This year marks the twelfth anniversary of the Affordable Care Act — and according to a recent “State of the ACA” report from the Centers for Medicare & Medicaid Services, a record-breaking 14.5 million people received 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 healthcare 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 haven’t met your out-of-pocket maximum? Which plans provide access to the doctors and hospitals you are most likely to use?
Luckily, 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 that 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 yourself 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 to compare coverage options and how to estimate annual medical expenses — before you start choosing health insurance plans.
That’s why we put together this guide. If you’re a freelancer, independent contractor, or a 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 the 2023 calendar year, you’ll need to 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 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 healthcare coverage under a SEP.
Last year, the U.S. 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, qualifying households could enroll in an ACA Marketplace plan at any time during the 2022 calendar year.
It’s unclear right now whether this new SEP will continue into 2023 — but it still might be a good idea to complete your application during the annual Open Enrollment period. If you start early, you can get your 2023 health insurance coverage 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 expected needs — as well as handle any surprises that may come 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 website may also provide useful comparison tools. Here are some terms to keep in mind as you compare potential insurance plans:
- Premium: The amount of money you pay each month to keep your health insurance plan active.
- Deductible: The amount of money you pay to access covered healthcare services before your health insurance provider begins sharing costs.
- Copay: The amount of money you pay to access covered healthcare services after your deductible is paid out and you begin sharing costs with your health insurance provider.
- Coinsurance: The percentage of covered healthcare service costs you are responsible for paying after your deductible is paid out and you begin sharing costs with your health insurance provider.
- Out-of-pocket maximum: The maximum amount of money you pay to access covered healthcare 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 will begin sharing 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 has trouble predicting your annual income in the gig economy, don’t worry — if you miss out on your health insurance subsidy when you apply for 2023 health care coverage, you can claim a tax credit equivalent to the subsidy amount on your 2023 taxes.
Don’t forget vision and dental
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 are required to include vision coverage for children under 18, and although Marketplace plans must offer dental coverage for children under 18, it is not required of you to buy it.
Does that sound complicated? Don’t worry. Services like Stride Health can help you navigate your vision and dental options, and help you create a customized coverage plan — whether you’re an adult who needs vision or dental coverage, or a parent who wants to ensure 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 as you explore your Open Enrollment options. If you haven’t yet applied for life insurance, you might want to consider adding a term life insurance policy to your coverage plan.
No, you won’t be able to purchase 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 during a 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 nearly anything the year brings.