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Open Enrollment Is Coming Soon. Here's What's Different This Year

From TIME - October 9, 2017

Open enrollment arrives each fall, as predictable as pumpkin spice lattes. But your health insurance choices are a lot more complicated than tall, grande or venti. It pays to review your options, even if youre happy with your current coverage. A wrong decision could cost you thousands of extra dollars over the coming year. Here are some factors to weigh, depending on where you get your coverage:

Employer coverage

Premiums for employer-sponsored coverage rose just 3% this year, according to the Kaiser Family Foundation, much less than the double-digit increases common on the individual market. That said, in recent years workers have been asked to shoulder a larger portion of their medical costs in the form of high deductibles, where your spending has to reach a certain threshold before insurance kicks in. The average deductible for people with employer-provided health coverage rose from $303 to $1,505 between 2006 and 2017, according to the Kaiser Family Foundationwhich hurts your wallet, especially if your raises are not keeping pace.

High-deductible health plans usually have lower monthly premiums than more comprehensive coverage, so they can be a good option for people who dont go to the doctor a lot. These plans are typically paired with health savings accounts, where you can sock away pre-tax dollars to pay your medical bills now or in the future (funds in them dont expire like they do in flexible spending accounts). One way to compare a high deductible and a more comprehensive plan is to weigh worst-case scenarios under each: add the plans annual out-of-pocket maximum to the yearly premium to find out the most youd have to pay given a serious diagnosis or accident, assuming you stay inside your plans network of doctors.

Affordable Care Act

Open enrollment for 2018 coverage in the roughly 39 states that use healthcare.gov runs from Nov. 1 through Dec. 15six weeks shorter than in prior years. Some states that run their own exchanges have extended the deadline for their own marketplace. For example, in New York, the deadline to enroll for 2018 coverage remains Jan. 31. Check your individual state for details.

Insurers faced considerable uncertainty pricing their 2018 products, given the efforts in Congress to repeal and replace Obamacare. While it remains on the books, the Trump administration has not supported the law like the Obama administration did. Charles Gaba, who runs ACASignups.net, estimates the national average premium increase from 2017 to 2018 to be around 34%, with 20% of that rise attributed to Republican efforts to undermine the law, according to rates filed so far.

The roughly 85% of consumers who receive premium subsidies, money given from the federal government directly to insurers to offset individuals' costs, wont bear the full brunt of these rate increases. Even so, you could really get nailed if you dont shop around, says Sabrina Corlette, research professor at the Center on Health Insurance Reforms at Georgetown University Health Policy Institute. Thats because the subsidies change from year to year based on market forces, and you might need to switch plans to take full advantage.

If you do nothing and allow yourself to be automatically re-enrolled in your current plan for 2018, you could receive a rude surprise when your premiums increase and its too late for you to do anything about it. Whats more, if your current carrier is discontinuing your plan for 2018, you could get automatically redirected into a plan you dont like as much. Instead, go to healthcare.gov or your state marketplace and update your personal information, including your estimated income and your covered family members. This will help re-determine your eligibility for premium subsidies and provide you with new estimates of how much your 2018 coverage choices will cost, after subsidies. You can also use the site to make sure your doctors participate in the plans youre considering, and to make sure your drugs are covered.

Theres been confusion about whether the Internal Revenue Service will continue to enforce the individual mandate, the requirement that most people sign up for coverage. Corlette says all signs indicate that its business as usual and people will have to pay a penalty at tax time if they do not enroll and dont qualify for an exemption.

Medicare

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