Don't Be Afraid to Ask for Help During Open Enrollment
By Janet Trautwein
On November 1, open enrollment for coverage on the Affordable Care Act's exchanges began in most states. That may be a daunting prospect. A recent survey found that most Americans admit to feeling "completely lost when it comes to understanding health insurance."
Licensed agents and brokers can simplify the process of picking a plan. Better yet, their services are generally free for consumers. Their expert advice can be crucial to helping a consumer enroll in a plan that suits their needs and budget.
Generally speaking, people may only enroll in or change their insurance plans during the open enrollment period, which is typically in the fall. In many places, the window to enroll is just 45 days long.
The options can seem endless. Is my doctor in-network? Is the drug I take every day covered? How much deductible or cost-sharing can I afford to take on?
People shopping on the exchanges may also need help figuring out what kinds of federal premium subsidies they qualify for. In 2020, 87% of those who purchased coverage through the online marketplaces received subsidies.
This year and next, thanks to March's American Rescue Plan Act, those subsidies are more generous and are available to all Americans, regardless of income. The law now dictates that no American must pay more than 8.5% of income in premiums for a benchmark plan. People who make less than 400 percent of the federal poverty level, or $106,000 for a family of four, typically pay even less as a share of income.
With those kinds of subsidies available, it's unwise to go without health insurance. The risk of financial ruin at the hands of something like a catastrophic accident or unexpected cancer diagnosis is just too high.
Uninsured people are more likely than their insured counterparts to be hospitalized for "avoidable health problems" and experience general declines in overall health.
Agents and brokers are uniquely equipped to help people find plans that best suit their individual health needs -- and their wallets. They're experts in the field -- in order to keep their licenses, they must submit to rigorous state requirements and exams.
Many people already know the value of enlisting help. In 2020, agents and brokers assisted nearly half of exchange enrollees. The Centers for Medicare and Medicaid Services has credited these actors with "increasing the health of the risk pool and creating a more stable individual market."
Choosing a new insurance plan for the new year may be intimidating. But consumers need not panic. Expert agents and brokers are eager to help.
Janet Trautwein is CEO of the National Association of Health Underwriters.