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Each year, the federal government sets an enrollment window for people to shop for health insurance coverage that goes into effect the following calendar year.
That signup period begins Wednesday and runs through Jan. 15, 2024, for plans on the federal marketplace.
This happens because of the 2010 health care reform law, the Affordable Care Act, signed into law by former President Barack Obama, which is why it has the nickname Obamacare.
Last year, Florida led the nation in the number of enrollees through the marketplace. More than 3.2 million Florida residents signed up for plans at healthcare.gov — an increase of more than 500,000 people from 2022, according to the Centers for Medicare & Medicaid Services.
To help people understand all the confusing components of health insurance, the federal government funds helpers called navigators. They guide people through the signup process, free of cost to the enrollee.
“We are unbiased and we will actually guide you into making sure that you select the proper insurance plan that fits your household best,” said Shirley Dominguez a navigation program community engagement specialist and senior lead navigator at Epilepsy Alliance Florida.
The monthly cost of a plan is tied to the deductible, which is what one pays for covered services before the insurance plan starts to pay. The lower the deductible, the higher the monthly premium.
For the 2024 coverage year, the federal government has capped what ACA enrollees will spend out of pocket in one year at $9,450. After that amount is exhausted, the insurance company pays the bills. CMS increased the out-of-pocket maximum from $9,100 for individual coverage in 2023.
Out-of-pocket costs include copayments, which is what a doctor may charge for the visit, and coinsurance, which is a percentage of the cost a patient will pay for a generic drug, for instance.
Marketplace enrollees who qualify for a tax subsidy, based on income, can choose to have their monthly premiums lowered right away or receive a lump sum tax credit when they file their taxes.
Dominguez recommends that anyone who wants to keep a doctor should call that physician's office and ask which health insurance plans they accept from the marketplace exchange specifically, so they can try to buy a plan that covers them by that provider.
If you miss the Jan. 15 deadline, enrollment in a plan would be possible in the event of a life change, such as getting married or divorced, having a child, or moving to a new ZIP code.
Learn more by visiting healthcare.gov.
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