You know the drill: It’s fall. You get the email from HR. Time to enroll in the health insurance plan.
Do you ignore it and figure what you already have is fine? Or do you take the time to study your options?
For many, fall is the time to select health insurance for the coming year, and that includes those who get insurance at work and those who use Medicare, the Affordable Care Act, or private insurance.
So many choices: A one-stop-shop HMO? A high-deductible plan with lower premiums? A spouse’s workplace plan rather than your own?
Having all the information can help you make an informed choice. One thing to keep in mind is the federal Affordable Care Act requires everyone to have qualifying health care insurance (with some exceptions) or make what’s called a “shared responsibility” payment at tax time. Here are a few things to consider:
Many people obtain insurance through a workplace plan offered by an employer. On average, a private employer will pay about two-thirds of the total premium. But plans change year to year. Deductibles can rise, premiums can change, and offerings may be added or removed.
The Marketplace (aka the “exchange”)
Those not covered by an employer plan may seek insurance on the Health Insurance Marketplace (sometimes called the “exchange”), created by the Affordable Care Act. The Marketplace offers a variety of plans. Learn more at healthcare.gov.
Health insurance is also available on the individual market outside the government marketplace. Healthcare.gov provides a link to available providers and a tool for comparing plans online at finder.healthcare.gov.
Most American workers contribute each pay period to Medicare, the federal medical insurance program for seniors. At age 65, you’re eligible for that coverage. The two main pillars of Medicare are Part A (which covers hospital charges) and Part B (which pays for medical care). Most people have already paid for Part A through a lifetime of payroll deductions, but there is a premium for Part B. And there are options for prescription drug coverage and plans to cover things that aren’t paid for by the basic parts.
Dates to remember:
Workplace plans: Your benefits administrator will be able to share the specific open-enrollment dates for your employer. Pay attention to the deadline when you need to advise your employer of your decisions. Remember, your spouse’s employer may have different enrollment dates.
Marketplace plans: The open-enrollment period for 2018 coverage through the Marketplace is from November 1 to December 15 for coverage that will begin January 1, 2018.
Medicare: Those turning 65 can sign up during an initial seven-month enrollment period (from three months before turning 65 to three months after the month you turn 65). And each year there is an open-enrollment period (October 15 to December 7) where those covered may consider additional coverage such as prescription drug coverage.
How do you manage your health insurance coverage? Is there a hack you’ve picked up through the years that might help others weigh the pros and cons of different types of plans?