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Open Enrollment 2018: What to Expect

Oct 25, 2017 3 min read Kate Ashford

Key Takeaways

  • Enrolling in the marketplace for 2018? Compare those plans.
  • Take advantage of FSAs, HSAs and federal subsidies.
  • Want to save on premium costs? Consider a high-deductible plan.


Open enrollment for the health insurance marketplace is right around the corner. As you contemplate your benefits for 2018, here are some things to keep in mind.


Deadlines have shifted

Open enrollment for individual and family health insurance plans is shortened this year, from about 90 days to just 45—Nov. 1 to Dec. 15. Coverage will start Jan. 1 if you sign up during this period.



Don’t miss the window, because if you aren’t covered by employer-sponsored health insurance, this is your only chance to enroll until next year. Note that there should be an exception made if you experience a life event that triggers a special enrollment period. (Examples: losing your health insurance, moving, marriage, divorce, the birth of a child.)


You may have to provide more proof

If you’re hoping to be granted a special enrollment period because of one of the life events mentioned above, be aware that you’re going to have to submit more documentation Opens in a new window,  per the Centers for Medicare & Medicaid Services’ market stabilization rule, proving you did indeed get married, get divorced, lose coverage, have a child, etc.


You’ll have to be current on premiums

Previously, individuals could allow premiums to lapse at the end of the year and re-enroll in the same plan at the beginning of the following year. Current rules allow insurers to require people to pay past-due premiums before enrolling them again.


There will be fewer options

Many insurers are pulling out of various markets across the country, so you may have already gotten notice that yours won’t be offering insurance next year. Or you may find that you simply have fewer insurers to choose from, and, if you’re in a rural area, you may only have one choice.


Your rates will likely go up

In one analysis Opens in a new window of silver-level health insurance plans (the most popular) in 20 major cities and Washington D.C., the Kaiser Family Foundation found that 15 of these plans will see premium increases of 10% or more in 2018. Another analysis Opens in a new window from ACAsignups.net suggests premiums will increase by as much as 29% on average, nationwide. There are a (very) few states in which average premiums may decrease, but, for the most part, expect to see higher prices for 2018.


Compare coverage

Don’t re-enroll with the same health plan if premiums have become unaffordable. As with any insurance, it pays to shop around before committing. Contact a health insurance broker who can talk to you about differences between plans and which one makes the most sense for your family.


Make sure you can’t get coverage elsewhere

For instance, if you live with a domestic partner, are you eligible to be added to their health insurance plan? What about coverage through a spouse? If you’re under age 26, you can still be on your parents’ health insurance. Leave no stone unturned as you consider which health plan option is the best fit for 2018.


Use pre-tax accounts if you can

If you work for an employer that offers a flexible spending account for medical expenses, take advantage of it. If you are in the 25% income tax bracket, paying for health services with pre-tax dollars saves you 25% on costs, as you won’t have to pay taxes on that money. Add up this past year’s expenses and use your open enrollment period to adjust your FSA withholding, if needed.


Take advantage of subsidies

If you’re eligible, make sure you apply for federal subsidies that can lower the cost of health insurance overall. Try this calculator Opens in a new window from the Kaiser Family Foundation to see how much you can expect to receive.


Don’t shop based on premiums only

The marketplace plan with the lowest premiums might require the highest out-of-pocket cost sharing, which can hurt if you must see a doctor regularly. Make sure you compare the total costs of all plans, including premiums and expected out-of-pocket spending.


Consider a high-deductible plan

If you don’t have a chronic health condition and aren’t frequently at the doctor’s office, a high-deductible plan could save you money in the long run. Premiums for these plans are typically lower than those for traditional health plans, because consumers must pay more out of pocket for medical services before insurance kicks in. High-deductible plans also offer the ability to contribute pre-tax money to a Health Savings Account (HSA), where funds can grow over time and you can use the money at any point for medical costs.

A good exercise: Look at your past year of medical costs and estimate what you would have spent out of pocket for services plus lower premiums, compared to higher premiums with a traditional plan, plus copays. The caveat: A high-deductible plan could be more expensive if there’s an unexpected medical event, which is always a possibility. Use this Prudential calculator to ensure you have enough money in emergency savings to cover your deductible, if needed. Otherwise, you may want to stick with a traditional plan.


What you can do next

Try a health insurance broker to help you determine which plan is best for your situation, and check out this subsidy calculator Opens in a new window to make sure you’re getting all the help you can. If you’re thinking about a high-deductible plan, make sure you have the emergency cushion to support it.


Kate Ashford is a freelance journalist who writes about personal finance, work and consumer trends. She has written for BBC, Forbes, LearnVest, Money, Real Simple and Parents, among others.


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