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What To Do If Your health insurance changes

Commissioner Teresa Miller is alerting consumers who have bought individual health insurance and do not get coverage from their employer to watch for communications from their insurer regarding their coverage for next year.

By November 1, insurers should send policyholders a letter regarding any changes in coverage for 2016. Insurers will notify consumers if they are:

  • Renewing the consumer’s coverage under the current plan,
  • Moving the consumer to a new plan with a different deductible and premiums,
  • Moving the consumer from a plan in the federal health insurance marketplace (marketplace), throughwhich consumers are eligible for a subsidy to help afforcoverage, to an off-marketplace plan for which subsidies are not available, or
  • Not offering this plan next year, so the consumer will have to shop for a new plan.

Commissioner Miller notes that individuals can shop for new plans starting November 1. Current plans are in effect until December 31, and consumers have until December 15 to enroll in a new plan to be covered by that plan starting January 1 and avoid any lapse in coverage.

A total of 19 insurance companies are selling health plans to individuals statewide. A list of health plans currently available to Pennsylvania residents through the federal marketplace is available at www.healthcare.gov or by phone at 1-800-318-2596. The list of plans available for 2016 will be updated by November 1. Consumers can get free in-person enrollment assistance from insurance agents or enrollment assisters by visiting www.localhelp.healthcare.gov

Remember, consumers are only eligible for subsidies to help pay premiums for plans bought through the federal marketplace at www.healthcare.gov. Individuals can also buy plans directly from insurance companies. These plans must all contain the same minimum benefits, and some of the plans sold by insurers may contain additional benefits.

Commissioner Miller is encouraging everyone with individual health plans to shop around even if your coverage is continuing in 2016. She urged consumers to pay particular attention to whether their insurer is keeping them on a marketplace plan for next year because consumers moved to non-marketplace plans are not eligible for subsidies and must return to the Marketplace, www.healthcare.gov. to buy a plan there in order to qualify for subsidies.

Information on proposed rates for 2016 individual and small group health plans is available here. For examples of plans and rates available where you live, visit our Proposed 2016 Affordable Care Act Rates by Rating Area.