Harris: ACA open enrollment deadline is fast approaching

By Charlestien Harris

The end of the year is coming, and usually, we don’t think about our health concerns until the new year. However, there is a deadline approaching fast: the Affordable Care Act (ACA) enrollment for health insurance. The open enrollment deadline for ACA plans is Dec. 15, with coverage starting in January. 

The annual open enrollment period for Affordable Care Act health insurance policies started on Nov. 1 and ends on Jan. 15. But if you want your new plan coverage to start on Jan. 1, you must enroll by Dec. 15. (If you enroll in a plan between Dec. 16 and Jan. 15, your coverage will start on Feb. 1 instead. If you buy coverage through one of the health insurance marketplaces created by the Affordable Care Act (ACA) of 2010, this period is your opportunity to enroll or re-enroll in a plan for 2025.

There are a few things to consider when choosing a healthcare plan. Let’s take a look at those considerations:

1. There are four “metal” categories. The four categories of health insurance plans include Bronze, Silver, Gold, and Platinum. These categories show how you and your plan share costs. Plan categories have nothing to do with the quality of care. Be sure to do your best research to find out which one of these plans will cover what you need covered and how much you will be required to pay for out-of-pocket expenses.
2. Your total costs for health care. You pay a monthly bill to your insurance company (a “premium”), even if you don’t use medical services that month. You pay out-of-pocket costs, including a deductible, when you get care. It’s important to think about both kinds of costs when shopping for a plan. Consider how your plans work together to get the most benefit and save you money when it comes to paying for your health care services.
3. Know your plan and network types. There are HMO, PPO, POS, and EPO plans. Some plan types allow you to use almost any doctor or healthcare facility. Others limit your choices or charge you more if you use providers outside their network.

• HMO stands for Health Maintenance Organization. It is a type of health insurance plan that usually limits coverage to care from doctors who work for or contract with the HMO. It generally won’t cover out-of-network care except in an emergency. An HMO may require you to live or work in its service area to be eligible for coverage.
• PPO stands for Preferred Provider Organization, which is a type of health insurance plan that offers coverage through a network of selected healthcare providers. PPOs have a list of preferred providers, and patients pay less if they use those providers. However, patients can also seek care outside of the network but will pay more for coverage.
• POS stands for Point of Service, which is a type of health insurance plan that allows you to use in-network and out-of-network providers:
• In-network: You pay less if you use doctors, hospitals, and other healthcare providers that belong to the plan’s network. You’ll have a lower deductible and coinsurance if you see a provider in the POS network.
• Out-of-network: You can see an out-of-network provider, but you will pay more of the bill. You’ll need a referral from your primary care doctor to see a specialist.
• EPO stands for Exclusive Provider Organization. It is a type of health insurance plan that limits covered services to doctors, specialists, and hospitals within the plan’s network. EPOs are a combination of health maintenance organization (HMO) and preferred provider organization (PPO) plans.

Taking care of your health is a very important part of life, but just as important is being able to find and pay for quality healthcare. Learning how to navigate the complicated healthcare system may require you to do some major research when it comes to making a critical decision such as choosing a healthcare plan. For more information, or to apply for coverage or view plans, visit the federal government’s HealthCare.gov website.

For more information on this and other financial topics, you can email me at Charlestien.Harris@banksouthern.com or call me at 662-624-5776. 

Until next week – stay financially fit!

Charlestien Harris is our financial contributor, a financial expert with Southern Bancorp Community Partners whose articles are seen in a number of publications around the region.