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Health Insurance Marketplace 2024 Explained

Health Insurance Marketplace 2024 Explained

Al Waller: Marketplace Open Enrollment for health care insurance coverage is here through January 15, 2024, thus it’s the perfect time to brush up on tips for picking the best health plan to meet your needs for 2024. Whether it’s your first time enrolling, or you’re a seasoned enrollee— we’re here to break down the complex world of health insurance so you don’t have to!

Welcome to ClearPath – Your Roadmap to Health & WealthSM. I'm your host, Al Waller. Joining me today is Mihaela Vincze, public health expert, for nonprofit Transamerica Institute®. Today, we’re going to discuss some considerations for preparing for Marketplace Open Enrollment.

Before we get started, I want to remind our listeners that we would love to hear from you and get to know what topics you’d like to hear about. Please drop us a line at [email protected].

Al Waller: Welcome back, Mihaela.

Mihaela Vincze: Excited to be here, Al.

Al Waller: Let’s start with the basics, who is eligible for Marketplace Open Enrollment?

Mihaela Vincze: Marketplace Open Enrollment is available to individuals and families who do not have access to affordable health insurance through an employer, or who do not qualify for government programs like Medicaid or Medicare.

Al Waller: Can you quickly go over what Medicaid and Medicare entail for those who are curious?

Mihaela Vincze: Of course!

  • Medicaid is a federal and state program that provides health coverage to low-income individuals and families.
  • · Medicare, on the other hand, is a federal health insurance program that provides coverage to individuals who are 65 years or older, as well as to those with certain disabilities.

Al Waller: So, for those who are self-employed, or perhaps work part-time, or are gig economy workers —the Marketplace would offer them an affordable plan.

Mihaela Vincze: That’s right. However, it is not limited to these groups. Anyone who is not covered by an employer-sponsored health insurance plan can sign up through the Marketplace.

Al Waller: Got it! So, why is Marketplace Open Enrollment so important?

Mihaela Vincze: Great question. Marketplace Open Enrollment is important because it allows us to sign up for or change our health insurance coverage for the following year—this year, the enrollment period is from November 1st to January 15, 2024. This is the only time of year when we can enroll in health insurance plans or make changes to our existing plans, unless we have a qualifying life event for a special enrollment period. Examples of these include having a baby, getting married, or losing coverage, etc.

Al Waller: Yes— open enrollment is designed to give us an opportunity to compare health insurance options and choose the best plan for our needs and budget.

Mihaela Vincze: That’s right. Health is always changing, so it’s important to make these adjustments on a yearly basis.

Al Waller: And it is important for us to take advantage of open enrollment to ensure that we have the coverage we need to stay healthy and protect ourselves financially in case of unexpected medical expenses.

Mihaela Vincze: I’m glad you brought that up because it’s a key reason why health insurance is so important. An example of an unexpected medical expense could be a sudden illness or injury that requires surgery or hospitalization. Even with health insurance, these types of medical expenses can quickly add up and become very expensive.

Al Waller: I think it goes without saying, but no one ever plans for a medical emergency! It is important to have health coverage to protect your health without facing significant financial burdens.

Mihaela Vincze: It really is!

Al Waller: Well, let’s dive into preparing for Marketplace Open Enrollment. Where should listeners start?

Mihaela Vincze: A good starting point would be to review your current plan. Looking at your current plan is essential to ensuring you have the type of coverage that would best meet your needs next year.

Al Waller: Yes— examining your current plans can help you decide if you still have adequate coverage.

Mihaela Vincze: Yes, ask yourself questions like do you envision yourself needing extra care in the following year? For instance, perhaps you have just been diagnosed with a chronic condition, and will be needing more doctor’s appointments, prescriptions, and follow-up visits. In this situation, evaluating the cost of premiums, deductibles, co-pays, coinsurance, and out-of-pocket maximums could be helpful for determining the type of coverage you’ll need.

Al Waller: Yes, asking those questions is essential. What else?

