10 Reasons to Shop ACA Health Plans

New plans have been added, premiums are rising, and pharmacies are closing across the US, which are just a few of the reasons you should compare Affordable Care Act (ACA) plans this year.

Here are the 10 reasons you should not just automatically renew your current ACA health plan.

1. The plan you have now may not be available.

Some insurers are leaving the marketplace, such as Oscar Health, which is withdrawing from California, and Cigna, which is exiting the Kansas and Missouri markets.

If your 2023 plan isn’t available and you don’t enroll in a new plan, you will be enrolled in a plan that most closely matches the one you currently have. But that plan may cost more and the doctors you see may not be in-network.

Even if your plan is available, there are other reasons to compare plans.

2. Your ACA plan premium may increase.

Premium costs are rising an average of 5%, so chances are you will pay more for the same plan. If you shop around, you could find a similar plan that costs less.

3. New plans may be available in your area.

Every year, plans enter and leave the marketplace. Check to see if a new plan:

- Costs less
- Covers more services
- Has a larger network of doctors, other healthcare providers, and pharmacies

4. Your in-network pharmacy may have closed.

Walgreens, CVS, and Rite Aid have closed or will close 1,200 pharmacies throughout the US by the end of 2024. You should compare plans to see if other pharmacies near you are in your plan’s network.

5. Your plan’s drug formulary may be changing.

A formulary is a list of prescription drugs covered by your plan. The formulary groups drugs into tiers, based mostly on the cost. The lower the tier, the lower the cost to you.

The medicines you take may no longer be on your plan’s formulary, or may have moved to a higher tier, which means they will cost you more. It is smart to compare plans to make sure the medicines you take are covered and you know the costs.

6. Your doctor of other healthcare providers you see may no longer be in-network.

Compare plans to make sure the providers you see are in-network.

7. Your health needs may have changed.

If you are seeing healthcare providers more often, a different metal plan might be less expensive in the long run. You may also be taking new medicines that might be less expensive through another plan.

⊕ Download Understanding ACA Metal Plans to learn more.

8. Your income or the number of people in your household changed.

Your household income and the number of people you claim as dependents (your household) may have changed. If so, you may be able to get more tax credits to reduce your monthly premium or save money by lowering your copays and deductibles.

⊕ Read Subsidies Help Lower Your ACA Health Plan Costs to see if you qualify for ACA cost savings.

9. Your benchmark plan may have changed, which could cost you more money.

A benchmark plan is the second lowest-cost silver plan. Only the lowest and second lowest benchmark plans have $0 premiums.

If you picked a $0 premium plan last year, that plan may no longer be the lowest or second-lowest cost silver plan. If that plan cost is higher than the benchmark plan in 2024, you will have to pay the difference in cost between your plan and the benchmark plan.

10. Your job-based insurance is not affordable.

If your job-based health insurance is not considered affordable—if it costs more than 8.39% of your household income in 2024—your family could qualify for financial help through tax credits and subsidies to lower the cost of their ACA plan.

⊕ Read our blog, An ACA Health Plan May Cost Less than Job-Based Insurance, to see how to calculate your plan’s affordability.

American Exchange can help you compare ACA plans

Want help comparing plans? Our licensed, independent health insurance benefits experts will listen to your needs, then compare all ACA plans available in your area. We help you find the best plan for your budget, health, and lifestyle needs at no cost or obligation to you. And we are available year-round to answer your insurance related questions. Contact us today.

Call: 1.888.995.1674 Email: enroll@americanexchange.com

Visit Our ACA Insurance Webpage

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Thanksgiving: November 24-25
Christmas: December 23-25
New Year’s Day: January 1

ACA Health Plan Resources

We publish a blog covering important ACA marketplace topics the second Tuesday of each month, and more often during Open Enrollment, which begins November 1st each year. We also create handouts to address common topics impacting ACA enrollees. Click on the link below to read or download:

American Exchange is a licensed health insurance broker. Robert Huffaker, NPN 13568432

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10 Reasons to Shop ACA Health Plans