It’s that time of year again.
Thousands of residents in our region who get their health insurance through Affordable Care Act marketplaces have to lock in their plans for coverage beginning in 2024.
The annual open enrollment period, which begins Nov. 1, is the only time for many people to sign up for coverage, switch plans, and explore savings programs.
It’s crucial that people do not wait until the last minute or miss final deadlines to make decisions, said Devon Trolley, executive director of Pennie, the marketplace in Pennsylvania.
“There really is only one time to enroll, and if people wait until they get sick or injured, it will be too late if they miss open enrollment,” she said.
Many participants will be eligible for financial assistance, including tax credits that can bring down monthly premium payments or cost sharing reductions that help pay for out-of-pocket costs like deductibles and copays.
The number of participating insurers and specific plans vary by individual county, and enrollment deadlines differ by state.
Pennsylvania
State residents who do not already get health insurance from their employers or other assistance programs like Medicaid can review and select plans on Pennie’swebsite and portal.
Jefferson Health Plans will join eight returning insurers to offer individual and small group plans across the commonwealth this year. Jefferson will offer plans in Bucks, Philadelphia, and Montgomery counties.
Highmark is also expanding into Bucks, Chester, Delaware, Montgomery, and Philadelphia counties, and Geisinger will now offer individual and small group options in Bedford County.
There are also stand-alone dental health insurance options. These plans will be offered to residents in 59 counties.
Monthly premiums will rise by a statewide average of 3.9%, according to the Pennsylvania Insurance Department. Exact premium increases or decreases will vary by each insurance plan.
About nine in 10 people will qualify for some kind of financial discount or savings, state officials said.
For people who lose Medicaid, a federal insurance program for people with low incomes, and need to switch to a marketplace plan, Trolley said the savings could be more.
“If you make a little too much for Medicaid, chances are you can get really significant savings through Pennie,” she said. “About one in five people who enroll after losing Medicaid pay less than a dollar per month for their families to get coverage through Pennie.”
Pennsylvanians can get in person or virtual enrollment support services through Pennie’s customer service center, insurance brokers, and Pennie “assisters.”
People who enroll or confirm plans by Dec. 15 will get health insurance coverage on Jan. 1, 2024. Anyone who enrolls in plans after that date and before the final deadline of Jan. 15 will get coverage starting on Feb. 1.
Delaware
Residents in Delaware can access the federalHealthCare.gov insurance portal through the state’sChoose Health Delaware website.
ACA plan options will expand this year as the state adds more insurers to its local marketplace. Celtic Insurance Company Ambetter Health of Delaware joins as a new carrier for coverage in 2024.
Existing carriers Aetna Health, AmeriHealth Caritas, and Highmark Blue Cross Blue Shield will return with individual and small group plan options.
“Improving healthcare accessibility and affordability across our state is one of my top priorities,” Delaware Insurance Commissioner Trinidad Navarro said in a statement. “I’m proud that our work has led both options and enrollments to an all-time high.”
Monthly premiums range from $274 to $654 across a total of 57 plan options, before financial discounts and savings. The average premium tax credit last year was about $197, according to the state Department of Insurance.
State officials expect ACA enrollment to rise this coming year as peoplelose coverage through Medicaid following the end of COVID-19 pandemic public emergency flexibilities.
People who enroll or confirm plans by Dec. 15 will get health insurance coverage on Jan. 1, 2024. Anyone who enrolls in plans after that date and before the final deadline of Jan. 15 will get coverage starting on Feb. 1.
Delaware participants canget assistance from local insurance navigators and organizations, including Westside Family Healthcare and Quality Insights, or from nearby agents and brokers.
Federal enrollment counselors are available at 1-800-318-2596.
New Jersey
Residents in New Jersey will benefit from a slightly longer open enrollment period than their neighbors. Plan options are offered through the state’s marketplaceGet Covered NJ.
People have until Dec. 31 to enroll for coverage beginning on New Year’s Day. People who select plans up through the final deadline of Jan. 31 will get coverage on Feb. 1.
Insurance carriers offering marketplace plans this year include Aetna CVS Health, Ambetter from WellCare of New Jersey, AmeriHealth Insurance Co., Horizon Blue Cross Blue Shield of NJ, Oscar Insurance Corporation, and UnitedHealthcare.
Premium rates increased by an average of 4.4%, but will differ by each individual plan.
In addition to premium tax credits and cost-sharing reductions, residents are also considered for a state subsidy called theNew Jersey Health Plan Savings. It lowers premium costs for people with household incomes of up to 600% of the Federal Poverty Level — $81,540 for individuals and $166,500 for a family of four.
Residents can gethelp and assistance with enrollment decisions from trained navigators in person or over the phone, and from local agents and brokers.
People can also reach the Get Covered NJ customer call center at 1-833-677-1010.