So you signed up for health insurance benefits via the Affordable Care Act (ACA) Marketplace last year. You really like your current plan, but you’re not exactly sure that you want to stay on it.
If your plan is like most other health insurance plans, you’ll have the option to automatically renew your coverage, year to year. Simple, right? You could easily just sit back, relax, and do nothing, and you’ll be automatically re-enrolled in a 2022 plan after the December 15 deadline.
But just because you can auto-enroll doesn’t mean you should. You could be missing out on major savings or an alternative health plan that could be a better fit for your health needs. You could also end up being surprised by higher costs or unexpected changes in your coverage.
And this year, you actually have until January 15, 2022, to sign up for a new plan.
“Re-enrolling is great when the other option is not having insurance coverage at all,” says Caitlin Donovan, senior director of the National Patient Advocate Foundation in Washington, D.C. “But that’s not a best-case scenario.”
A smart option would be to compare plans and be active in the enrollment process—even if you want to stay on the same plan. If you’re wondering whether it’s truly worth your time and energy to update your application and make a deliberate choice, consider these 10 reasons you don’t want to rely on automatic re-enrollment.
1. Your current plan may have changed
Health insurance companies change plan details all the time, Donovan says. The premium, or how much you pay for your insurance; deductible, or the amount you pay out of pocket before an insurance provider foots the rest of the bill; and cost-sharing amounts, or the actual amount your insurance provider eventually pays, can all change. So can the services and the types of medications covered on your plan.
And all of that could add up to a pain in your wallet.
2. You could be reassigned to a different plan
Not only could your health plan change, year over year, but it’s possible that it could be terminated or removed from the Marketplace entirely.
In that case, you could be reassigned to a similar but different plan, says David Anderson, a research associate at Duke-Margolis Center for Health Policy in Durham, North Carolina. Your letter from your insurance company will tell you if this happens and which plan you’ve been enrolled in.
Like we said earlier, if you do nothing before December 15, 2021, you may be automatically re-enrolled in a plan shortly thereafter. But don’t worry: If you don’t like the plan, you can log into your ACA account anytime until January 15, 2022, to enroll in a different one.
However, know that plan changes made after January 1 won’t take effect until February 2022.
3. Your payment amount could change
Marketplace plan premiums that an individual pays almost always change from one year to the next, says Anderson.
And with so many new health insurers joining the ACA Marketplace, it’s likely that some new insurers will come in under the existing insurers’ premiums. That can lead to lower premium subsidies, which help you save on insurance, in many parts of the country.
Premium subsidies are based on the cost of the average ACA benchmark health plan—which is the second-least expensive silver plan (ACA plans have different metals, like silver and bronze, associated with them, based on how expensive they are). This is the most common choice among ACA Marketplace shoppers, due to the moderate costs associated with it.
In 2022, the average benchmark plan is expected to be about 3% lower in states where healthcare.gov is available compared to where it was this year, per the Kaiser Family Foundation. Your subsidy, which is based on your income, is the difference between the premium for the benchmark plan and how much you end up contributing to it.
Bottom line: If you auto-renew in a plan without checking its premiums, you could end up paying a lot more than you want or need to.
4. Your doctor may drop your plan
It’s not uncommon for doctors to leave health networks, and they may or may not let you know, says Donovan. You might get a letter giving you a heads-up—or a bill for a much higher amount than you expected.
Your best bet is to call your doctor’s office or your insurance company and double-check that your doctor is still in network, says Donovan.
5. Your health needs may change
If your situation has changed—you’ve been diagnosed with a chronic condition or you’re anticipating a new medical need next year (say, a surgery or a pregnancy)—there may be 2022 plans with coverage and features that better meet your new needs.
And make a habit of it. You’ll want to do a reassessment every year to see whether your plan still meets your needs, Donovan advises.
6. You may not get the right premium subsidy (or you could lose it)
If you don’t return to the ACA Marketplace to update your financial information, the Marketplace will determine your 2022 premium subsidy, or your potential cost savings (see No. 3), using the most recent income information it has for you. That would be your 2020 tax returns.
