Thursday, December 11, 2014

Hey, Doc, When I Can I Renew My Marketplace Health Insurance?

This week’s segment in Texas Medical Association’s (TMA’s) “Hey, Doc” health insurance marketplace education campaign answers more questions about aid provided to some Texans who enroll in the exchange, called subsidies, and how to renew your marketplace plan.

Q. Hey, Doc, How do I renew my marketplace plan? 

A. You should be getting notices from the marketplace and your insurance company about how to renew for 2015 the coverage you bought for 2014, and whether you still qualify for subsidies to help pay for it.

If you don’t take any action by Dec. 15, the marketplace may automatically reenroll you in your 2014 plan, or a similar one if your insurance company no longer offers it. The marketplace notice should tell you how to renew, and the notice from your insurance company should tell you if it still offers the same plan or if your plan changed. Both notices will also give you information about renewing any subsidies you are receiving. (See “Will I still get my subsidy from last year?”)

If any of your personal information changed, like your income, address, or family size, be sure to update your marketplace account. If you don’t do these updates, you could get enrolled in the wrong plan or for the wrong subsidies.

It's also possible that your insurance premiums, deductibles, and out-of-pocket costs can change even if you renew the same plan, so be sure to check. Plan networks also change, so check with your insurance company and your doctor to find out if your doctor and hospital are still included.

If you find out the plan you had is no longer good for you, you can always switch during open enrollment. You must switch by Dec. 15 for your coverage to take effect Jan. 1, 2015. But you can still change to a new plan even if you are automatically enrolled in the same one from 2014. In that case, you have until Feb. 15, 2015, to switch.

Q. Will I still get my subsidy from last year? 

A. That depends. Subsidies are provided by the federal government to help you pay for your insurance. Remember that your subsidy depends on how much money you make. (See “Who gets a subsidy?”) So if your income went up since last year, your subsidy will probably be less. You might even have to give back part of it to the government if you started making more money after you first signed up in 2014.

Also remember that you had to provide some specific information about your income when you first applied. (See “How do I apply for a subsidy?”) If you gave the marketplace permission to automatically recheck your income and tax returns, the marketplace can automatically renew the amount of financial assistance you received in 2014. If you did not give the marketplace permission to do this, you’ll have to reapply. And keep in mind that if your income has changed, you should update your application to make sure you are getting the correct subsidy and you don’t have to refund anything later if you receive too much.

The marketplace and your insurer should each send you a notice around the time of open enrollment explaining how to renew your subsidy.

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