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If you purchase your own health insurance rather than receive coverage from an employer, it’s time to review your options: Open enrollment for the Affordable Care Act (ACA) in 2020 has begun. From November 1st until December 15th, you will have the option to compare all the plan options, sign up for a new health insurance plan, or change your coverage with your existing ACA insurer. Outside of the open enrollment period, you can only change your health coverage after a “qualifying life event,” such as a marriage or a new baby in the family.
Of course, it can sometimes be overwhelming to review all the options and make a decision before the deadline. Below, our personal injury attorneys have compiled answers to a few common questions about ACA coverage for 2020.
Where can I sign up for an ACA plan?
The ACA provides healthcare insurance options if you do not already receive coverage through your job or from another government program. You have two options when buying your own health plan under the ACA: Either purchase a 2020 plan through the individual market or your state’s health insurance marketplace. The state marketplaces can be found on HealthCare.gov, and all plans on the ACA exchanges are required to offer a core baseline of 10 essential health benefits.
What can I do during open enrollment?
Until the enrollment period ends on December 15th, you will be able to choose a new health insurance plan either through the state market or a private insurer. You may also opt to renew your existing plan. Although most marketplace plans automatically renew, your plan may be changed by the insurer next year, and your insurer will be required to send notice about the changes.
Here are some of the things that can change for 2020:
- Prescription drug coverage
- Copays
- Co-insurance
- Provider networks
- New benefits added
Should I switch to a new plan this year?
If you’re already enrolled in a health insurance plan, you are not required to switch at this time. However, it’s always a good idea to explore other plans during open enrollment, to ensure that you and your family are receiving the best insurance coverage available. As your life changes, your insurance plan should reflect those changing needs.
Additionally, the Wall Street Journal has reported that premiums have dropped by an average of 4% in 2020, at least for the average 27-year old purchasing coverage. On the other hand, deductibles have risen across the board, which could impact the value of your current or future plan as well.
Am I required to have health insurance?
In the past, the Affordable Care Act included an individual mandate, which required almost every American to carry valid health insurance. This provision was eliminated by Congress in 2017, so there is no longer a federal penalty for failing to purchase individual health insurance. However, some states have adopted the individual mandate for residents, including New Jersey.
Here’s a full list of the states that require you to carry valid health insurance:
- California
- District of Columbia
- Massachusetts
- New Jersey
- Rhode Island
- Vermont
What are my options?
Under the ACA, individual or family plans (whether through the state marketplaces or a private insurer) are categorized into four different levels: bronze, silver, gold, and platinum. Bronze plans have the lowest insurance premiums, but they have higher out-of-pocket expenses. On the other end of the spectrum, platinum plans have lower out-of-pocket expenses with higher premiums.
Can I get financial assistance with my health insurance?
Depending on your family size and household income, you may be eligible for subsidies or tax credits to help pay for the cost of a private or state marketplace plan. If your household income is less than $49,960 (or less than $85,320 with a family of three or more), you could be eligible for financial assistance.
If you’ve run into legal issues with your past health insurance provider, our attorneys can help. Call Levinson Axelrod, P.A. at (732) 440-3089 today.