The registration period for health insurance for 2024 has opened: how to choose a policy

November 1st started Open Enrollment period — time to purchase health insurance under the ObamaCare program for the next year (2024). We've put together a short guide on what this means and how to choose an insurance policy.

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1. What is Open Enrollment

Open Enrollment is a specific period of time each year (usually 45 days in November-December) when US residents can purchase or change their health insurance plans.

2. Open Enrollment dates in 2023

Federal Insurance Exchange (Marketplace) in 2023 it is open from November 1 to December 15. Several states have their own regional insurance exchanges, and their open enrollment periods may vary, but they generally do not deviate too much from the federal Open Enrollment.

3. Why is it important not to miss these dates?

Open enrollment is the only time of the year when a person can sign up for new health insurance coverage or change the plan they have. If you don't do this by December 15, you risk being left without insurance in 2024. The only chance to change or buy health insurance at another time of the year is a major life event.

4. What are important life events?

A qualifying life event (QLE) is a change in your life situation that affects your coverage or makes you uninsured (through no fault of your own). Such events include:

• marriage;
• birth/adoption of a child;
• divorce;
• death of a person who was included in your insurance plan;
• moving;
• involuntary loss of previous coverage (for example, leaving a job if you were covered by your employer).

5. How to choose the right insurance plan

If you like the insurance plan you currently have and can renew it through 2024, this is the easiest option. The main thing is to update it if necessary, that is, add dependents or some services.

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If you're buying insurance for the first time or have decided to switch to a different plan, you need to do your research to determine the policy that's right for you. Here are a few questions to help you make a decision:

1. Do the services in the plan meet your medical needs?
2. Does this plan (in its network) cover the doctors and hospitals you use most often?
3. What is more important to you: a wider network or lower monthly fees?
4. Does the plan cover the medications you (or your family members) need?

If you need help choosing an insurance plan, check out the resource Health Advocate.

Personal advice on which plan is right for you can be obtained from the company InsuranceNY.net. The company's agents have been working in the market for more than 25 years and will be happy to help you not get lost in the insurance maze.

If you need to apply for Medicaid or Medicare, private individual or business insurance, call or text 212-532-1211 or contact by email: [email protected].

The initial consultation is free.

6. Important terms when choosing health insurance

Choosing a health insurance plan can sometimes feel like reading a foreign language—the general gist seems to be clear, but some words remain a mystery. Sometimes these words hide important data.

Here are some concepts you need to know when choosing insurance:

1. Premium (premium) - a fixed amount that the insured pays to the insurer every month for participation in the health insurance plan.
2. deductibles (so-called deductible) - the amount that the patient must spend on medical services from his own pocket before insurance coverage begins to operate.
3. Copayments – additional payment from the patient's pocket for the service/drug in addition to what is covered by the insurance. Usually this is some percentage of the cost of the service.
4. Network – a network of doctors and hospitals with whom your insurer has a pricing agreement. Medical services received “out of network” will be more expensive, and deductibles and copayments will be higher. Therefore, when applying for insurance, be sure to review the list of medical institutions in your “network,” especially if you already cooperate with a doctor.
5. maximum out-of-pocket (out-of-pocket maximum) is the limit on the amount a patient can pay for medical services during the year, including copayments and deductibles. If you were sick a lot or received expensive procedures, and reached this limit in a few months, then the insurance company does not have the right to demand additional payments and deductibles from you until the end of the year. The out-of-pocket maximum for all ObamaCare plans in 2024 cannot exceed $9 for an individual or $450 for a family.

A detailed glossary of all insurance terms can be found on the US Department of Health website. here to register:.

If you are ready to choose your own insurance, this can be done here.

7. What types of insurance are there?

If you divide as roughly as possible, then insurance can be paid and free.

Paid is provided by the employer (their conditions must be discussed directly with the employer), or you can buy such a policy yourself. So-called metal insurance plans are available in this category:

1. Bronze plan provides the lowest monthly fees and the highest deductibles and copays.
2. Silver plan: average monthly contributions.
3. Gold Plan: monthly insurance premiums are above average.
4. Platinum plan charges customers the highest monthly premiums while providing the lowest deductibles and copayments.
5. Catastrophic plan provides low monthly fees, but high deductibles. It is difficult to execute (you will need to collect a lot of documents) and has very limited application for a number of conditions (income, age, etc.). If you are interested in this insurance plan, it is best to discuss your options with a specialist.

The cost of a specific health insurance plan depends on:

• living place;
• total family income and number of insured persons;
• age (child, adult, senior 65+);
• health status of the insured (insured), in particular, pre-existing condition, that is, chronic diseases or diseases requiring long-term treatment (asthma, diabetes, cancer).

On this link There is a calculator available to help you calculate your monthly insurance premiums, but you will need to provide the information about yourself listed above.

Free insurances are mostly income-based and often depend on immigration status. These policies include Essential Plan, Medicaid, and CHILD HEALTH PLUS (CHP). We described in detail how to get free insurance policies in America, in this stuff. You can read about insurance for different categories of immigrants here и here.

You may be interested in: top New York news, stories of our immigrants, and helpful tips about life in the Big Apple - read all this on ForumDaily New York.

8. Can you change your insurance plan after you've chosen it?

If the registration period is still open, then yes. If Open Enrollment has already ended, then most likely not, unless you have a qualifying life event (see point 4).

9. When will the insurance purchased during Open Enrollment become effective?

From January 1, 2024.

If you purchase insurance outside of the Open Enrollment period and at another time - due to a qualifying event - then the start of coverage depends on the date you purchased the policy. If you start taking out insurance before the 15th of the current month, the policy will begin to be valid on the 1st of the next month. And if you take out a policy on the 16th or later, you will have to wait a month and a half for insurance.

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