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Learn about Your Local Coverage Options

Today’s video addresses the importance of knowing if your coverage options change, particularly in the individual market, because this is annual open enrollment season. However, this subject applies to everyone making coverage decisions because options can change. One has to consider the insurance company, the product, and the network in order to make the best decision possible. Reviewing options can be tedious work but you don’t want to miss out on an option that might be a better one for you and your family.

The individual market has been tumultuous since the Affordable Care Act reforms of 2014 took effect, especially in the early years. I’d like to provide an example of Connecticut which, compared with many other state environments, is more manageable because of its relatively small size.

In the first year of the Affordable Care Act reforms, 2014, consumers in Connecticut could choose from products offered by three insurance companies. In 2015, offerings were provided by six insurance companies but by 2018, three insurers had left the market and the non-profit cooperative option was closed due to an Insurance Department ruling. As a result, since 2018, only two insurers, Anthem and ConnectiCare, have offered products in the state. Both companies have offered many products, both on and off the Marketplace, but networks narrowed as we have seen in so many other state environments.

For 2022, ConnectiCare is offering plans with a national network, both on and off the Marketplace, reversing the trend of narrower and narrower networks. This development is wonderful news for many people. Anyway, the point here is not for people to learn about Connecticut but to understand that to not stay abreast of how your options change may leave you with an option that is less desirable than what you could have elected.

Understanding your coverage options in the individual market is particularly important because almost everyone must make a decision during the annual open enrollment window. But the same approach is relevant to all coverage decisions. In previous videos we have discussed how Part D and Advantage plans can change from year to year. Medicare supplement options were stable for decades but a number of changes have occurred in the last 15 years. It is common for an employer or union to change insurance companies and offer new products with different networks of providers so review that information carefully too.

In sum, you don’t want buyer’s remorse and end up locked in to your current plan because that was easier than reviewing the options available to you.