Everything You Need to Know About Changing Plans During Open Enrollment

The only time you can change health plans under ObamaCare is during open enrollment or a special enrollment period. Verify info or change plans by Dec 15 to ensure you have the right plan and cost assistance starting January 1st.

Although you can’t change plans outside of the set enrollment periods, you can change the cost assistance amounts you receive at any time (by updating your information on your Marketplace account) as long as your Marketplace plan qualifies for cost assistance.

Only some plans auto-renew, and plan options and cost assistance amounts change each year, so make sure to double check your renewals by December 15 each year for a plan that starts January 1st.

The above is true no matter when you enrolled in your marketplace health plan or even if you bought A Plan outside of the Health Insurance Marketplace (although non-Marketplace plans don’t qualify for cost assistance).

More Details on Deadlines to Change Plans or Verify Cost Assistance for New Policy Periods

If you miss the soft December 15th deadline you can still make changes at any time during open enrollment which ends (for 2014 open enrollment that was February 15th, 2015).  If you don’t change plans you may be automatically renewed in a similar plan with similar cost assistance.  If your information has changed you risk getting the incorrect amount of cost assistance and may end up owing money on next years federal income taxes due to premium tax credit repayment limits.  In most cases you will get a notice letting you know whether your plan will automatically renew or not and whether or not you have to take action.

Why Would Someone Want to Change Plans

Let’s talk about Your Options for changing health plans, why you would want to, and what you should be looking out for to know if you have to or not.

Changing plans and verifying your information isn’t just about making sure everything is right, in many cases it can be saving money and getting a better plan too. For instance the plan you are on could have gone up in price, while the competition could be offering a plan that offers better services, for lower premiums, and qualifies for most cost assistance. Worse, your plan could not be set to auto-renew and you could end up with a gap in coverage without even knowing it!

FACT: There has been a 25% increase in marketplace plans, an average increase in premium growth of only 4%, and cost assistance thresholds (Federal Poverty Levels) have increased allowing more Americans access to subsidies.  Even if you like your plan shop around, verify your information, and see what new options you have for 2015.

Dates to Know For Changing Plans

Before we get to the details let’s go over a few key dates to know in regards to switching your marketplace plan:

November 15, 2014: Open enrollment starts.  This is true both inside and outside of the marketplace.

December 15th, 2014: Anyone who wants their plan to start by January 1st, 2014 must take action to ensure they are renewing the plan they want for 2015. You can still change plans for the rest of open enrollment, but your plan won’t start by January 1st.

December 19th, 2014: Auto-enrollments were processed for coverage starting January 1st.

December 31st, 2014: All plans enrolled in during last open enrollment end.

January 1st, 2015: Plans that will be offered next year automatically renew with same cost assistance if applicable.

February 15th, 2015: This is the last day to enroll in a plan, change plans, or apply for cost assistance.  This is true both inside and outside of the marketplace.

• November 1st, 2015: The first day of open enrollment for 2016 coverage.

• January 31, 2016: The last day of open enrollment for 2016 coverage.

December 15 (ongoing): the last date to renew plans for January 1st. Open Enrollment is set to end on December 15 starting in 2017.

FACT: In most cases what is true for the marketplace is true outside the marketplace too.  Double check with your insurer, but as a rule of thumb you should expect your window of time to switch plans for 2015 to be consistent between all major medical plans.

Will My ObamaCare Health Plan Automatically Renew?

If you bought a health plan last year during open enrollment, in many cases, it will automatically renew on January 1st.  In some cases you may be automatically enrolled in a similar plan with similar cost assistance and benefits. If you want to take control of your health coverage and ensure you are enrolled in the health plan of your choice for next year you’ll have to make sure you log into your account and take action before December 15th. If you enroll in a plan after December 15th it won’t start by January 1st.

When Can I Switch My Health Plan Under ObamaCare?

If you want to be safe and know you have the coverage of your choice for next year you’ll need to change your plan during ObamaCare’s  open enrollment period between the start and end of open enrollment.  This is true both inside and outside of the marketplace.

The Affordable Care Act established open enrollment periods that have been adopted by Private Insurers inside and outside of the marketplace.  The result of this is that open enrollment is the only time you can apply for cost assistance, enroll in a plan, or change your plan.  There is one exception to this rule however, if at anytime you lose your coverage during the year you may qualify for a special enrollment period outside of open enrollment.  During a special enrollment period you can do anything you can do during open enrollment.

FACT: For 2015 open enrollment went from November 15th, 2014 to February 15th, 2015. For 2016 open enrollment goes from November 1st, 2015 to January 31, 2016. Moving forward into 2017 open enrollment is slated to go from October 1st to December 15th, although extensions are likely.

How Do I Change Plans During Open Enrollment?

If you haven’t changed your plan or reenrolled this year changing plans simply requires you to follow the steps below during open enrollment.  If you have already enrolled in a plan this year you can still change plans during open enrollment, but you may have to wait for your new plan to start.

You can change plans during Open Enrollment 2 ways:

  • Online. Log in to your Marketplace account.
    • Select “My Plans and Programs”
    • Select the red “End/Terminate All Coverage” button
    • Navigate to “Eligibility & Appeals”
    • Select the green “Continue to Enrollment” button
    • You can then shop for plans and enroll in a new one. Note that depending on the date you confirm your new plan, the coverage start date may be later than your original selection.
  • By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).

FACT: Get more information on keeping or changing your marketplace plan from healthcare.gov.

