Preparing for Affordable Care Act next open enrollment — five things you should know


Open enrollment for buying or changing plans in the Health Insurance Marketplace begins November 15, 2014, and runs through February 15, 2015. During this time, the health plans offered on the Marketplace are “open” and accepting new people. Uninsured people and others who did not use the Marketplace last year can get coverage that can start as early as the beginning of 2015.
Are you one of the nearly 320,000 Pennsylvanians who currently get their health coverage through the Marketplace? If you do nothing, your insurance plan will automatically reenroll you. For many people, this will work just fine. But having the right health insurance is very important for your health. You should make sure that automatic reenrollment is the best choice for you.
Here are five things you should consider as we head into the open enrollment period:
1. Watch for important mail (or email) from the federal government and your insurance plan. The government will send you a notice about reenrollment. Your insurance company will send you a notice about how much your plan will cost in 2015 and how much you will save on your monthly bill, if you are eligible for Affordable Care Act financial assistance (through a tax credit).
So far, it looks like premiums won’t change much next year on average. But that’s on average. The plan you are enrolling in could have a significant increase or decrease.
2. Is your health or your family’s health changing? Is a baby on the way? Do you need surgery? Make sure your current health plan still meets your needs. Maybe a plan with a more expensive monthly premium, but a lower deductible and lower copays, would be better for next year.
3. Have your finances changed? Did your household income go up or down? Make sure you update your financial information with the Marketplace. If your income went up and you don’t report it, you may wind up receiving more financial assistance (tax credits) than you should. You would then end up having to reimburse the government. If your income went down, you may be missing out on some financial help, just when you need it the most.
4. Has your health plan changed? Health plans change from year to year. For example, premiums and copays may change. Your doctor may no longer be covered by the plan. Look over your plan carefully to make sure it’s still right for you.
In addition, some new health plans are being added to the Marketplace, and some plans are leaving. One of the new plans may give you better value at lower cost. If the plan you have now is discontinued, your insurance company will automatically offer you a plan that is most similar to the discontinued one.

5. Remember: If you do nothing, you will be automatically enrolled in the plan offered in the notice from your insurance company. To keep that plan, you don’t have to do anything. But, if you want to change that plan, you must take action. The notice will explain what to do.
If you have questions, or would like more information about open enrollment, you can:
• Contact your health insurance plan.
• Go to on the web to get a list of nearby organizations that can give you personal help.
• Call the Marketplace’s 800 number: 1-800-318-2596.