posted by Kelley Schultz, Executive Director, Commercial Product Employer, AHIP
on October 21, 2019
Everyone should have comprehensive coverage to protect their health and financial security. For individuals and families who buy coverage on their own, open enrollment for 2020 plans begins Friday, Nov. 1 and ends Sunday, Dec. 15. Consumers who do not get coverage through their job or through a government program like Medicare and Medicaid can shop and enroll through the federal health care Marketplace – also called the exchanges.
in 2020, many health insurance providers are expanding offerings in the individual market. Premiums for ACA coverage are expected to increase less than 1% nationwide. Average 2020 ACA premiums are expected to decrease in nearly half of states. This means some consumers will have more options and lower premiums than this year.
Shopping for a plan on healthcare.gov or a state marketplace is similar to years prior. Every county nationwide will offer health plans and financial assistance through the individual marketplaces.
By Nov. 1, enrollees will receive a notice from their current plan with any changes to their benefits or costs. For 2020, consumers in all states will be able to view quality ratings for health plan options, including cost and provider network details. Health plans receive star ratings from 1 to 5 for overall quality, as well as individual ratings for member experience, medical care, and plan administration. Of note, ratings aren’t available for new plans or plans with low enrollment volume, but that doesn’t mean the plan has low quality.
Like before, consumers have the option to keep their current coverage or enroll in a new plan. Everyone should update their application, review available coverage options, verify their financial assistance amount, and either choose to stay in their current plan or pick a new plan.
Consumers who receive financial assistance should visit healthcare.gov to update their application and verify their financial assistance amount. Financial assistance can change based on changes to income, family size, or premiums in the area. So even if a consumer doesn’t experience income or household changes, the financial assistance amount could change. This is why it is important to verify financial assistance before the enrollment deadline.
Like last year, alternative coverage options (like short term plans) are available to consumers in some areas. Short-term plans can provide protection from catastrophic events when an individual or family is transitioning between comprehensive coverage and would otherwise be uncovered. However, these short-term plans may cover fewer benefits and can result in higher out-of-pocket costs if consumers need services that aren’t covered.
While no one plans to get sick or injured, people should consider what type and how much coverage they will need throughout the year. When reviewing plans, consumers should think through important questions such as:
Consumers can use tools available on healthcare.gov or their health plan’s website to help answer these questions. They can also contact the health insurance provider directly, call the Marketplace, or consult a trusted agent, broker or navigator for health reviewing their options before choosing coverage for the year.