This year marks the twelfth anniversary of the Affordable Care Act—and according to a recently released “State of the ACA” report from the Centers for Medicare & Medicaid Services, a record 14.5 million people gained health insurance coverage through the ACA Marketplace in 2022.
If you were one of the millions of people who applied for ACA coverage, you know how important your annual health insurance decisions can be.
Choosing the best Marketplace plan for you and your family is one of the best ways to save money on health care costs, but health insurance options are often confusing. What is coinsurance and how is it different from a copay? What happens when you meet your deductible but still haven̵7;t reached your maximum amount? Which plans provide access to the doctors and hospitals you are most likely to use?
Fortunately, you don’t have to navigate Open Enrollment on your own. Haven Life recently partnered with Stride Health, a service that specializes in providing healthcare to 1099 independent contractors.
Stride Health is an approved partner of Healthcare.gov, which means if you need an Affordable Care Act health insurance plan this year, Stride Health can help you sort through your options and choose the best plan for you and your family. Stride Health can also help you choose vision and dental plans.
While services like Healthcare.gov and Stride Health are designed to help people make smart open enrollment decisions with as little stress as possible, it’s still a good idea to understand how open enrollment works—including when to apply, how comparing coverage options and how to estimate annual healthcare costs – before you start choosing health insurance plans.
That’s why we put together this guide. If you’re a freelancer, independent contractor, or gig worker looking for health insurance in 2023, here’s what you need to know.
Apply for health insurance before open enrollment ends
If you want Affordable Care Act health insurance coverage in calendar year 2023, you must apply for coverage while Open Enrollment is active. This year, Open Enrollment begins on November 1, 2022 and ends on January 15, 2023.
After open enrollment closes, the only way to access an ACA Marketplace plan is by qualifying for the Special Enrollment Period, or SEP. If you move, get married, have a baby, adopt a child, or lose existing health insurance coverage, you may be able to apply for ACA health care under a SEP.
Last year, the US Department of Health and Human Services established an ongoing special enrollment period for households with income levels not exceeding 150% of the federal poverty level. Under this SEP, eligible households can sign up for an ACA Marketplace plan at any time during the 2022 calendar year.
It’s unclear right now if this new SEP will continue into 2023 — but it may still be a good idea to complete your application during the annual open enrollment period. If you start early, you can get your health insurance for 2023 in place before 2022 ends.
Know how to compare coverage options
If you understand how to compare health insurance plans and anticipate annual medical expenses, you’ll be more likely to choose a health insurance package that can meet your family’s anticipated needs — as well as handle any surprises that may pop up. You’ll also be better prepared to use cost-saving tools like health savings accounts to manage your deductibles, copays, prescription costs and more.
Stride Health can help you evaluate your options and choose health insurance coverage — and services like Healthcare.gov and your state’s Marketplace site can also provide helpful comparison tools. Here are some terms to consider when comparing potential insurance plans:
- Premium: The amount of money you pay each month to keep your health insurance active.
- Deductible: The amount of money you pay to access covered health care services before your health insurance provider starts sharing costs.
- Copay: The amount of money you pay to access covered health care services after your deductible is paid and you begin sharing costs with your health insurance provider.
- Co-insurance: The percentage of covered medical expenses you are responsible for paying after your deductible is paid and you begin sharing costs with your health insurance provider.
- Max out of pocket: The maximum amount you pay to access covered health care services before your health insurance provider covers all costs.
Some health insurance plans charge higher monthly premiums in exchange for lower deductibles. Other plans charge low monthly premiums but require you to pay a large deductible before your insurer begins to share costs.
You may also be eligible for a health insurance subsidy, also known as a premium tax credit. These credits are based on annual income and can help lower the cost of health insurance by reducing the amount you pay in monthly premiums.
If you’re a freelancer or gig worker who’s having trouble predicting your annual income in the gig economy, don’t worry – if you miss out on your health insurance allowance when you apply for health cover for 2023, you can claim a tax credit equal to the subsidy amount on your 2023 taxes.
Don’t forget vision and dental care
Affordable Care Act health insurance plans are not required to include vision and dental coverage for adults. The rules are slightly different for people under 18 – as are the responsibilities. All Marketplace plans must include eye protection for children under 18, and while Marketplace plans must offer dental protection for children under 18, you are not required to purchase it.
Does that sound complicated? Do not worry. Services like Stride Health can help you navigate your vision and dental care options and help you create a customized coverage plan—whether you’re an adult who needs vision or dental care, or a parent who wants to make sure your kids have access to glasses, braces and annual checkups.
Consider adding life insurance to your coverage plan
There’s one more thing to consider when exploring your open enrollment options. If you have not yet applied for life insurance, you may want to consider adding term life insurance to your coverage plan.
No, you won’t be able to buy life insurance through the ACA Marketplace – but you can use services like Haven Life to apply for affordable life insurance coverage that can protect your family in the worst case scenario.
That way, you’ll have everything you need to start 2023 with the best possible insurance coverage – and you’ll be prepared for almost anything the year brings.