Mihaela Vincze: It's very important to consider your healthcare needs and how a health plan can help meet those needs. As I mentioned earlier, our health statuses change and it’s important to ensure that we’re getting the type of coverage that meets our needs for the best health and financial outcomes. It might be a good idea to make a list of questions to ask your insurance provider to ensure you have the coverage you need for certain conditions.

Al Waller: That’s a great point. Reaching out to insurance providers can help ensure that you have the level of coverage you desire from their specific health plans.

Mihaela Vincze: Yes, and I think that fits in well with my next tip… Do your homework and research health plans! There are so many online resources you can use to compare different plans and their costs.

Al Waller: What else should listeners consider?

Mihaela Vincze: There are different levels of health insurance plans offered through the Health Insurance Marketplace. Bronze plans have the lowest monthly premiums but the highest out-of-pocket costs, while Platinum plans have the highest monthly premiums but the lowest out-of-pocket costs. Silver and Gold plans fall between these two in terms of both premiums and out-of-pocket costs. It also may be a good idea to speak with a licensed insurance agent to help you navigate your options.

Al Waller: Yes- it’s imperative that we look at what options are out there! Can you list a couple of resources?

Mihaela Vincze: Sure, Al!

  • Healthcare.gov. This is the official website for the Health Insurance Marketplace, where you can find information about health insurance plans and enroll in coverage. You can also use the "Find Local Help" tool on Healthcare.gov to search for assistance from a broker or agent in your area.
  • Young Invincibles. Young Invincibles is a nonprofit organization that specifically helps young adults enroll in health insurance coverage—you can check out their website at younginvincibles.org.

Al Waller: Those are great. Thank you. Now what else should listeners be aware of?

Mihaela Vincze: Check for subsidies. Depending on your income, you may be eligible for subsidies to help pay for your monthly insurance premiums. Healthcare.gov is a great resource to see if you qualify.

Al Waller: Yes, you’d be surprised with how low those premiums can get based on your eligibility. Is there anything you’d like to wrap up with?

Mihaela Vincze: Mark your calendar and don't miss the deadline! Make sure to enroll during the open enrollment period, which runs from November 1st to January 15th. Missing the deadline could result in a gap in coverage.

Al Waller: So, let’s summarize the episode now! To prepare for the upcoming Marketplace Open Enrollment, you may want to:

  • Review your current health plan.
  • Assess your potential health care needs for next year.
  • Reach out to your insurance provider to see what’ll be covered next year.
  • Research other health plans.
  • Check for subsidies.
  • Mark your calendar, November 1st to January 15th, to make changes to your Marketplace plan.

Thank you again, Mihaela.
Mihaela Vincze: Of course, it was good to be here.

Al Waller: If you have comments, feedback, or topic ideas, please reach out to [email protected]. Don’t forget to hit that subscribe button so that you don’t miss an episode of ClearPath—Your Roadmap to Health & Wealth.

Until the next time, I’m your host Al Waller. Stay safe, be well, and thanks for listening.

ClearPath – Your Roadmap to Health & Wealth is brought to you by Transamerica Institute, a nonprofit private foundation dedicated to identifying, researching, and educating the public about health and wellness, employment, financial literacy, longevity, and retirement.

You can find our weekly podcast on WYPR’s website and mobile app, wherever you get your podcasts, and at transamericainstitute.org/podcast.

ClearPath – Your Roadmap to Health & Wealth is produced by Transamerica Institute with assistance from WYPR.

The information provided here is for educational purposes only and should not be construed as insurance, securities, ERISA, tax, investment, legal, medical, or financial advice or guidance.

Al Waller is a long-time Baltimore native and employment expert with a 30-year career in leading and advising locally and globally based corporations on matters including: Talent Acquisition and Retention, Employee Relations, Training and Development.
Mihaela Vincze is a public health expert and experienced health care educator. Serving as Transamerica Institute’s health care content developer, she shares insights on health and wellness on ClearPath—Your Roadmap to Health and WealthSM. Mihaela earned her master’s and bachelor’s degrees in public health at California State University, Northridge.