Skip to Content
News

2023 Open Enrollment Period

Article

Navigating the Individual Market

Published Nov 1, 2022 • by AHIP

Every American deserves affordable coverage and access to high-quality care – regardless of their income, health status, or pre-existing conditions. Consumers who do not get coverage through their job or through a government program like Medicare shop and enroll through the federal or state health insurance marketplaces – also called the Exchanges.

For individuals and families who buy coverage on their own, open enrollment for 2023 begins November 1. Consumers must enroll by December 15, 2022 for coverage that starts January 1, 2023 or by January 15, 2023 for coverage that starts February 1, 2023.

This year marks the 10th open enrollment period for the Affordable Care Act’s (ACA) health insurance marketplaces. The marketplaces have continued to stabilize and grow, providing comprehensive and affordable coverage to more than 14.5 million Americans.

In August, Congress passed the Inflation Reduction Act to extend the American Rescue Plan Act (ARPA) enhanced subsidies through 2025. As a result, marketplace enrollees will continue to see more affordable health insurance options this open enrollment period, including more $0 premium and low-cost plans.

In addition to lower costs, health insurance providers are expanding offerings in the individual market for 2023. On average, consumers will have access to 6-7 health insurance providers. However, due to medical inflation, the average second lowest cost silver plan premium will increase by 4% from 2022. Despite this increase, premiums will still remain low due to the Inflation Reduction Act’s extended enhanced subsidies. In fact, the average lowest-cost premium after application of advanced premium tax credits (APTC) is decreasing from $3 in plan year 2022 to $1 in plan year 2023.

By November 1, enrollees will receive a notice from their current health plan regarding information for 2023 open enrollment. These notices may look different from previous years as they may not include information on expected 2023 premiums and advanced premium tax credits (APTC). As a result, consumers are encouraged to visit their Healthcare. gov applications as soon as possible to receive the most accurate and up-to-date information.

Shopping for a plan on Healthcare.gov or a state marketplace will look similar to previous years, with a few changes.

Every county nationwide will offer health plans and financial assistance through the individual marketplaces, and this year, Healthcare.gov will offer new “easy-pricing” plan options for consumers to consider. These plans offer the same deductibles and cost-sharing for certain benefits. In addition, consumers may see new changes to the shopping experience, including improvements to the provider and drug search features and additional transparency around deductibles for health and drug costs. There are a lot of important factors to consider when choosing a plan – such as cost-sharing, premiums, deductibles, provider networks, and out-of-pocket costs.

Health insurance plans are committed to helping all Americans make informed health coverage decisions for themselves and their families. Here are key considerations for anyone who is navigating the individual market:

  • If you don’t enroll in a plan by January 15, 2023, you cannot purchase coverage for 2023 unless you qualify for a Special Enrollment Period.
  • There are 7 states with different Open Enrollment dates. You’ll find those dates below.
  • It is important to consider expected health care utilization – including prescriptions, doctor’s visits, and specialty care needs – when selecting a health plan, and especially when considering premiums and deductibles.
  • It is critical to update information—especially financial information—when reviewing options and shopping for insurance plans. Based on this information, people may qualify for subsidies to help them afford coverage.
  • Shopping for coverage can be done safely and securely—either online or via the telephone. Starting November 1, consumers can log in to HealthCare.gov and CuidadoDeSalud.gov or call 1-800-318-2596 to fill out an application and enroll in a 2023 Marketplace plan.
  • To find someone local or to be contacted by a Marketplace-registered agent or broker, consumers should visit www.healthcare.gov/find-assistance.
2023 OEP