If you are enrolled in a health insurance plan you purchased through the Affordable Care Act exchanges (or marketplaces), your plan is set to autorenew this fall. You don’t have to do anything extra to keep your policy in force for 2015.
That’s the good news.
The bad news is that if you don’t look at your policy and make sure all the information is still correct, and that you are still getting the best deal for your money, you may be sorry later.
Here are the questions you need to answer before your policy renews:
Has your income changed?
If your household income has increased since you first enrolled, you may no longer qualify for the same advanced premium tax credit amount – if you still qualify at all.
The IRS won’t know that you’re making more money right away, so unless you report the change to your marketplace, your credit amount won’t change.
When you file your tax return, unfortunately, you could be in for a shock.
The IRS will compare the amount you said you were going to make for the year with the amount you actually made.
If the amount of credit you actually qualified for turns out to be less than what you received, you have to pay it back at tax time.
This could be a significant amount of money, depending on your situation.
Have your health care needs or other circumstances changed?
Regardless of the time of year, you must report important life changes, such as marriage or divorce, having a child, moving, becoming disabled or losing disability status, becoming pregnant, or other events, to your state’s marketplace.
If your life has changed since you signed up for a plan, the next enrollment period (Nov. 15 to Feb. 15, 2015) is your chance to make changes.
For example, if you or a family member has new medical issues, you may want to purchase a different plan with higher monthly premiums but offers more medical coverage.
On the other hand, you may have not had to visit the doctor or emergency rooms in 2014, and you’ve decided to take your chances with a less expensive policy.
Will your premiums change?
The cost of health insurance premiums, like everything else, tends to go up with inflation.
For 2015, there may be additional increases as insurance companies adjust to the realities of costs under ACA regulations.
Your insurance company will send you information this fall about changes to your premium and benefits. Be sure to read it.
Will your Advanced Premium Tax Credit amount change?
Your credit amount could change for several reasons.
In addition to changes in your household income, your credit amount could change because of a quirk in the ACA law called the “benchmark” rule.
The maximum Advanced Premium Tax Credit amount is calculated based on a so-called benchmark plan, the second-lowest priced silver plan offered by your state’s marketplace.
For example, if insurers in your area introduce a cheaper plan, that could result in you having to pay more to keep your plan.
If you autorenew your 2014 plan and you haven’t experienced life changes, you’ll also renew the same subsidy you got last year.
To help avoid getting the wrong subsidy and having to pay it back later, ask your marketplace for a redetermination of your subsidy.
Is your plan still the best deal, or should you switch plans?
The insurance plan that gave you the best health care coverage for the least money last year may not be the best deal again this year.
With all the changes in the marketplace and competitive forces, insurers have changed many rates and benefits.
Rates aren’t the only things that can change from year to year.
Before you let your plan autorenew, make sure your doctor and other health care providers are still covered, and that your prescription coverage has not changed.
When you compare plans, be sure to look at other plans offered by your current insurance company, plans offered by competing insurance companies in the exchange, and private plans outside the exchange.
Remember, if you purchase a private plan, you won’t qualify for premium tax credits or cost-sharing reductions.
If you don’t need or want to make any changes, great! You don’t have to do anything – your plan will autorenew.
Otherwise, your window to make changes to your plan is Nov. 15 through Feb. 15, 2015.
By going to your state’s marketplace and comparing prices and plans, you can make sure you’re still getting the best deal for you and your family.
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