Health Care Open Enrollment 2018: What You Need To Know

Health care open enrollment for 2018 began on Nov. 1, 2017. Act quickly to find the best deal.

If you're confused about the state of the Affordable Care Act, you're not alone. News of skyrocketing premiums, a shorter enrollment period and the elimination of cost-sharing subsidies have caused widespread consternation.

To confront these changes, health care experts recommend consumers act early and be prepared to do their homework if they want to secure the best deal for their families. Subsidies, tax credits and Medicaid are still available, depending on your income and plan. It just may take a little more work to identify the most cost-effective option for you.

Whether this is your first time signing up for health insurance under the Affordable Care Act, or you are a return customer, here's a summary of what's changed and what you should look out for this year.

Federal enrollment period Nov. 1 – Dec. 15, 2017

Those who signed up last year may remember they had until Jan. 31 to enroll in a plan, but there's a much shorter window now. The open enrollment period on the federal marketplace, HealthCare.gov, has been cut down to just six weeks, ending on Dec. 15.

If you live in one the states that run their own exchanges, you may have longer. For example, the deadlines in California, Connecticut, Massachusetts, Minnesota and Rhode Island vary between late December and the end of January.

If you already have insurance through the federal marketplace, you can't switch plans after Dec. 15. You will most likely be automatically enrolled in your existing plan, but HealthCare.gov strongly recommends you update your information and compare various plans prior to the deadline to ensure you get the best coverage for your money.

If you don't enroll by the deadline you won't be eligible for a 2018 plan unless you qualify for a Special Enrollment Period because of a loss of coverage or a change in life circumstances.

Premiums

You probably aren't surprised to hear that premiums are going up in 2018. But premium increases will vary a lot, depending on where you live, your income and your plan.

The average monthly premium for the lowest cost plans will increase 17 percent from $248 to $291, according to an analysis by the Department of Health and Human Services (HHS). Since 71 percent of enrollees were in a silver plan in 2017, that increase is likely to impact a lot of people. The average increase on a "benchmark" silver plan is 37 percent (from $300 to $411). Gold plan premiums will increase by an average of 19 percent.

To offset these premiums, Advance Premium Tax Credits (APTC) will also increase. Since APTCs are based on the benchmark silver plan, the rapid rise in that plan's premiums means a larger-than-usual increase in tax credits as well. HHS estimates the average APTC will be $555 in 2018, compared to the 2017 average of $382.

Because of the uneven rise in premiums and the increased tax credits, you may want to consider switching your plan level for 2018. For example, you may be able to upgrade from a silver plan to a gold plan with better coverage for the same – or even less – money next year.

Plans

The exchanges will still offer bronze, silver, gold and platinum plans. In addition, there will be an "expanded bronze" plan and a high-deductible bronze plan (HDBP) in 2018. These plans have slightly lower premiums and higher out-of-pocket expenses. The HDHP allows you to set up a tax-advantaged health savings account.

The number of insurers participating in the federal marketplace will decline next year, giving consumers fewer insurers to choose from. There will be an average of three insurers per state, according to HHS. But eight states (Alaska, Delaware, Iowa, Mississippi, Nebraska, Oklahoma, South Carolina and Wyoming) will have only one insurer in 2018.

Penalty

In spite of President Trump's calls for the elimination of the individual mandate, no such action has been taken to date. That means that people who can afford insurance and don't purchase it will face penalties again in 2018. The fine is calculated two ways: per person and as a percentage of income. You pay whichever is greater. The fines for 2017 were as follows:

• $695 per person ($347.50 per child under 18) up to a maximum of $2,085 per family, or
• 2.5 percent of total household adjusted gross income up to a maximum of the annual premium for the average bronze plan.

The penalty for 2018 will be adjusted for inflation.

Enrollment support

As in the past, the best place for you to start the process of enrolling is on HealthCare.gov. Depending on which state you live in, and whether that state has set up its own exchange, you may remain on the federal health care page, or be directed to your state's health exchange page.

You can get help enrolling from the federal call center at (800) 318-2596. If you want in-person advice from someone in your area, HealthCare.gov allows you to input your zip code to get a list of agents or brokers in your area who can help you apply for free.

The Donald Trump administration slashed funding to nonprofit "Navigators" who help people enroll in person by more than 40 percent for the coming year. Because of this, many Navigators say they will cut staff and outreach. This is all the more reason to sign up now!

Mary Purcell is a freelance writer and health and finance researcher. She covers savings and insurance for MoneyGeek.com.

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