Six must-know facts about Obamacare open enrollment

Obamacare 2015, money

BY JASON ALDERMAN

If you buy your own health insurance, add this important date to your yearend to-do list: November 15.

That’s the date open enrollment is available for individual healthcare plans offered through the Healthcare.gov site, your respective health insurance marketplace (https://www.healthcare.gov/medicaid-chip/eligibility/) or independent agents in your community.

If you’re working for a company that provides your health insurance, chances are your open enrollment period has already begun. The SHOP insurance marketplace, open to small businesses and nonprofits with 50 or fewer full-time employees, also begins taking online applications November 15.

If you buy your own personal or family coverage, don’t wait until November 15 to start planning your 2015 coverage decisions – do it now.

Here are six things you should know to get started:

1. Timing is tight. Last year’s health insurance enrollment process lasted six months. This year, it’s only three – November 15 to February 15. You may be able to enroll outside of those dates if you’re facing a major life change like a divorce, birth of a child or marriage; otherwise, that’s your window.

2. Sticker shock is a possibility. Obamacare didn’t guarantee cheap healthcare coverage; it guaranteed available healthcare coverage. Keep in mind that if you bought health coverage last year, your insurer will automatically re-enroll you on December 15 for new coverage effective January 1. However, that’s no guarantee that your monthly premium will stay the same. Some experts are predicting only modest increases (http://www.cnbc.com/id/102055144#.), but depending on where you live, your premiums might go up or down. And if your 2013 carrier grandfathered your 2014 coverage, those changes may go well beyond price.

3. Your doctors and hospitals might change. Hospitals and physician practices scrutinize the state of the health insurance market very closely. Their income depends on it. In 2013, some medical practices made news by dropping insurance plans altogether and accepting only cash or credit; others changed the insurance plans they would honor. Something to keep in mind: the best way to confirm that you’ll still have access to your favorite doctor and hospital choice is to pick up the phone. Your doctor’s website may list the particular insurance plans his or her practice may accept, but don’t expect the list to be current. Call your practitioner or their business office to confirm they’re sticking with your plan or any you’ve chosen to use instead. You don’t want to be surprised with enormous out-of-network costs later.

4. Planning future health needs is important. If in the next year you’re planning to expand your family, undergo elective surgery or other factors that could affect how you’ll use the healthcare system, query the plans about specialists, prescriptions and other specific services before you sign up. It could save you thousands in potential out-of-pocket costs.

5. Coverage isn’t immediate. Depending on when you enroll during the open enrollment period, your actual coverage may not start until two to six weeks later. Check effective dates of coverage for every plan you’re evaluating to make sure the timing addresses your particular needs.

6. You can get help. Personal referrals from friends and fellow professionals to particular plans and agents are always a good way to start your enrollment search. There may also be nonprofit assistance within your community or state to help you evaluate individual plans. On the national level, nonprofit Enroll America runs a nationwide site (http://www.enrollamerica.org/resources/in-person-assistance/) with specific tools and resources for help in your search.

Start now to build a good toolbox full of online and personal resources to help you with your 2015 health insurance search.


Jason Alderman directs Visa’s financial education programs. To Follow Jason Alderman on Twitter: www.twitter.com/PracticalMoney.

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