However, if your circumstances have changed since then—you lost your job or got a new job, for example—that projection may be off.
- If it’s too high, you could wind up spending more money each month than you have to (though, the difference would be refunded to you when you file your taxes in 2023).
- If it’s too low, you may have to pay back some or all the credit you received.
And by the way: That’s only if you’ve authorized the Marketplace to access your tax returns. If you’re among the small percentage of people who do not provide this consent, you may be auto-enrolled in a plan but lose your subsidy. (Note that if you have a state-run health insurance exchange, the rules for you may be different.)
Whether you plan to renew or change plans, you’ll want to log in to your Marketplace account and update or verify your financial information, Anderson says.
If you do decide to actively reenroll, you’ll be prompted during the enrollment process to update your financial information—so you can be sure to get the savings you’re entitled to, Anderson says.
7. You may miss out on new higher subsidies
A lot more subsidies—higher ones, even—are available this year, thanks to the American Rescue Plan Act (ARPA). The ARPA increased premium subsidies across all income levels and extended eligibility to those with incomes higher than 400 percent of the poverty level.
For most people, these higher subsidies took effect in 2021 and will continue through 2022. But if you did not take advantage of the new subsidies this year, you could miss out if you don’t actively renew your plan.
For example, if you were among the 800,000 ACA enrollees in a zero-premium bronze plan in 2021 (which has the highest costs when you need care), you may be able to upgrade to a silver plan with the new ARPA subsidies (and end up paying less for care).
8. You may have access to a better, more affordable plan
You’ll likely have more options to choose from in 2022 than in 2021—maybe a lot more, depending on where you live.
The average consumer in healthcare.gov states will have 83 health plans to choose from in 2022, compared to 46 plans in 2021, according to the Kaiser Family Foundation.
One of these new plans may be a better fit for you than the one you chose last year—but you’ll never know unless you do a little bit of comparison shopping.
9. You could get a vision and/or dental plan
If the plan you’re on currently does not offer a vision and/or dental plan, you may be able to find a different plan that does, says Anderson.
“Some plans offer them, some don’t,” he says. “So if you currently don’t have them and you don’t look around, you’re not going to have them next year.”
10. It’s easier than ever to find the best plan for you
Look, we get it—a good insurance plan is hard to come by, and it’ll cost you, either way. But the good news is more help than ever is now available to you. That’s thanks, in part, because funding for navigators, trained enrollment experts who can help you find said plan, has been restored in healthcare.gov states following years of substantial cuts.
“There is a fourfold increase in navigators this year,” Donovan says. Many navigators offer new resources like extended hours, remote assistance, and language translation services too. And their services are totally free. (Find contact info and hours via healthcare.gov here for navigator programs near you.)
Of course, you’re also welcome to speak with a licensed insurance agent at 1-800-273-8115 to see if there’s a UnitedHealthcare plan to fit your unique needs and budget.
One last thing: You may not be automatically re-enrolled in the first place!
Keep in mind that you may not be signed up for automatic re-enrollment. If you are, a letter from your insurance company should be arriving in the mail, telling you if you’ll be auto-enrolled in your 2021 plan or a similar plan.
Healthcare.gov. Retrieved from https://www.healthcare.gov/keep-or-change-plan/automatically-enrolled/. Accessed November 22, 2021.
Healthcare.gov. Retrieved from https://www.healthcare.gov/keep-or-change-plan/choices/. Accessed November 22, 2021.
KFF.org. October 29, 2021. Retrieved from https://www.kff.org/health-reform/issue-brief/ten-changes-to-watch-in-open-enrollment-2022/.
KFF.org. October 29, 2021. Retrieved from https://www.kff.org/health-reform/issue-brief/explaining-health-care-reform-questions-about-health-insurance-subsidies/
Healthinsurance.org. September 27, 2021. Retrieved from https://www.healthinsurance.org/faqs/should-i-let-my-individual-health-insurance-plan-automatically-renew/.
HealthReformBeyondTheBasics.org. August 2020. Retrieved from https://www.healthreformbeyondthebasics.org/key-facts-auto-renewal-of-aptc-for-2018-in-healthcare-gov/.