The open enrollment season can be a nervous time for the self-employed.
The stakes are especially high because if you need to buy individual or family coverage, the next few weeks may be your only chance for 2024, with a few exceptions, such as moving to a different state, getting married, divorcing. To have or to have a child.
“For most people, the nationwide open enrollment period for individual and family coverage is the best opportunity to review your options and enroll in a new plan,” says Anthony Lopez, vice president of individual and family and small business plans at eHealth, a private told. The online marketplace for health insurance, in one email.
Choosing health insurance on your own can be difficult – without the help of the human resources department. Instead of throwing up your hands in frustration, here are answers to frequently asked questions about open enrollment for self-employed individuals.
Healthcare.gov and other options for information
Freelancers, consultants, independent contractors and other self-employed individuals can visit www.healthcare.gov Researching and enrolling in flexible, high-quality health coverage through the federal government or their state, depending on where they live. You can also choose to work directly with an insurance agent or private online marketplace to help you with options. To be considered self-employed, you cannot have anyone working for you. If you have a single employee, you may be able to use Shop Bazaar for small businesses,
Deadlines you need to stick to
Most states have set December 15 as the deadline Coverage begins Jan. 1, so don’t delay when it comes to signing up for benefits, said Alexa Irish, co-chief executive of Catch, which helps self-employed individuals choose health care plans. Does. Also, remember to pay your first month’s premium before your health care starts, otherwise you’ll be out of luck, too. “If you miss those deadlines, there’s no chance,” said Laura Spear, co-CEO of Catch.
If you’re already enrolled in a Marketplace plan
People who were already enrolled in a plan last year can make changes until Dec. 15 for coverage starting Jan. 1. Doing nothing will mean they are automatically re-enroled into the previous year’s marketplace plan.
Qualifying for tax credits and other savings
Many people assume they won’t be entitled to savings, but they should still check out their options, Irish said. In fact, according to data from the Centers for Medicare & Medicaid Services, a federal agency within the U.S. Department of Health and Human Services, 91% of total Marketplace enrollees received the advance premium tax credit in February 2023, which will help reduce the cost of their monthly health insurance. Reduces payments. ,
Credits and other eligible savings are available based on applicant’s income and household size can be estimated Even before they officially apply. It’s worth examining the savings potential every year, Irish said.
What to Consider in Making Coverage Decisions
The thought process will be similar to what you faced when choosing health insurance offered by an employer. Whether you’re signing up for the first time – or deciding whether to renew your existing plan or choose a different plan – you’ll want to consider factors such as who in the family needs coverage and for what purpose. For, and how different plans compare in terms of coverage options and cost. This analysis needs to take into account the copays, the medications you take or start taking, whether the plan covers your doctors, and your out-of-pocket maximum.
If you’re self-employed and aiming to grow your business in the coming year, perhaps by hiring employees, it’s good to know that you can enroll in a small business plan any time of year, Lopez said. Can. “Small business group plans are not governed by the same open enrollment rules as individual and family plans. So, you can enroll in an individual plan today, then switch to a group plan in mid-2024 if you have more than a few employees. and want to provide them with health benefits,” he said.
How much does health insurance cost if self-employed?
Costs will vary depending on the plan you choose, who is covered, and what subsidies you are eligible for. But, as a general guideline, the average total monthly premium before tax subsidies in February 2023 was $604.78. According to the Centers for Medicare and Medicaid Services, the average total premium paid by consumers per month after tax subsidies was $123.69.
Self-employed individuals may also be eligible for the cost-sharing deduction, an exemption that reduces the amount paid for deductibles, copayments, and coinsurance. You’ll find out what you qualify for when you fill out the Marketplace application, but keep in mind, to get the cost-sharing reduction you must enroll in a “Silver” plan, one of four categories of Marketplace plans. Is.
Considering policy options, working with an agent
You don’t have to go through this process alone. There are assistants who are trained and certified by the Marketplace to help you apply and enroll. If you want more specific help, you can also choose to work with An agent or broker who is trained and certified They are licensed to sell marketplace health plans in the state. Agents can give you advice and more detailed information about the plans they sell, and since health insurance premiums are regulated by your state’s insurance department, you may be less likely to pay more by working with an agent. No need to worry about.
A few things to note: Some agents may offer other plans that are not available on government exchanges, but they comply with government requirements. However, to take advantage of premium tax credits and other savings, you must enroll in a plan through a state or federal marketplace, either on your own or through an agent.
The Risk and Reward of High-Deductible Plans
Markets offer many plans to choose from and they will vary in coverage and price. One option that is becoming more popular, especially among young entrepreneurs, is called a high-deductible health insurance plan. This type of insurance plan comes with higher deductibles in exchange for lower premiums, which can be a good option for people who are healthy and don’t visit the doctor much. Another benefit of a qualified high-deductible plan is the ability to contribute to a tax-advantaged savings vehicle known as a health savings account, or HSA.
When deciding whether to choose a high-deductible plan, individuals should take into account factors such as how often they visit the doctor, how much they can pay out-of-pocket, whether their doctor is in-network and what is out-of-network. – Pockets are maximum. It’s also important to know that you have the means to cover a high-cost medical event if the need arises. If a high-deductible plan suits your circumstances, you may consider an HSA.
Lopez advises people not to delay when it comes to reviewing their coverage options, which may also include dental and vision insurance. “The final week of open enrollment can be a busy time even for licensed agents; if you want the best chance to speak to an agent to get your personal questions answered, don’t put it off.”
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