Changing Plans and Verifying Info for Cost Assistance

Everything You Need to Know About Changing Plans During ObamaCare’s Open Enrollment Peroid Each Year

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 without having a qualifying life event that qualifies you for special enrollment, 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.

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).

TIP: The only other way to change plans is by qualifying for a special enrollment period for something specific like moving, where you wouldn’t be able to keep the plan you currently have.

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

If you miss the December 15th deadline you can still make changes at any time during open enrollment (in instances where there are extensions for example). 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: Each year new plans are offered and cost assistance thresholds (Federal Poverty Levels) increase allowing more Americans access to subsidies.  Even if you like your plan shop around, verify your information, and see what new options you have this year.

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 1: The first day of open enrollment for coverage.

• December 15: the last date to renew plans for January 1st.

• January 1: Coverage purchased during open enrollment starts

TIP: All enrollment deadlines may be subject to extensions each year. Past years had different deadlines.

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 the year 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 enrollment is extended, in some cases if you enroll in a plan after December 15th it won’t start by January 1st (make sure to check the site for details if enrolling during an extension).

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.

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

You you must enroll in a plan, switch plans, or re-enroll in a plan by December 15th each year unless the deadline is extended.

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.

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 for the year.

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 a Previous Year’s Application

Almost more important than your plan itself, reporting changes to the information included on your 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, you may not get the right amount of cost assistance.

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 previous years that you haven’t reported or changes you expect.

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 application that appears on your “My Account” page. It will be, pre-filled with most of the information you provided in a previous year.
• 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. If you don’t, your updates won’t be sent to the health insurance company.

You can also report changes to your 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 the year.  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 are offered.  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 and save yourself the headache.

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