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Open Enrollment 2015 – Tips For Obamacare Plans

A Picture of Rebecca Bradley Rebecca Bradley
11/16/2015

Ways To Improve Your 2015 / 2016 Health Insurance Open Enrollment Experience

Whether your state relies on the federal facilitated Marketplace or its own exchange, you will soon have to make decisions about insurance coverage. The 2016 annual Open Enrollment Period (OEP) runs from Nov. 1, 2015, through Jan. 31, 2016. Coverage begins on Jan. 1, 2016, if you enroll in a plan by Dec. 15, 2015.

Under the Patient Protection and Affordable Care Act (ACA), the OEP allows Americans to purchase required health policies for the upcoming year. Those who fail to enroll face an IRS-imposed penalty. For 2016, this penalty will be $695 per adult and $347.50 per child, or 2.5 percent of your income, whichever is greater.

Your plan selection really boils down to three factors: plan costs; specific coverage provided; and doctors and facilities within the plan’s network. Even if you are satisfied with your current plan, you should research other policies from privately owned and for-profit companies. But rest assured, these policies all meet the ACA’s coverage requirements.

Factors impacting 2016 coverage

In 2014, more than 2 million Americans were automatically re-enrolled in their Marketplace plans or similar ones. Only 54 percent actually purchased different plans. But this year’s OEP should see more people enrolling, even as more providers are leaving the exchanges. Many plans are also decreasing their number of out-of-network benefits for Health Maintenance Organizations (HMOs) and Exclusive Provider Organization (EPO) plans.

Enrollment may also be affected by many 2016 plans’ rising costs. According to the nonprofit Kaiser Family Foundation (KFF), the silver plans (the most common) with 2015’s lowest premiums are “usually no longer one of the two lowest-cost silver plans in 2016.”

Whichever plan you select, the following steps will help narrow down your search:

  • Plan costs – Consider all of a plan’s financial requirements, including premiums, copays, coinsurance, deductibles and out-of-pocket costs.
  • Income requirements — If your income is between 100 and 400 percent of the Federal Poverty Level (FPL), you qualify for federal subsidies. If your income is between 100 and 250 percent, you also qualify for cost-sharing reductions; this means lower copays and deductibles.
  • Preferred doctors — Review all plans’ provider lists, as doctors may join or leave. You may want to contact your doctors first.
  • Benefits and coverage – Check your Summary of Benefits and Coverage (SBC), which compares different plans’ costs and coverage. The SBC is provided when you shop for your own coverage or through your job, or renew or change coverage. You can also request an SBC from health insurance companies.
  • Prescription drug coverage – Review the plans’ drug coverage, including any deductibles and copays and whether generics are available.
  • Plan type – You may prefer different plan types, such as HMOs or Preferred Provider Organizations (PPOs); these let you visit any in-network doctor.

You Can Use The Form Below To Determine What Your Options Are For 2015/2016 Open Enrollment – Obamacare Plan Comparison 

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