Medical bills are one of the leading causes of bankruptcy in the United States. Many people are uninsured or underinsured, which puts them at risk of facing huge hospital bills that they can’t repay.
Insurance is an essential safeguard for both your health and your wallet. The Affordable Care Act (ACA), often referred to as Obamacare, makes it easier to get health insurance outside of an employer-offered plan. Even those with pre-existing conditions, who previously had a difficult time finding insurance at all, can get coverage through ACA.
If you’d like to sign up or change your existing ACA health insurance plan, the open enrollment period opens today, Nov. 1, 2017. However, it’s important to know that the government has made significant changes to the ACA and Healthcare.gov for 2018. Here’s what to expect.
What are this year’s changes to the ACA?
Some of the latest changes could impact what coverage is available to you and how much you’ll pay. And if you don’t pay attention to the new deadlines and rules, you could miss out on being able to enroll in a plan at all. Being aware of these updates to the regulations can ensure you get the care you need.
Here are the five biggest changes you’ll see this year:
1. Shorter open enrollment period
Previously, the open enrollment period was three months long, running from Nov. 1 through Jan. 31. But this year, the enrollment period will only be six weeks long, starting today and ending on Dec. 15, 2017. If you don’t enroll within that timeframe, you might miss out on getting a plan and end up paying a penalty.
If you rely on the ACA for your health coverage, mark down the new dates on your calendar. And because Healthcare.gov has had trouble handling traffic in the past, try to enroll in a plan as soon as possible, rather than waiting until the last day, to ensure you can sign up.
This year in particular, expect the website to be down for hours at a time on a regular basis. To keep up with site maintenance, Healthcare.gov will shut down for 12 hours every Sunday (except Dec. 10), from midnight to noon.
2. Stricter rules surrounding special enrollment
If you miss the open enrollment period, you might still be eligible for coverage through special enrollment. If you got married, had a baby, or lost your job, you could qualify for special enrollment and be able to sign up for an ACA plan outside of open enrollment.
However, according to the new rules and regulations, insurers have concerns about abuses of the special enrollment option. To prevent people from wrongfully signing up for a plan, insurers will have stricter verification requirements that you’ll need to meet before they insure you.
To qualify for special enrollment, you must provide proof of the qualifying life event, such as a letter from your employer stating you were let go or a birth certificate for your new baby.
If you think you’ll need to take advantage of special enrollment, plan ahead and gather the necessary documents so there are no delays when you apply for coverage. And if possible, sign up during the upcoming open enrollment period to avoid any issues.
3. Decreased assistance
For the past few years, the government provided some consumers with advance payments of the premium tax credit (APTC) to help offset their insurance costs. With the new regulations, some consumers — such as enrollees who receive a subsidy and enroll in a lower-tier silver plan — will face higher premiums.
With fewer subsidies available, lower-income individuals might have to pay more out-of-pocket for health insurance. Because of the higher expenses, some might opt to accept the penalty for not having health insurance, rather than pay the premiums.
The penalty remains at $695 per adult without coverage or 2.5 percent of your household income — whichever is higher. (You can use this tool from the IRS to estimate how much you’d be fined if you went without health insurance.)
It’s important to understand what subsidies you are eligible for by using Healthcare.gov’s premium estimate tool. And if an ACA plan is not affordable for you, don’t go without coverage altogether. There are some alternatives you can use to get coverage for emergencies.
4. Changes to billing policy
According to the Center for U.S. Health System Reform, approximately 25 percent of enrollees stopped paying the premiums for their plan. Some got new insurance and forgot to notify their old issuers; others simply couldn’t afford it.
Thanks to the new rules, those who fell behind will have to pay all overdue payments before they can enroll for the new year. That means some will face a big surprise bill, potentially making it impossible to afford a new plan.
If you’ve fallen behind on your payments, contact your insurer to find out what you owe. Then, you can start saving up so you can pay off the balance and enroll for the new year.
5. Increased premiums
In 2016, 78 percent of enrollees could find a plan on Healthcare.gov that cost less than $100 per month — but that will likely change this year. Depending on where you live, you could see premiums rise a significant amount. In Maryland, for instance, rates will rise by an average of 33 percent.
An increase will hurt your budget, no doubt. But if there’s any way you can still afford insurance, it’s worth paying the added premium for health coverage. A single car accident or injury could cost you thousands in medical bills, which you’d otherwise have to pay on your own.
If your premiums go up, contact a health insurance marketplace navigator or assister to help you identify all subsidies and tax credits you might be eligible for to reduce your cost.
Documents you need to sign up during open enrollment
Signing up for health care on Healthcare.gov will be easier if you have the documents you need on hand. Here’s a checklist of information you need in order to apply for a plan through the exchange:
- Date of birth
- Home address and mailing address
- Social Security number
- Information — including Social Security numbers — about those in your household (spouse, children, other dependents for tax purposes), even if they don’t need coverage
- How you plan to file your taxes (e.g. filing separately or jointly)
- Income information, including investment income or disability payments you receive
- Employer information for everyone in your household, and the health coverage available
- Estimate of your household income
- Current health coverage information for everyone in your household
- A completed Employer Coverage Tool form, if someone in your household has or is eligible for an employer-sponsored health care plan
If you or someone on your application is an immigrant lawfully in the U.S., you need to provide information from your documents. Additionally, you can get help applying for coverage on the exchange during open enrollment. You need to list your helper on your application if you have one.
Choosing a health care plan
The changes for the 2018 ACA open enrollment period are significant, but that doesn’t mean you should skip insurance altogether. Health insurance can protect you from facing massive bills and ensure you get the care you need.
If you need assistance comparing plans or enrolling, you can use Healthcare.gov to find local insurance navigators and assisters who can help you through the process.
Miranda Marquit contributed to the reporting for this article.