Medicare and the Affordable Care Act (ACA) offer medical coverage for millions of Americans, so if you’re a subscriber, open enrollment is very important. From October to December of each year is when you can change your medical insurance plans, sign-up for a new plan, or renew your existing one. There is a lot to know and find out, but here are the top 5 things you should know.
1. Check for Changes in Your Medicare Plan
Changes to medical insurance plans happen every year, and most often they’re mentioned in the fine print, so check your plan to avoid limited coverage or additional fees.
Changes to original Medicare plans are detailed in the Medicare handbook or the official website. Parts D, Medicare Advantage plans, and medical insurance offered through the ACA give you notice of any changes through the mail.
2. Monthly Premiums Aren’t Your Only Expense
While monthly premiums are important, they’re not the least of your potential expenses because you might have to pay for certain services and procedures. ACA and original Medicare plans come with annual, out-of-pocket deductibles. Once you go over that limit, your health insurance plan will pay the rest, but only up to 80%, for example, if you’re a Medicare subscriber, according to Nolo. [1] ACA plans also vary widely in regards to deductibles, premiums, and maximum out-of-pocket payments.
3. Your Current Plan Might No Longer Be the Cheapest
People often end up renewing their plan because they believe it will continue to be their best option. However, keep in mind that your health may take a turn for the worse and that plans change every year. Even if you remain in good health, your costs may increase. Research by Chao Zhou and Yuting Zhang finds that only 5% of subscribers get the best coverage for their money and that most people pay for things they don’t need.
4. Plan Ahead for Major Changes
If major life changes are on the horizon for you, take them into consideration because a marriage, kids, a divorce, or a change of jobs, for instance, might require a different plan and some considerable forethought.
The age of your children is also important because as a parent, your health insurance will only cover them if they’re under 26, according to the US Department of Health and Human Services. [3] Moreover, if you’re about to reach 65, you need to plan ahead.
5. Be Aware of Possible Medicare Penalties
Eliminating annual penalties and the ACA for people who don’t have health coverage is a hot topic, but it’s not yet a done deal. These penalties can rear their ugly heads later when you need insurance the most. If you don’t have health insurance, you will be charged 2.5% of your total household earnings, and the maximum fine is $695 per adult, per U.S. Department of Health and Human Services. [4] Those with no medical insurance then have to pay all the expenses themselves and a big fine on top of them.
Open Enrollment Doesn’t Last Long – Take Advantage of It
Open enrollment is almost here, so take advantage of it and find the best plan for your family or yourself. It doesn’t last long, and if you want to make changes later on, you are bound to pay large penalties.
[1] https://www.nolo.com/legal-encyclopedia/medicare-faq.html
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470484/
[3] https://www.hhs.gov/healthcare/about-the-aca/young-adult-coverage/index.html
[4] https://www.healthcare.gov/why-coverage-is-important/the-fee-for-no-coverage/