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As you approach open enrollment this year, it is more crucial than ever that you carefully research your options. The COVID-19 pandemic, as well as decisions made in Washington, DC, in the past couple of years, are having complicated effects on insurance choices and costs, so you will have to take extra care to evaluate your options to pick the plan that offers you the best and most affordable coverage.

  • Additional insurers are joining the ACA Marketplaces (healthcare.gov) in many states. You may have new options for 2021 that you did not have last year.
  • If you buy your insurance in the individual market, BEWARE of 鈥渟kinny鈥 plans and insurance look-alikesthat don鈥檛 provide adequate coverage: short term plans, association health plans, fixed indemnity plans, and health care sharing ministries. These types of plans do NOT provide adequate coverage for people with bleeding disorders 鈥 and, unfortunately, many are widely advertised, often in very misleading terms. Make sure your plan meets ACA standards for coverage and financial protection, and don鈥檛 be duped by misleading sales pitches or look-alike websites. To avoid pitfalls, start your search on www.healthcare.gov.
  • As you compare plans on healthcare.gov, remember that you may be eligible for assistance with your premiums and/or copays. Most people who buy their insurance on healthcare.gov qualify for tax credits to help them with their monthly costs!
  • Watch out for health plans that limit your ability to make use of manufacturer co-pay assistance programs. Health plans with accumulators do not credit manufacturer co-pay assistance toward your overall deductibles or out-of-pocket maximums,聽leaving patients on the hook for out-of-pocket costs up to their yearly maximum. Unfortunately, it can be hard to spot whether your plan contains an accumulator adjuster. Read your plan documents carefully and call plan administrators to ask specific questions. Learn more about accumulator adjusters in this recorded session from HFA鈥檚 2020 Symposium.
  • Have you experienced employment changes, due to COVID or otherwise, that impact your health coverage? Please check out this resource created by HFA and NHF outlining possible options. Some additional considerations:
    • If you lost your job in 2020 and opted to continue your job-based coverage under COBRA, you may wish to explore whether it makes sense to switch to a Marketplace plan for 2021. Start your research on www.healthcare.gov.
    • If you experience job loss this fall, make sure you arrange for insurance that will cover you for the remainder of 2020, whether through COBRA or through special enrollment period coverage via the ACA Marketplace. Coverage that you obtain during open enrollment will only go into effect on January 1, 2021.

A reliable resource for information on open enrollment for 2021 individual insurance plans can be found聽here聽and a detailed set of FAQs (including many in Spanish) can be found聽here.


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