Dec. 15 Still the Best Deadline to Buy Marketplace Health Insurance, Despite Extensions

An extended deadline can encourage procrastination, but this is no year to wait to compare your health coverage options for Affordable Care Act (ACA) plans. Healthinsurance.org released today four reasons why – for many – it’s best to enroll by Dec. 15.

“The longer open enrollment period may seem like extra wiggle room during the busy holiday season, but for most marketplace buyers, Dec. 15 is still the deadline you want to keep in mind,” said Louise Norris, a licensed agent and analyst with healthinsurance.org. 

The enrollment window is longer this year – through Jan. 15 in nearly every state. However, in most states, Dec. 15, 2021, is still the last day to enroll if you want your ACA coverage to take effect Jan.1, 2022. And this year, it’s more important to compare plans early, since this open enrollment includes unprecedented changes in the marketplace that affect the cost, availability and coverage of available health plan options.

“It’s never in your best interest to let your ACA coverage auto-renew from one year to the next,” Norris said. “It’s one thing if you do your homework and actively decide to stay with the same plan. But you can’t just count on your plan costs and coverage to stay the same, especially in 2022.”

Here are some of the top reasons people should evaluate their health plan options for 2022 – and do so before Dec. 15. (We’ve included actual scenarios from marketplace buyers, whose names have been changed to protect their privacy. Read more about these comparison scenarios.) 

Your state’s enrollment deadline may be different

It’s important to know the enrollment deadline for your state. While your plan will likely renew automatically, you could find yourself uninsured if it doesn’t. 

If you live in a state with an extended enrollment period, you will have coverage for 2022 if you enroll by Jan. 15. However, you may have a gap in coverage for January if you enroll after Dec. 15 because health plan enrollments after Dec. 15 may not take effect until Feb. 1 or March 1, depending on the state you live in and the terms of the plan. 

You could miss out on cost savings

Thanks to the American Rescue Plan, premium subsidies are more widely available and also larger for the 2022 plan year. Delaying coverage by waiting to enroll could mean missing out on these cost savings for the month of January. 

Real-life scenario: Dennis is single, 52 years old, and lives in Mesa, Arizona. In 2021, he pays $0 for his premium after his subsidy is applied. But the plan has a $6,000 deductible and an out-of-pocket cap of $8,000. For 2022, Dennis chose a plan that will cost him $4 a month after his premium tax credit is applied. It has a $0 deductible and an out-of-pocket cap of $2,850. By comparing plans, he’s reducing his deductible alone by $6,000.

You could be surprised Jan. 1

Your plan costs and benefit details – including provider networks and covered drugs – can change from year to year, even if your same plan continues to be available and you are able to auto-renew for 2022.  If your plan auto-renews before you participate in open enrollment, Jan. 1 could bring surprises such as different medical and prescription drug benefits, changing plan costs and a different provider network. 

By evaluating your coverage options before Dec. 15, you can anticipate plan and subsidy changes and have time to decide whether it makes sense to stay put – or find a new plan for 2022.

Real-life scenario: Dee is a 55-year-old single woman in Houston, Texas. This year, her coverage costs her $41/month after her premium tax credit (subsidy) is applied. But her renewal notification said if she keeps her current plan in 2022, it will cost her $152/month. After reviewing her options, Dee chose a new plan costing $57/month in 2022 (after her premium tax credit is applied). The new plan has a $0 deductible, and the $15 copay for primary care visits will still fit in her budget. 

January expenses might not count toward your new plan’s deductible

If you let your plan auto-renew – but then decide after Dec. 15 that you prefer a different plan – you might end up with higher total out-of-pocket costs in 2022. You’ll have to start over at $0 in out-of-pocket costs on your new plan, even if you incurred out-of-pocket expenses under the auto-renewed plan early in the year.

“All of this is a reminder of how important it is to actively review your coverage before Dec. 15,” Norris says. “How will you know what you’re leaving on the table, if you never check your options?”

Find more detailed information about open enrollment in healthinsurance.org’s ACA Open Enrollment 2022 Guide.

Healthinsurance.org is a free online source of consumer health resources, including information about individual health insurance, major medical insurance and affordable medical insurance.