When is The Latest Date to Enroll to Ensure Coverage for 2015

You must enroll in a health plan by December 15, 2014, in order to have coverage January 1, 2015. All 2014 Marketplace plans end on December 31, 2014.  So if you have double checked your plan will auto-renew you can just let it roll over, if however your plan won’t automatically renew or you want to make changes you should do so by December 15th to be safe to ensure new coverage for all of 2015.  If you switch plans between December 15th and January 1, 2015 your coverage will start February 1st, 2015.

FACT: Even if you miss the soft deadline of December 15th, 2014 you can update your application or change plans any time during open enrollment all the way up to February 15, 2015.

Do I Have to Switch My Plan?

Most of us won’t have to switch our health plans under open enrollment.  If you have to switch your plan due to your insurer no longer offering your plan you will get a notice in the mail.  To be on the safe side we suggest you log in to your marketplace account and double check your plan options and verify your income and any other changes by December 15th at the latest.

ObamaCare Notice to Change Plans

At some point before open enrollment starts on November 15th, 2014 you’ll get two notices about your marketplace coverage.  One notice will be from your health insurance marketplace and the other your insurer.  The notices will let you know if your plan will be automatically renewed or not, what options you have, and if you need to verify information.  Failing to act on the notice could have a simple result like your automatic renewal in the same plan with the same cost assistance, but in some cases it could result in losing coverage or not getting the proper assistance.  Your best bet will be to double check by logging into the marketplace before December 15th, 2014.

Learn more about notices to change and renew marketplace plans.

Will My Cost Assistance Automatically Renew?

Cost assistance is based on income and the costs of your health plan.  In most cases it will automatically renew along with your plan, however if your income changes or your plan changes then your cost assistance changes.  To ensure you are getting the right subsidies you’ll want to verify your information with your health insurance marketplace and ensure you know what plan you are enrolling in or renewing for 2015.

Why Do I Need To Verify My Plan and Information?

One option for automatic renewal involves enrolling you in a similar plan.  Is an HMO similar to a PPO?  Is that one drug you need coverage for similar to a generic?  Is your family doctor similar to the doctor down the street?  Is $120 a month similar to $110 a month after tax credits?  We can’t answer these questions for you, so double checking your specific situation is always going to be the right call.

FACT: If you don’t report changes to the marketplace you could end up owing money on your Federal income taxes due to receiving too much cost assistance!

Reporting Changes to The Information You Provided on Your 2014 Application

Almost more important than your plan itself, reporting changes to the information included on your 2014 application for the health insurance marketplace is vital.  If you have changes to income or status that qualify you for more subsidies missing out on that could mean paying more than you need.  On the other end of the spectrum life changes or income changes that reduce or eliminate subsidies won’t slip under the radar, they will instead be applied to your year end federal taxes.  Don’t fail to report changes and then regret it later.

Important: You must report these changes even if your notice says you’ll be automatically enrolled in a plan. You should report these changes as soon as possible.  If you don’t report them by December 15th, 2014 you may not get the right amount of cost assistance in 2015.

Healthcare.gov suggests you report the following changes:

  • Changes to income
  • An offer of job-based coverage to anyone in your household, even if they don’t enroll in it
  • Any changes to your household. These include:
    • Birth or adoption
    • Divorce or separation
    • Death
    • Placing a child for adoption or foster care
    • A child on your policy turning 26
    • A dependent changing status so they’re no longer your dependent
  • Someone in your household getting coverage from a public program like Medicaid, CHIP, or Medicare
  • Change of your permanent home address

These may be changes that happened in 2014 that you haven’t reported or changes you expect in 2015.

Important: You must report these changes even if your notice says you’ll be automatically enrolled in a plan.

How Do I Report Changes?

Follow these steps to report changes to the Marketplace:

  • Log into your Marketplace account.
  • Open the 2015 application that appears on your “My Account” page. It will be, pre-filled with most of the information you provided in 2014.
  • Make any changes to your income, household members, eligibility for job-based insurance, or other information, and submit the application.
  • You’ll get new eligibility results based on your updated information.
  • You can then enroll in either your current plan or a different plan.

Very important: Make sure to finish all the steps on the to-do list that appears after you submit your application. Select “Continue to Enrollment” and enroll in the plan you choose, even if it’s the same plan you had in 2014. If you don’t, your updates won’t be sent to the health insurance company.

You can also report changes to your 2015 application by contacting the Marketplace Call Center.

What If I Don’t Report Changes to the Health Insurance Marketplace?

If you don’t report changes to the marketplace you may get too much cost assistance and owe money at the end of the year, not get all the cost assistance you are entitled too, or even lose your cost assistance all together!

When you update your information, your coverage could change in important ways. For example:

  • You may gain or lose eligibility for premium tax credits and other savings
  • The amount of your premium tax credit and other savings may change
  • You could gain or lose eligibility for Medicaid or CHIP
  • If you’ve moved to a new residence, you may be eligible for different plans

Why Switch Health Plans Under ObamaCare?

This year 25% more plans are being offered in the marketplace.  So while you may like your plan, shopping around could yield you an even better plan with very similar benefits.  Health insurance is a relativity big and important expense.  It is well worth the time it takes to verify your information and see your marketplace options before calling it a day for 2015.  Finding the perfect plan doesn’t just mean upfront savings on premiums, it means savings throughout the year on out-of-pocket medical expenses and ensuring the best health care your money can buy.

Final Words on Changing Your ObamaCare Plan

Changing your plan and reporting changes to your application isn’t about following some wacky set of rules, it’s about freedom of choice and taking responsibility for your healthcare.  It’s an opportunity for you to pick the plan you want based off of costs and benefits offered in 2015.  Don’t wait until the last minute to change your plan, the process should be quick and painless.  Verify your information and make your choices before December 15th, 2014 and save yourself the headache.

 

Change your plan, or verify your information each year. Some plans auto-renew, others don’t.
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