If you don’t have health insurance through your employer, your family, or a significant other, ‘tis the season for enrolling in an affordable plan. December 15 is the deadline to apply for coverage beginning January 1, 2024 on Pennie, Pennsylvania’s official marketplace for buying health insurance with the financial assistance available under the Affordable Care Act.
Enrolling in a plan can be daunting (I know from experience), so I spoke with Devon Trolley, Pennie’s executive director, and Joanna Rosenhein, consumer engagement manager at the nonprofit Pennsylvania Health Access Network (PHAN), to get some advice. If you’re looking to renew your coverage or are one of the over 100,000 uninsured Philadelphians, here’s what you need to know.
There’s More Financial Assistance Available
Nine out of 10 people covered by a plan on Pennie receive financial assistance that pays for some or all of their premium, and one-third of them pay less than $50 a month for insurance. People are paying less than in past years, after Congress extended the expanded and increased subsidies it passed during the pandemic.
“If folks have looked at Pennie plans in the past and found that it's too expensive, we definitely recommend just taking another look,” said Rosenhein of PHAN.
You can use Pennie’s Cost Savings Calculator to estimate how much financial assistance you may be eligible for.
Plans Change Every Year – And So May Your Costs
If you’re already covered through a Pennie plan and don’t make any changes before the open enrollment deadline, you’ll be automatically re-enrolled in the same plan. But Rosenhein says it’s a good idea to check every year whether there might be a better one out there.
“The plans change drastically every year, the costs change,” she said. This year, two new plans are available to people in the Philly area, from Jefferson Health Plans and Highmark. Rosenhein also urges people to update their application if they’ve had any changes that could affect their eligibility or subsidy amount, like a change in income. Otherwise, when you file your taxes the next year, you could find that you’ve been paying a lot more, or a lot less, than you needed to. (I’ve been in the latter category, and it’s not fun.)
How To Shop Around for Plans
Wading through plans can feel like a taxing thought experiment weighing very different possible futures. Here are some tips to help make the process as painless as possible:
- Consider more than just the premium. Rosenhein says that if you’re going into a year where you expect to have a lot of medical expenses – having surgery, giving birth – forking over more for your premium might be a good idea. “That might mean you're paying more on a monthly basis, but overall for the year, your costs could be lower,” she said. Pennie gives a rough idea of which plans will end up costing you more in the end based on your situation.
- Make sure your providers and meds are covered. Pennie lets you enter your providers and medications and filter plans that cover them. You can compare up to three plans side by side. But, it’s still a good idea to confirm that your doctors participate in a given plan, as Rosenhein says there are sometimes hiccups with this tool.
- Ask for help. Rosenhein’s organization, PHAN, provides free, unbiased assistance with applying for insurance and selecting a plan on Pennie through their helpline. Just call or text (877) 570-3642.
If you miss the December 15 deadline, you have one more chance. If you sign up by January 19, you can still get coverage next year. It just won’t start until February 1, so you’ll miss a month of coverage under the new plan.
Don’t Wait!
Once the open enrollment period ends, you won’t have another opportunity to select a plan until next year, except in case of some major life events. “If someone waits until they get sick or injured, it's too late,” Trolley said.
