eHealth Answers Consumer Questions About Reshopping for Health Insurance During Open Enrollment
The Affordable Care Act (ACA), also known as Obamacare, created specific open enrollment periods during which eligible consumers can sign up for individual and family major medical health insurance and apply for subsidy assistance. The first-ever open enrollment period ended
The second nationwide open enrollment period is scheduled to begin
Answers to Consumer Questions About Subsidies and Major Medical Health Insurance Coverage for 2015
Question: How do government health insurance subsidies work?
Answer: The ACA provides government-funded subsidies to help reduce monthly health insurance premiums for qualifying persons. Consumers may qualify for subsidies if they have an annual household income between 133% and 400% of the federal poverty level (up to about
Question: If I enroll in a new plan during open enrollment, when can my coverage start?
Answer: The new open enrollment period is for 2015 health insurance plans only. During open enrollment, coverage under any new plan you select can begin no sooner than
Question: I already have coverage. Am I required to apply for health insurance again during this open enrollment period?
Answer: You are not required to enroll in a new plan for 2015, unless your insurance company or licensed agent tells you otherwise, but reshopping during open enrollment -- especially if you used a government subsidy in 2014 or may qualify for a subsidy in 2015 -- could save you money, and you may find a new plan better suited to your personal coverage needs.
Question: Am I going to lose my health insurance subsidies for 2015 if I don't reshop during open enrollment?
Answer: The answer depends on your personal circumstances. When you first applied for a subsidy, did you give permission for your tax records to be accessed so that your subsidy could be automatically updated each year? If the answer is yes, and if your income hasn't changed much and plan prices in your area do not change significantly, you'll probably continue to receive the same subsidy as long as you remain in the same plan. If your income has increased to over 500% of the federal poverty level (about
Question: Make it easy for me. Who should shop for health insurance during open enrollment, and who shouldn't?
Answer: Here's a simple breakdown of who should shop or reshop for health insurance during open enrollment, and who may not need to. Find the category that best describes your personal situation:
- "I am currently uninsured:" Don't let open enrollment pass you by! This may be your only chance to get health insurance coverage for yourself and your family for 2015. You may even be eligible for subsidies to make your coverage more affordable.
- "I am no longer happy with my current health insurance plan:" Anyone no longer happy with their current health insurance plan should take advantage of open enrollment to look at their coverage options. There may be other plans that are better suited to your medical or financial needs or that cover the doctors and hospitals you prefer to see.
- "I am a subsidy recipient who gave permission for my tax information to be accessed but my income has changed:" When you completed your application last year you may have given permission for your tax information to be accessed for the purpose of updating your subsidy eligibility this year. If that's the case, and if your income has changed, you should reshop and re-enroll in coverage during this open enrollment period. Depending on how your income changed, your subsidies may be scheduled to end after
December 31, 2014unless you take action. It's also possible that you may be due more subsidies in 2015 than you are currently receiving.
- "I am a subsidy recipient who gave permission for my tax information to be accessed and my income has not changed:" You may still want to reshop during open enrollment because it's possible your coverage options may change even if your personal circumstances haven't. For example, if the "benchmark" health insurance plan in your area has changed, it could alter the value of your subsidy for 2015. And just because your favorite doctor is in your coverage network for 2014 doesn't mean that he or she will also be in-network for 2015.
- "I am a subsidy recipient who did not give permission for my tax information to be accessed in order to update my subsidies:" Your subsidies will end after
December 31, 2014unless you take action. If you believe you are still entitled to subsidies in 2015, you must reshop, apply for a subsidy again, and enroll in a plan for 2015.
- "I did not receive subsidies in 2014 but think I may qualify for them in 2015:" If you think you may be eligible for subsidies to help make your monthly premiums more affordable, take advantage of open enrollment to apply for subsidies and enroll in a plan for 2015.
- "I will not qualify for subsidies in 2015:" If you're happy with your current plan, you shouldn't need to take any action unless advised to do so by your health insurance company or licensed agent. However, there are new plans available in 2015 and it's always a good idea to take a fresh look at your coverage options once per year. Unless you experience a qualifying life event (like a move, marriage, birth of a child, or other event) open enrollment may be your only chance to change your health plan for 2015.
Question: Am I going to lose coverage under my current plan if I don't reshop during open enrollment?
Answer: No, you should not lose coverage under your current ACA-compliant health insurance plan in 2015, unless your insurance company or licensed agent informs you otherwise. Here's a possible exception: your insurance company may decide to stop offering your plan. If that happens, they will probably advise you of other plans you may wish to consider. You should also work with a licensed online agent like eHealth to review plans from multiple insurers and make sure you find the best match for your needs.
