The vast majority of Americans will find multiple options for health insurance coverage for 2023 on HealthCare.gov after open enrollment began Tuesday under the Affordable Care Act. People searching for plans on the government marketplace should consider their budget, health, doctors and a variety of other factors before picking a plan. Currently, more than 14.5 million people get their health insurance through the ACA, commonly known as “Obamacare.” The number swelled during the coronavirus pandemic after Congress passed generous subsidies to make coverage more affordable. While most people have three or more options, about 8% of participants will choose from only two insurance carriers, a number that drops to one in rural counties across Alabama, Alaska, Arizona and Texas. According to the Biden administration, 80% of consumers should be able to find a plan for $10 or less per month after tax credits. Here’s a look at navigating the Affordable Care Act marketplace: HOW DOES THE MARKETPLACE WORK? The ACA marketplace is geared toward people who don’t have health insurance through their job, Medicare, Medicaid, the Children’s Health Insurance Program or another source. While most states use the federal marketplace at HealthCare.gov, some have set up their own. These are: California, Colorado, Connecticut, Idaho, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island and Vermont plus the District of Columbia. Premium tax credits and other savings reducing the cost of insurance are based on income and the number of people in your family. For example, individuals with an annual income between $13,590 and $54,360 are eligible for a subsidy. Those who make less than that qualify for Medicaid. You can use the HealthCare.gov calculator to determine what savings are available to you. Know the deadlines for coverage in 2023: Dec. 15 for coverage that starts on Jan. 1 and Jan. 15 for coverage that begins Feb. 1. WHAT TO LOOK FOR IN CHOOSING A PLAN Shop around, even if you’re currently covered under the ACA. First, you’ll want to see what the monthly premium — the amount you pay for coverage — will be. Next, check on the plan’s deductible — that’s what you pay up front for health services before your insurance begins to share some of the remaining costs for the year. Look into the plan’s copayments or coinsurance. Those are the the fees you pay every time you visit the doctor’s office or go to an urgent care clinic, for example. Plans with coinsurance can be trickier to budget for because you pay a percentage of the service cost, instead of a set fee. And make sure to know the out-of-pocket maximum. After you hit that number, your insurance will cover 100% of costs. You’ll want to keep that number in mind if you might have big health expenses — a major surgery, childbirth or ongoing therapy or treatment — in the upcoming year. “Consider whether you are going to have an expensive year,” said Kelly Rector, an insurance broker and president of Missouri-based Denny and Associates Inc. “If you know you’re going to be hitting that out-of-pocket max no matter what, maybe you look at the lower premiums and higher deductible plan.” DOES YOUR DOCTOR PARTICIPATE IN THE PLAN? Do you want to continue seeing a favorite doctor or need […]

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