Examine Plan Networks Closely

Research plans for convenience to nearby in-network doctors, clinics and facilities. You will avoid wasting time and money by looking for someone who offers suitable locations. You’ll also be more likely to get the preventative and daily care you need to stay healthy and avoid more expensive problems later.

When you use the Marketplace to search for plans, some of the information provided, including coverage networks, may be outdated, Brooker said.

When investigating whether your providers or medications are covered, you may need to call insurance companies or ask your insurance agent to do so for the most up-to-date information. “Healthcare.gov relies on data files that insurance companies give them, which are known to be bad and inaccurate,” Brooker said.

Apply for Federal Subsidies

This is the move that could save you big if you qualify. Premium tax credits, which reduce the amount you have to pay for Obamacare premiums, were included in the Affordable Care Act. American Rescue Plan Act 2021 made the loan available to more people for 2021 and 2022, and these changes have been extended through 2025. Inflation Reduction Act.

As a result, 92% of enrollees receive premium tax credits and half receive premiums. reducing cost sharing (which reduces your maximum out-of-pocket amount). Four out of five 2025 ACA enrollees would be able to get coverage for $10 a month or less after subsidies. You can apply for a loan by reporting your income and other information using the Health Insurance Marketplace.

Research Government Support Programs

Some states, including California, New Mexico and New York, also offer state-based subsidy programs that will expand in 2025. According to Covered California, a person earning up to $75,000 in California will be able to get help with premiums in 2025.

For revenue estimates, review your Marketplace information based on your 2025 revenue, not 2024. Also examine the number of members in your household. Count yourself, your spouse, and anyone else you apply for tax purposes, even if they don’t need coverage. Income and household factors may affect your eligibility for rebates.

Review New DACA Qualifications

If you are an immigrant protected under Deferred Action for Childhood Arrivals (DACA), your insurance costs may be reduced if you qualify for premium tax credits and cost-sharing reductions.

Before November 1, 2024, DACA recipients cannot sign up for health insurance through the Marketplace or the government-provided Essential Health Program. As of November 1, DACA recipients are considered legally present for eligibility and enrollment on the Marketplace plan.

However, a lawsuit is being filed against this new extension.

Protect Your Personal and Plan Information

New changes taking effect in 2024 limit how brokers can enroll you in an ACA plan due to complaints from consumers and honest brokers. Some unscrupulous agents and brokers signed consumers up for coverage without their knowledge or switched them to a new plan, costing consumers time and money.

The Marketplace Call Center at 1-800-318-2596 can resolve coverage issues if you have unknowingly signed up for or switched to a plan.

From January 2024 to August 2024, Centers for Medicare and Medicaid Services (CMS) It received 90,863 complaints that consumers had their Marketplace plans changed without their consent and 183,553 complaints that consumers signed up for Marketplace coverage without their consent.

“Of more than 90,000 complaints, CMS suspended or terminated 1,478 brokers,” Brooker said. “With new permitting requirements, accountability from CMS, and the elimination of bad actors, I am hopeful that we will achieve stability in the market and allow brokers to refocus on the needs of consumers without these unacceptable complications.”

Contact a Broker for Help

A qualified health insurance broker can perform many of the above steps for you or help you do so, Brooker notes. A health insurance broker or agent can help you understand how to calculate your income, even if you’re self-employed or retired but don’t yet qualify for Medicare.

“Insurance is confusing, so let the people who have figured it out help you.”

He suggested asking a broker which insurance companies they work with and sell to. Ideally, you want to have maximum access to most carriers to take advantage of the options. In some areas, insurers work with only in-house staff, while others may work with up to 50 carriers across multiple states.