If you want to buy individual or family health insurance for 2018, now is a great time to start your planning. Here’s what you need to know for the open enrollment period for 2018 individual and family health insurance plans:
The open enrollment deadline has changed.
Open enrollment starts Nov. 1, 2017, and continues through Dec. 15, 2017. But your coverage doesn’t start immediately. If you sign up between Nov. 1, 2017, and Dec. 15, 2017, your coverage will start Jan. 1, 2018
You need to sign up for health insurance during open enrollment if:
- You don’t have health insurance through your employer or your spouse’s employer.
- You don’t have government coverage (such as veterans, Medicare and Medicaid)
- You’re over age 26 and can no longer be on a parent’s health insurance.
- You qualify for tax credits to help you pay for health insurance coverage.
This is the time to make changes to your current plan.
You can renew your current plan or choose another plan during this time.
If you miss open enrollment, you may have to wait for a year to sign up
There are penalties for not having health insurance.
If you went without health insurance in 2017, the penalty is 2.5 percent of your income or $695 per adult (whichever is more) and the penalty for each child in the family without coverage will be up to $347.50. The maximum penalty is set at $2,085. For the 2018 tax year and beyond, the penalty will remain at 2.5 percent, but the flat and maximum amounts will adjust for inflation.
If you owe a penalty, it will be taken from your tax refund. Unlike nonpayment of child support or other activities, the federal law prohibits the government from garnishing your wages or filing liens to collect an insurance penalty.
You have a choice three levels of individual/family health insurance plans.
Plans in the health insurance marketplace are divided primarily into three categories:
- Bronze – highest out-of-pocket expenses for services (lower premiums)
- Silver – somewhere right in the middle
- Gold- least out-of-pocket expenses for services (higher premiums)
All health plans must cover 10 essential benefits.
No matter the level, all must provide some coverage for at least 10 essential benefits.
- Outpatient care including chronic disease management
- Emergency care
- Pregnancy and newborn care
- Mental health and substance abuse services
- Prescription drugs
- Rehabilitation services and devices
- Lab tests
- Preventive and wellness services
- Dental and vision care for children
The level of coverage for these services can vary. All the plans in the marketplace must provide consumers with a brief, understandable description of what they cover and how their plan works. The Summary of Benefits and Coverage (SBC) must be posted on the plan’s website. Check out the SBCs for the different plans you are considering. This is a good way to compare plans and benefits.
Your family size and income determines your eligibility for tax credits
You may qualify for a premium tax credit which is based on income and family size. To qualify, your family income must fall between 100 and 400 percent of the federal poverty level (FPL).
That means, for example, a family of four with an income between $24,300 and $97,200 in coverage year 2017 would qualify for these credits. (The government uses FPL standards from the previous year to determine eligibility.) For 2018 coverage for a family of four, the income bracket adjusts to $24,600 to $98,400.