Shopping Tips for 2018 Open Enrollment

This year’s open enrollment is different from previous years. First, the time to shop and enroll in a plan is cut in half; open enrollment this year is from November 1 to December 15. Second, the Trump administration’s recent decision to stop repayments for plans with reduced cost-sharing has caused some unexpected consequences for plan premiums and tax credits for marketplace enrollees. Consumers need to be aware of these changes and how it may affect choosing a plan this year that best suits their needs. We’ve put together a Frequently Asked Question, also included in our new and improved Navigator Resource Guide, to help consumers with this very unusual open enrollment season.

I see an “extra savings” sign for silver plans on healthcare.gov. What does this mean?

In general, people with household incomes between 100 to 250 percent of the federal poverty level are eligible for plans with reduced cost-sharing like deductibles, copayments, and coinsurance, making it more affordable to access the doctor or medical services. If eligible, these plans are only available through a silver level plan. Therefore, healthcare.gov provides a notice of “extra savings” to notify eligible consumers of this option.

BUT – this year is different. While in the past those eligible for reduced cost-sharing plans were better off purchasing a silver plan, this year that may not be true. Because of recent policy decisions by the Trump administration, many insurers this year have increased their premiums on silver-level plans. At the same time, many consumers will also see an increase in their premium tax credit. How these changes affect you may vary depending on your state.

If you are eligible for premium tax credits and reduced cost-sharing plans, particularly if you have an income between 200 and 250 percent of the federal poverty level, you may be able to find some gold plans for a lower premium than the silver plans. A Kaiser Family Foundation study found that the lowest-cost gold plan premium is lower than the lowest-cost silver plan premium in 478 counties around the country. These gold plans may have lower cost-sharing than even the reduced cost-sharing plans available to those that are eligible. And this year, 54 percent of subsidy-eligible enrollees will be able to find $0 premium bronze-level plans. However, consumers need to be aware that these plans generally come with high deductibles and cost-sharing.

Consumers who are not eligible for premium tax credits or reduced cost-sharing plans because their household incomes are too high (more than 400 percent of the federal poverty level) may be able to find a cheaper plan outside of healthcare.gov, i.e., by purchasing directly from an insurer. However, if you buy off-marketplace, make sure to read the fine print and confirm that your coverage is minimum essential coverage so you don’t have to pay a mandate penalty.

The bottom line this year is to shop and compare. In addition to looking at the monthly premium cost, take a look at the deductible and any copayments or coinsurance you’ll be responsible for when using your coverage. If you think you may need to see the doctor or get medical services often, these costs will be an important factor to consider. Both the marketplace and other organizations have tools including a plan comparison worksheet that can help you compare plans. Also, if there are particular local doctors, hospitals or prescriptions drugs you want covered, you’ll want to check out healthcare.gov’s look-up tool for doctors, hospitals, and prescription drugs under health plans. Be aware, however, these tools may not always be up-to-date. You may want to verify the information with your provider.

Leave a Reply

Your email address will not be published. Required fields are marked *