Open Enrollment under the Affordable Care Act is quickly approaching. If you already have a health insurance plan, this is your chance to make any changes. Those who do not carry health insurance may opt in for coverage during this time period. To enroll for 2017, you must sign up between November 1, 2016 and January 31, 2017, unless you qualify to enroll under a Special Enrollment Period.
To qualify for a Special Enrollment Period (SEP), you must meet special criteria. Some of this criteria may include:
- Getting Married
- Having a Baby
- Adopting a Child
- Fostering a Child
- Legal Separation
- Change in Income
Different rules may apply if you have a plan through your employer. Talk to your employer about any special dates you should know about.
It’s not unusual to spend more on lower-premium health insurance plans than high-premium Gold or Platinum plans. Typically, Silver and Bronze plans offer lower monthly premiums but higher out-of-pocket costs for deductibles, coinsurance and copays. According to HealthCare.gov, a person’s average out-of-pocket costs will typically be as follows:
- Bronze 40%
- Silver 30%
- Gold 20%
- Platinum 10%
However, these are estimates based on averages from the government website.
Unfortunately, many Americans have a tight budget to spend on health insurance. They might understand that they will spend more in the long run on healthcare when they opt for a lower-premium plan, but they purchase the plan they can afford monthly. As a result, many of these Americans will forego necessary healthcare because they are afraid of the out-of-pocket costs, even after using their health insurance.
It’s very important to evaluate your current medical needs and to estimate any future medical needs – including any potential emergency situations. Calculate your potential out-of-pocket costs for each plan and let this help to guide your decision in choosing a health insurance plan.