Before Your Health Insurance Renews, Read This

What Changed

For the last few years, extra federal help kept Marketplace plans unusually cheap. That extra help has now ended. The regular rules are back, and they are less generous.

• There’s an income limit again. Earn even $1 over it, and the help drops to zero.
• Help is smaller below the limit, too. Many people will pay more than they did before.
• Prices are up. Many insurers raised rates for the new plan year.
• Guessing wrong costs more. If your income ends up higher than you guessed, you repay all the extra help at tax time.

Where the Income Limit Falls

The cutoff is 400% of the federal poverty level. Here’s what that looks like for common household sizes:

Household size	Help stops above
1 person	$63,840
2 people	$86,560
4 people	$132,000

Based on federal poverty guidelines for the 48 contiguous states and DC. Alaska and Hawaii are higher.

Who Feels It Most

• Self-employed people and small business owners
• Early retirees who aren’t on Medicare yet
• Couples and families just over the income line
• Anyone whose income changes during the year

Don’t Just Let It Auto-Renew

If you do nothing, you’ll likely be renewed into the same or a similar plan. Your help gets recalculated using old information. That can mean a surprise bill now, or another one at tax time.

Instead, update your income and compare your options. In most states, sign up by December 15 for coverage that starts January 1. Dates vary, so check the enrollment deadlines for your state. Want a second set of eyes? Call 888-730-6031.

Who You Work With Matters

Not every plan, or every agent, puts the full picture in front of you. Some plans come bundled with extras you never asked for. Others look cheap until you see the deductible.

A good agent shows you everything before you sign. That means what’s covered, what’s not, and exactly what you’ll pay. Nothing should be a surprise after you enroll.

Over the Income Limit? There Are Options

Paying full price doesn’t have to mean settling. Many states also offer private plans outside the Marketplace, such as short-term health insurance. These plans aren’t ACA coverage, so they aren’t the right fit for everyone. A licensed agent can help you weigh the trade-offs. For a deeper look, read who lost subsidy help and what to do.

What Happens If Your Health Insurance Renewal Is Automatic?

If you do nothing, your health insurance renewal usually happens on its own. The Marketplace keeps you in the same plan, or moves you to a close match. However, it uses the income and household details already on file.

That shortcut can cost you. For example, a raise or a new job can change your savings. Likewise, a new baby or a divorce changes your household size. As a result, your monthly price can be wrong all year.

• Your plan may change. Carriers adjust networks, drug lists and deductibles each year.
• Your price may change. Rates and savings are recalculated for the new plan year.
• Your doctors may leave. A renewed plan can drop a doctor you see often.

So read your renewal notice line by line. Then compare it with other plans in your area. Need help reading it? Call 888-730-6031.

How Do You Update Your Income Before Your Plan Renews?

First, log in to your Marketplace account during open enrollment. Next, open your application and update your income, household and address. After that, review the new savings estimate before you pick a plan.

Use Your Best Estimate for the Coming Year

Your savings are based on next year’s income, not last year’s. Therefore, plan for raises, bonuses, side work and job changes. If you are self-employed, use your expected net profit.

A careful estimate protects you at tax time. Meanwhile, you can still update it during the year if your income changes. Our guide to health insurance subsidies explains how the savings are calculated.

What If Your Insurance Company Is Leaving the Marketplace?

Several carriers are leaving some states for the next plan year. For instance, Cigna is leaving the ACA marketplace, and its individual plans end December 31. In addition, other carriers are shrinking their service areas in certain counties.

If your carrier leaves, you must choose a new plan. Otherwise, the Marketplace may place you in a plan that does not include your doctors. Read what to do when your insurance company leaves the marketplace for the next steps.

Not sure if your carrier is staying? An agent can check your county in minutes. Call 888-730-6031.

How Can You Lower the Price at Health Insurance Renewal?

A higher renewal price is not the final word. In fact, small changes often bring the monthly cost down. Try these steps before you accept the new rate.

• Compare every metal level. A Bronze or Silver plan may fit your budget better.
• Check smaller networks. An HMO or EPO often costs less than a PPO.
• Review cost-sharing savings. Lower incomes can qualify for lower deductibles on Silver plans.
• Drop extras you do not use. Remove bundled add-ons that raise the total.

Also, look at the whole year, not just the premium. A cheap plan with a high deductible can cost more if you need care. Our open enrollment checklist keeps every step in order. For a quick side-by-side quote, call 888-730-6031.

What Are Your Options If You Earn Too Much for Help?

Above the income limit, you pay the full price for a Marketplace plan. Even so, you still have choices. Some families save by switching metal levels or networks. Others look at private plans outside the Marketplace.

• A different Marketplace plan: a narrower network can lower the monthly price.
• A higher deductible plan: this can pair with a health savings account.
• Short-term coverage: available in approved states for healthy applicants.

Each option has trade-offs, so compare them side by side. Our page on health insurance options without subsidies walks through each one.

How Vivna Helps

• Licensed agents who explain your options in plain English
• Plans from 50+ carriers, compared side by side
• Help checking what you qualify for
• No cost to talk with us

Every state has its own plans and prices. Find your state’s health insurance options to see what’s available where you live.