Dec. 15 open enrollment deadline approaches for marketplace coverage that’s effective Jan. 1

Minneapolis, MN, Dec. 06, 2022 (GLOBE NEWSWIRE) -- Today healthinsurance.org reminded consumers that in most states, the open enrollment deadline for purchasing ACA-compliant health insurance is Dec. 15 if they need their coverage to be in effect on Jan. 1, 2023.

“It pays to plan ahead, and shopping for health insurance is no exception,” said Louise Norris, health policy analyst for healthinsurance.org. “For example, if you don’t check whether or not your insurer is leaving the market, you might find yourself uninsured at the start of the year, or auto-enrolled in a plan with a completely different carrier and provider network.”

Open enrollment for Affordable Care Act (ACA) plans, also called Obamacare, ends in most states Jan. 15, 2023. However, healthinsurance.org recommends that consumers enroll by Dec. 15 , as doing so will ensure that the coverage can be effective January 1, 2023.

And in one state, Idaho, Dec. 15 is not just the deadline for Jan. 1 coverage; it also marks the last day of open enrollment for consumers in that state.

Enroll by Dec. 15 for coverage effective Jan. 1

On Jan. 1, 2023, insurance coverage will be in effect for consumers who enroll in or change their health insurance plans by Dec. 15, 2022 and pay their first premium by the due date.

“Consumers have until Jan. 15 in most states to participate in open enrollment, but if they wait that long, they may have a gap in their insurance coverage at the beginning of the year,” said Norris. “Or they may find that they end up with coverage under two different plans in 2023: One for January, and another – with a new deductible and out-of-pocket exposure – starting in February.”

In addition to ensuring coverage is in effect Jan. 1, there are other advantages for consumers who don’t delay enrollment.

“Beginning early gives you more time to understand your health insurance options and ask questions,” Norris says. “Open enrollment is a busy time of year for insurance brokers and navigators, so delaying enrollment could make it more difficult to find the help you need. If you’re enrolling online, it’s also a good idea to give yourself a time buffer for any technical issues you might experience.”

The risks of auto-renewal, especially with carriers exiting the market

If you currently have ACA coverage through the marketplace and your insurer is leaving the market, your exchange may automatically enroll you in a 2023 plan offered by a different insurer if you don’t select a new plan by Dec. 15, 2022. It is generally not in a consumer’s best interest to allow their plan to auto-renew – even if the same plan continues to be available – and this year is no exception, according to Norris.

“Automatic re-enrollment is a safety mechanism to prevent people from becoming unintentionally uninsured, but it’s never a good idea to put your health insurance decisions on autopilot,” said Norris. “Each year, there may be changes to the plan you have, or it may no longer even be available for the coming year. Automatic re-enrollment might keep you insured, but you can’t count on it to put you in the plan option that best meets your needs.”

There are some significant insurer exits taking place at the end of 2022, including Bright HealthCare, which covers nearly a million people across 15 states. Some insurers – including Friday Health Plans, WPS Health Plan and Oscar Health – have also scaled back their plan availability for 2023 in several states.

The Dec. 15 deadline is particularly important for consumers enrolled in plans from carriers leaving their market after 2022. Impacted consumers need to understand what happens when a carrier exits the market or when their plan is discontinued.

“If your carrier leaves the market and your plan is no longer available after the end of the year, it’s important for you to take action,” Norris said. “If you didn’t enroll through an exchange, letting open enrollment pass you by will likely leave you uninsured come New Year’s Day. It’s in your best interest to find out what your options are and make sure you have a plan that fits your budget, includes your doctors, and will meet your health care and prescription needs.”

Fortunately, enrollees have until Dec. 31 to pick a new plan with a Jan. 1 effective date if their current plan is being terminated at the end of the year, which provides more leeway than most other enrollees have.

“But even if the impending termination of your plan is giving you until Dec. 31 to pick a new plan with a Jan. 1 effective date, the process is still much smoother if you select your new plan by Dec. 15,” Norris said. “Enrolling now can help you avoid potential problems and complications.”

In addition to people who have to pick a new plan, it’s important for all current enrollees to actively compare their plan options for 2023, even if they were happy with their plan this year and it’s still available for next year. And it’s important to note that there are carriers entering markets in various states for 2023. In fact, there’s an increase for 2023 in the number of insurers offering plans through HealthCare.gov – the exchange used for enrollment in 33 states.

Larger subsidies also continue to be available through the American Rescue Plan to help offset the cost of health insurance coverage in 2023. Federal rulemaking also addressed the family glitch this year, and that will make some families newly eligible for subsidies in 2023. Consumers may find there are new options and cost savings potential for 2023 that weren’t available during last year’s open enrollment.

To avoid surprises, enroll by Dec. 15

As with the costs of many consumer goods, the costs of medical goods and services increase each year. Consumers who want to budget for health expenses next year can review health insurance plan details for ACA plan options available in 2023, including premium costs; out-of-pocket expenses like the deductible, copays, and coinsurance; and covered medical and prescription benefits.

“When this plan year ends, you don’t want any surprises when it comes to your health coverage and your budget,” Norris said. “A year is a long time to wait if you’re locked out of an ACA plan, or if you’re stuck in a plan you don’t like or can’t afford. Open enrollment is typically your one opportunity each year to make sure you’re covered and in the right plan, and to make changes if you’re not. Planning ahead and enrolling early can potentially save you a significant amount of money.”

Additional tips and information about open enrollment are available in healthinsurance.org’s ACA Open Enrollment 2023 Guide.

Healthinsurance.org is a free online source of consumer health resources, including information about individual health insurance, major medical insurance and affordable medical insurance.