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On the Money: Consider key issues before choosing health plan

Tom Murphy Associated Press

The health care overhaul makes renewing insurance so easy you don’t have to do a thing. However, there are many reasons to resist this temptation.

More than 7 million people signed up for coverage through the overhaul’s public insurance exchanges after the first annual open enrollment window started last fall. Open enrollment returns starting Nov. 15, and experts say it brings with it the perfect chance to take stock of your insurance coverage, even if you like the plan you have this year. That coverage – or the cost of it – may change for 2015. Plus, new and better options also could be available in your market.

Here are some key questions to consider before finalizing your coverage for next year.

1. Why shouldn’t I let my plan renew automatically without doing anything?

Automatic renewal doesn’t guarantee that your plan or the bill for it will stay the same. It just ensures that you have something set up for next year in case you are unable to study your options and pick a plan during the enrollment window.

Your insurer will send you a letter outlining your 2015 coverage and detailing the policy’s terms, so you should look for changes to your plan and its price. The insurer may raise the deductible or coinsurance, items that could cause you to pay more out of pocket for care before most coverage starts. It also may change the premium or cost of coverage.

Many customers on the public exchanges used income-based subsidies or tax credits to help pay for their coverage. Plans that are automatically renewed also may come with this year’s subsidy amount, which could stick you with a bigger bill if your premium climbs in 2015.

In some cases, an insurer may automatically enroll you in another plan that’s similar to your 2014 coverage if it stops selling your old plan.

Your doctor also may no longer be in your coverage network. Check on that with both the doctor’s office and your insurer to make certain.

Even if you have no problems with your coverage for 2015, you should still consider other options. More insurers are expected to enter the exchanges, so an even better choice may be out there for 2015.

“The bottom line is everybody should go and shop in the marketplace,” said Rachel Klein, enrollment program director for the nonprofit advocacy group Families USA.

2. Will my tax credit or subsidy change?

That depends on your income and your insurance market. It’s estimated that more than 80 percent of the people who signed up for coverage under the health care law are receiving subsidies.

If your income changes or you think it will change, you need to update that part of your enrollment file after open enrollment starts in November. Think about whether you or anyone in your household may receive a raise next year or if you might make some more money through a second job. That could reduce your subsidy.

Look at last year’s tax returns for help. The number you need is your modified adjusted gross income.

Life changing events like marriage, divorce, the birth of a child or the loss of a job also can change your subsidy level.

Don’t think you can get away with skipping these updates. The government will catch up with you when you file your taxes. If your subsidy is too big in 2015, the overpayment could be taken from your refund or added to your bill when you file in 2016.

Subsidies are determined based on a benchmark plan in your market.

3. When do I have to have all of this figured out?

Customers will enroll in a new plan by Dec. 15 if they want coverage that starts Jan. 1. That gives you about a month to make a decision after open enrollment starts.

New Year’s Day is an important start date because all coverage purchased on the exchanges for 2014 ends Dec. 31 regardless of when you bought it.

The open enrollment period for next year ends Feb. 15. If you wait until then to buy a plan, the coverage won’t start until March 1.

4. Where can I find help?

Several websites can be good resources.

The federal government’s Healthcare.gov answers some common questions and offers details about the application process. It also links to state marketplaces. IRS.gov has videos that explain tax credits.

Another nonprofit advocacy group, Get Covered America, also lays out the enrollment process on its website, getcoveredamerica.org. Its features include links to teach you more about health insurance options and a calculator that helps determine subsidy help.

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