Question: Last year I got my health insurance plan and subsidies through the online government exchange. Do I need to reshop through the government exchange again for 2015?
Answer: A lot of consumers expressed frustration with their experience of the government-run health insurance exchanges during the last open enrollment period. The good news is that you may have other options, even if you're eligible for subsidies. Licensed private health insurance marketplaces like eHealth can help. At eHealth, consumers from most states can apply for subsidies and enroll in coverage in precisely the same health insurance plans available through their government exchange.
Question: Why should I shop for my 2015 health insurance plan through eHealth rather than through the government exchange?
Answer: When you shop with eHealth during open enrollment you may benefit in the following ways:
- eHealth makes it simple to shop for coverage and enroll in the plan of your choice. With more than fifteen years of expertise, eHealth understands how consumers like you want to shop for health insurance. We're always improving our website and shopping tools to make it easier -- and faster -- to find the coverage you need.
- eHealth offers a broader range of coverage options. The health insurance plans offered through government exchanges may only represent a fraction of the coverage choices available to you. You may have other options that will also meet your coverage requirements under the ACA and protect you from a tax penalty. eHealth is your best source for selection, representing over 200 brand-name insurers nationwide.
- eHealth may be able to help you apply for government subsidies. Subsidies are available for qualifying shoppers, depending on your income and other criteria. Subsidy-eligible consumers in most states can apply for government help through eHealth and then enroll in the very same health plans (at the same prices) that are offered through government exchanges.
- eHealth provides personal advice and ongoing advocacy. The customer service representatives available to help you at government exchanges aren't usually licensed agents and probably can't provide you with personal advice about your coverage choices. At eHealth, our unbiased, licensed agents make all the difference when it comes to your long-term satisfaction. Even after you enroll, eHealth can continue to serve as your advocate with the insurance company.
eHealth is a total coverage marketplace. There's more to "coverage" than just health insurance -- which is what government exchanges are mostly limited to. By contrast, at eHealth you can also find dental and vision insurance, as well as products like short-term insurance, travel insurance, and accident or critical illness insurance. eHealth has all you need to craft a total coverage package for yourself or your family.
Question: What happens if I miss the open enrollment period?
Answer: If you miss the ACA open enrollment period for 2015 you may run the risk of going uninsured -- or being stuck in your current plan -- for all of 2015. Outside of open enrollment, you may only be able to enroll in a major medical individual or family plan when you experience a qualifying life event such as marriage, the birth of a child, or a move to a new city or state. So don't let open enrollment pass you by without taking a look at your eligibility for a subsidy and your coverage choices for 2015. You'll be glad you did.
For additional information on subsidies, re-enrollment and the Affordable Care Act, consumers can visit eHealth's new Subsidy Help Center, a dedicated consumer resource center providing educational information, videos, and tools designed to help subsidy-eligible consumers navigate open enrollment and get the health insurance subsidies they may be due next year.
For more health insurance news and information, visit the eHealth consumer blog:Get Smart - Get Covered or visit eHealth's Affordable Care Act Resource Center atwww.eHealth.com/affordable-care-act.
This press release contains forward-looking statements, including statements regarding the open enrollment period for individual and family health insurance and eHealth's ability to assist consumers in applying for subsidies and health insurance plans during the open enrollment period. These forward-looking statements involve certain risks and uncertainties that could cause actual results to differ materially from those indicated in such forward-looking statements, including, but not limited to, eHealth's ability to maintain its relationships with insurance carriers and its ability to offer qualified health insurance plans; insurance carriers gaining approval to market health plans and providing eHealth permission to display them on eHealth's website; eHealth's ability to obtain health plan information and incorporate it into its web platform; eHealth's ability to enter into and maintain relationships with government exchanges; the Federal government's willingness and capability to resolve issues with eHealth's integration with healthcare.gov; the ability of eHealth's Internet platform and technology to interact with government exchanges; eHealth's ability to successfully integrate with healthcare.gov and other government exchanges; eHealth's ability to timely meet requirements to sell qualified health insurance plans and assist individuals in applying for subsidies; potential changes in laws, regulations and regulatory guidance; and any changes to the Affordable Care Act and related regulations and rules. Other risks and uncertainties that can affect actual results are included under the captions "Risk Factors" and "Management's Discussion and Analysis of Financial Condition and Results of Operations" in eHealth's Annual Report on Form 10-K for the year ended December 31, 2013 and most recent Quarterly Report on Form 10-Q, which are on file with the
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