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Open enrollment is upon us. In most states, this period lasts from Nov. 1 to Jan. 15 or 16, and you must have coverage in place by Dec. 15, 2023, to be insured starting Jan. 1, 2024. If you’ve had a qualifying life event (like getting married, having a child, or changing your employment situation), you can make changes to your coverage at other times of the year. But for the rest of us, this is the time to upgrade (or downgrade) your health insurance plan.
I’m a full-time freelancer, and I’m gearing up to pick a new marketplace health insurance plan that will start Jan. 1. I was unsatisfied with the plan I selected for 2023, and I intend to upgrade my coverage for 2024. So if you have questions about open enrollment, or just need a little reassurance, read on. We’ll tackle this potentially stressful situation together.
How does open enrollment work?
Before we move on to the tips, let’s take a little time to discuss the details of open enrollment. There are four ways to get health insurance coverage in the U.S. If you are over 65, you qualify for Medicare, and if your income is below a certain level, you qualify for Medicaid.
For the rest of us, you can get coverage through your employer, or if you’re self-employed, you can turn to the healthcare marketplace at HealthCare.gov, or through your state’s health insurance portal. Marketplace plans are regulated by the Affordable Care Act (or ACA). And these plans are going up in price for 2024 (big surprise there). Data from Peterson-KFF notes that marketplace plan premiums are expected to increase between 2% and 10%, or a median of 6%.
Here’s what to think about if you’re choosing new coverage through your employer or the marketplace.
1. Consider your budget (and who you’re covering)
Unfortunately, our personal finances have to loom large when we make decisions about health and well-being, but these are the waters we currently swim in. When you look at available plans, you’ll see a breakdown of four different metal levels: Bronze, Silver, Gold, and Platinum. The lower the metal level, the cheaper your premiums (the amount you pay every month) will be.
Make sure you check policy prices and deductibles based on the people you’re insuring. Is it just you, or do you have a spouse, children, or both to insure as well? Note that if you pay lower premiums, it generally means that your deductible (the amount you must pay before your insurer picks up the tab for care) will be higher.
Depending on your circumstances, this may not be a problem. Signing up for a high-deductible plan might be a good move, especially if you can save money in a health savings account (HSA) to cover the cost of care not paid for by insurance. But if you’d prefer (and can afford) to pay more in premiums in exchange for receiving fewer bills for lab tests and procedures, you might instead decide to opt for a higher metal level. That’s what I’m doing for 2024.
2. Assess your health needs
It’s best to think about your medical needs and preferences when you’re choosing a new plan, too — these matter just as much as the financial considerations. For example, if you have a chronic illness and tend to seek medical care often, it might be worth the higher upfront costs of a higher-level plan, if only so you can visit doctors and not receive huge bills after the fact.
If you see a lot of specialists and don’t want to get a referral from your primary care doctor every time, again, a higher-level plan could help you out here. But on the other hand, if you’re a pretty healthy person, rarely see a doctor, and don’t have kids to worry about, a high-deductible Bronze plan could be just the ticket for you.
No matter your health needs, if you have current medical care providers who you want to keep seeing, ensure they’ll still be in-network for your new plan — or that you can afford any extra cost out of your checking account for an out-of-network provider.
3. Ask for help
Finally, if all this open enrollment business is just too much for you to sift through on your own, there is help available. You can check out the Find Assistance section of HealthCare.gov and find a local insurance navigator to contact, or you can submit your contact information, and a broker will reach out to you. Health insurance is complicated, and there are many factors to weigh when picking coverage, so you’re definitely not alone if you’re confused.
I hope my tips help you pick new coverage and that you end up reasonably happy with your health insurance in 2024. No matter what plan you end up with, it’s worth saving as much as you can in a high-yield savings account so you can cover copays and any other medical expenses that pop up throughout the year.
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