It’s open enrollment season for the Affordable Care Act here in North Carolina. Open enrollment ends on December 15th. Anyone who needs insurance for 2021 can pick a plan now. If you need health insurance, and can’t get it from your job or you are unemployed -- this is the time for you. It’s the season when anyone who wants a 2021 ACA/Obamacare health plan can shop for one.
The Affordable Care Act set up marketplaces for private health plans in every part of the country. The options vary depending on where you live, but there are more choices in many markets for 2021 than in previous years, and average prices are down slightly. <[link removed]>The federal website healthcare.gov <[link removed]> is a good first stop to look for options in your area.
♦ Open enrollment ends on December 15th. Anyone who needs insurance for 2021 can pick a plan now.
♦ If you miss the deadline, you may be unable to qualify for new coverage unless you have a major change in your life, like job loss or a divorce.
♦ Plans that are compliant with the Affordable Care Act are available for anyone under 65, regardless of health history.
♦ Plans are organized via four “metal” tiers. In general, bronze plans tend to have the highest deductibles and platinum plans the lowest. In picking a plan, you should consider both the premium and how much you would have to pay in cost sharing if you became ill. Plans also differ according to which doctors, hospitals and drugs they include.
♦ If you earn less than 400 percent of the federal poverty level — or around $51,000 a year for a single person or $105,000 for a family of four — you can qualify for subsidies that limit your premium for certain plans to a set fraction of your income.
♦ For people with incomes below around $31,000 for a single person or $65,500 for a family of four, subsidies will also lower your deductibles and copayments if you buy a plan in the silver category.
♦ Choosing an insurance plan is hard. Health insurance is a complicated product, with its mix of premiums, deductibles, co-payments and provider networks. But free professional advice is also available. Navigators who work for nonprofit groups and professional brokers, who earn a commission by selling health plans, can help you understand your options and the process of signing up. You can look up contact information for helpers in your area here <[link removed]>.
♦ Once you’re shopping outside of healthcare.gov, not all the plans will be held to the same standards, and there are sketchy options out there that don’t offer comprehensive coverage. Plans that adhere to all the Affordable Care Act rules, which include a standard set of benefits, and are sold to people regardless of prior illness, are called “qualified health plans.”