans.
Some plans have lower premiums but charge you more out-of-pocket when you require care. Other plans charge higher premiums but cover more of your medical expenses. You’ll need to decide how you want to balance your premium costs with your out-of-pocket costs.
The easiest way to compare health plans available in your area, along with their estimated cost, is to use healthcare.gov’s new “window-shopping” feature. Even before completing an application, you can browse plans by entering your ZIP code, household income and family size.
Check whether you qualify for financial assistance.
About 85 percent of the people who enrolled in a marketplace plan a year ago received tax credits that made their premiums more affordable. Nearly seven in 10 consumers who qualified for help paid $100 or less per month for their coverage. Almost half got covered for $50 or less per month.
If you’re new to the marketplace this year, you can find out whether you’re eligible for a tax credit by visiting healthcare.gov and creating an application with your most up-to-date income information. This year’s application has been shortened and simplified for most people.
Ask for help in enrolling if you need it.
The healthcare.gov website is running much more smoothly this year. But if you’re not computer-savvy, don’t fret. Call the marketplace assistance center at 1-800-318-2596 and speak with a trained counselor. Local organizations are also available to help. For a list of groups in your community that can provide in-person assistance, visit localhelp.healthcare.gov/
The deadline for enrolling in a health plan is Feb. 15. Coverage begins on Jan. 1 for those who sign up by Dec. 15. Don’t delay. Once this open enrollment period is over, your next chance to buy insurance and apply for help may not come for another year.