It’s a ritual many of us go through at the end of every year: Updating, changing or canceling your health coverage.
Yep. We’re talking about open enrollment.
Open enrollment is a 45-day window at the end of each year when you can sign up for a health insurance plan. But if that window closes, you may still be able to enroll in a plan if you lose coverage, get married, or have a baby.
Not sure what these programs are? Here’s a quick overview:
- Medicaid is an insurance program that provides free or low-cost health coverage to some low-income people, older folks, families and kids, and people with disabilities.
- CHIP is an insurance program that offers low-cost health coverage for kids. Generally, it supports families who make too much money to qualify for Medicaid, but not enough to buy private insurance.
Whether you’re taking advantage of open enrollment or scrambling to find coverage after the fact, now is a time to catch up on the latest health insurance updates.
To help you out, here are some health insurance changes to know about in 2021.
ACA (mostly) still in effect
For the most part, the Affordable Care Act (ACA) is still the same.
However, there is one notable change: No more individual mandate penalties (in some states).
At one time, people who chose not to buy health insurance would pay a fee when they filed their federal taxes. But most states dropped this fee starting with the 2019 plan year. Be aware that some states — like Massachusetts, New Jersey, DC, California, and Rhode Island — still require residents to have health coverage unless you qualify for an exemption.
Out-of-pocket limit goes up to $8,550
An out-of-pocket limit is the maximum amount you have to pay for covered health services before your plan kicks in to cover 100 percent of the costs.
The most you have to pay for covered services for the 2021 plan year is $8,550 for an individual and $17,100 for a family. In 2020, the limit was $8,150 for an individual and $16,300 for a family.
The out-of-pocket limit for your plan might be different, but it can’t go over the amount set for the year.
The out-of-pocket limit does not include:
- Monthly premiums
- Services not covered by your plan
- Out-of-network care and services
- Costs above the amount a provider may charge for a service
Short-term plans are still available (in most states)
Short-term, limited-duration insurance (STLDI) plans can fill gaps in coverage if you’re between jobs or changing insurance plans.
An STLDI plan can provide coverage for a period as short as one month or as long as three years. However, some states limit the sale of short-term plans. What’s more, STLDI plans only offer limited coverage and benefits. They’re also not regulated as much as traditional health plans.
Average premiums set to increase
The monthly cost of health insurance plans (also known as the premium) is increasing slightly for 2021. According to the Kaiser Family Foundation, there’s an overall rate increase of just 1.1 percent (median).
However, there’s good news for people with benchmark plans (the second-lowest-cost silver plan): The average monthly cost for these have gone down 3 percent in 2021.