Understanding Health Insurance Changes for 2021

Understanding Health Insurance Changes for 2021

Healthcare reform is always a topic of conversation, now more than ever, so if you’re confused on what will happen with your coverage in 2021, you’re not alone! We are here to help you understand what to expect in terms of health insurance this year.

ACA has not been repealed or replaced, and lawsuit doesn’t affect enrollment in 2020 plans

So for the time being, nothing has changed about the ACA. It could be a very different story in six months however, but unfortunately we won’t know much more until the Supreme Court issues their ruling in the case.

Individual Mandate Penalty No Longer Applies (in most states)

The repeal took effect back in January 2019, which means there is no longer a federal penalty for being uninsured in future years.

The rest of the ACA remains in effect

Other than the mandate penalty repeal, the rest of the ACA is still fully in effect, including premium subsidies, cost-sharing reductions, guaranteed-issue coverage, Medicaid expansion, employer mandate, pre-existing condition protection, etc.

Maximum Out-of-Pocket Limit Increasing to $8,550

In 2021 the maximum out-of-pocket limit is increasing to $8,550 from $8,150 the year before (2020). This limit applies to all non-grandfathered, non-grandmothered health plans.

Average Premiums are increasing slightly for 2021

For the third year in a row, overall average premiums for the benchmark plan are decreasing for 2021. However, enrollees who received premium subsidies in 2020 may find their subsidy amounts are smaller in 2021, thus resulting in slightly higher premiums. We encourage and assist our clients in shopping carefully during open enrollment.

Short-Term Plans continue to be available in most states

There are only 11 states where no short-term plans are available at all, however the other states continue to offer short-term plans. Some of these plans are more robust than the traditional short-term plan, thought of a s a middle-ground between short-term coverage and ACA.

Large Group, Medicare, and Medicaid

For clients who receive insurance from Medicare or Medicaid, the changes for 2021 will generally be the same sort of changes that happen each year. More importantly, there is a special Medicare Advantage open enrollment period from January 1st to March 31st where clients are able to enroll in Medicare Advantage or Original Medicare plans.

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