The Affordable Care Act, as most already know, has brought an entirely new set of rules to the US health insurance system. One of the most concerning, is also one that's not being talked about on the news with nearly enough urgency. If you purchased a new healthcare plan in 2014 it likely affects you, too.
No Changes to Plans Until the Next Open Enrollment
Unlike the days of old, if you had the urge to change or alter your coverage, you could do so at any time throughout the year. This is a freedom that many won't be enjoying under the new system.. at least not in the sense that we all once knew it.
Aside from the changes in monthly premiums, doctor's networks and plan options, arguably one of the most significant tenets of the Affordable Care Act, is centered around when you can and cannot make changes to your healthcare coverage. Here are the three most substantial:
Plan Cancellations & Purchase Dates
Under the former system it was a non-issue for anyone who wanted to cancel their plan temporarily, and then reinstate coverage at a later time. A good example of this would be someone who--let's say, during the summer months--needed to suspend their insurance due to an unforeseen expense or financial issue. This, however, has changed in 2014. Now, if you cancel your plan after the March 31st open enrollment cutoff, you will not be able to purchase health insurance until the November 15th 2015 open enrollment. And even then, your actual coverage won't kick in until the first of the year.
Deductibles & Copays
There was a lot of flexibility with things like max-out-of-pocket expenses, copayment amounts and deductibles prior to the rollout of the new system. Now, the plan you choose, as well as all of the plan's coverage details, is the plan you'll have all year until 2015 open enrollment begins. An example would be someone who decides for whatever reason that they need a lower monthly premium, and wishes to compensate by taking a higher deductible plan.
No Option of Upgrading
In much the same way that copayments and deductibles cannot be changed, the same stands for those who want or need to upgrade their plan. The most common scenario here, is the person who purchased a new 2014 plan in haste, on the health insurance exchange, or to meet sign-up deadlines without taking time to consider whether it actually addressed their medical needs. Another would be the individual or family who--at some point during the year--finds themselves in need of something not covered under the plan they selected. This could be a new medicine, physical therapy, specialized procedures, or anything not covered under the policy they selected.
Is it Too Late to Make Changes?
We know that this might come as a bit of a shock, but there's no need to get panicked. If you've already signed up for 2014 coverage and are concerned about having made the right choice, or still need to sign up and don't know which plan to select, you have until March 31st to get things squared away. The surefire way to make sure everything is done efficiently, properly and on time, is to speak with a health insurance agent who genuinely knows the fine points of the Affordable Care Act.
If you're in Illinois or the Chicago area, Premier offers completely free assistance on all health insurance signups or plan modifications. Give us a call at 800-369-0287 or send us an e-mail, we're located in the Lisle/Naperville area and charge no fees for our services.