Deadlines approaching for 2023 health insurance decisions

Some big cost savings are coming for seniors on Medicare next year, including caps on insulin costs, but such changes underscore the importance of preparing for health insurance choice deadlines, even for people who don’t participate in the seniors’ program.

Open enrollment, the opportunity for people to choose a health insurance plan for 2023 under the Affordable Care Act, extends to January 15, an earlier deadline should be noted.

“The December 15 deadline is crucial for those who have current plans because on December 15 your plan resets. Whatever you have then, that’s coming Jan. 1,” said Keith Ballingall of Health Market Connect, a federally funded health insurance navigator in Concord, during a webinar Wednesday on changes in the health market.

“It’s so important to review your plan before December 15,” he said. Among the issues: “Some of the plan names have changed so you might think you’re going into a different plan, but it could be the same.”

The Anti-Inflation Act passed by Congress this year and signed into law by President Biden will offer a number of financial benefits to seniors on Medicare, the seminar noted. Many vaccines, including those for shingles, a common disease among seniors, and pneumonia will be free next year. Also, no one on Medicare pays more than $35 a month for insulin.

The bill gives Medicare the ability to negotiate the prices of many drugs in later years and limits the out-of-pocket cost of prescription drugs for Medicare beneficiaries to $2,000 per year beginning in 2025.

This benefit does not apply to people who purchase commercial health insurance unless further changes are made, although this seems unlikely at the federal level at this time.

“We hope states will push for this to be rolled out into commercial operations,” said Lucy Hodder, law professor at UNH’s Franklin Pierce School of Law and director of health law and public health policy programs. “We’ll see if the states pick up where the federal agencies left off.”

Another change at ACA next year is the end of the so-called “Family Mistake.” Previously, individuals with a family member who had health insurance through their work could not receive a government-subsidized Affordable Care Act marketplace plan. Now they can, albeit within limits.

Individuals can enroll in a plan through the federal government’s website, healthcare.gov. Two navigators, First Choice Services and Health Market Connect have people available to offer advice or do research to help with decision making. Navigators cannot recommend a specific plan.

The programs will be offered next year through the federal marketplace Healthcare.gov by Ambetter, Harvard Pilgrim and Matthew Thornton/Anthem. Premiums have increased by an average of 4.8% this year, although increases vary by company and level of insurance taken out.