The Open Enrollment period in Year 10 has become one of the most challenging. Of course, it’s nothing compared to Year 1, when the healthcare.gov website didn’t work, and we were in the middle of a government shutdown. Or the challenges we faced during 2020 when we had to shift all our appointments to virtual.
What makes this year difficult is that the Marketplace in the state of Florida is working as a Marketplace the way it was intended. That means more competition and more choice, and thus consumers are having a harder time finding a plan that fits their needs. In Central Florida, we have 10 different carriers offering 189 plans. Most of the plans are in-network with only one of our two major hospital systems. Since many group practices are now owned or operated by our hospital networks, it limits consumers’ choice of providers. One of our pediatric hospitals accepts very few Marketplace plans at all.
Open Enrollment Period and 2023 Coverage
Another big challenge has come from the fact that new carriers entering the market in Central Florida are HMOs. That benchmark plan (second lowest cost silver plan) was, for the last few years, an EPO, which allows consumers to receive care from a specialist without a referral. That plan is now an HMO. This creates additional barriers for members who do not already have an established Primary Care Provider. These days, patients often wait months for an initial visit with a PCP, even if that provider is accepting new patients.
I remember working with a woman in her 20s enrolled in a silver HMO plan. Because she was young and healthy, she purchased coverage mainly for a catastrophic event and hadn’t bothered to establish a relationship with the assigned PCP. She visited the emergency room with chest pains only to discover that she had a cardiac issue. The ER docs encouraged her to follow up with a cardiologist as soon as possible. But because she needed a referral for such a visit and didn’t have a PCP, her care was delayed several weeks.
Health Insurance Marketplace Departures
We had a carrier exit the market in Florida statewide just a few weeks before Open Enrollment 2023. This plan was an EPO that didn’t require referrals for specialists and was closely affiliated with one of our major hospital networks. Members received a letter “crosswalking” them into a plan that was an HMO and affiliated with a completely different hospital network. Those consumers who don’t speak to a navigator and simply allow the Marketplace to enroll them in this plan will discover soon enough that they can no longer see their established doctors and that their medications may not be covered.
Finally, the end of the “family glitch” which denied Florida Marketplace tax credits to spouses and children of employees with affordable employer coverage offers is a fantastic change. Yet it also means families must re-assess their options and decide what works best; navigators can help them weigh the options. There hasn’t been a lot of publicity about this change, so many families may remain uninsured into 2023 when they could have enrolled in affordable coverage.
Open Enrollment Dates for 2023
The open enrollment process for the 2022 and 2023 plan years will begin on November 1, 2022, and end on January 15, 2023. This is the same open enrollment period that was in effect for previous years. You can enroll in a plan through the Health Insurance Marketplace, your state’s marketplace, or directly through an insurance company.
The special open enrollment period is a time when you can sign up for health insurance outside of the normal enrollment period. This is usually because you’ve had a life event, like losing your job or getting married, which means you need to get coverage. The special open enrollment period is usually shorter than the regular enrollment period, so it’s important to sign up as soon as possible.
Need Enrollment Assistance?
Covering Central Florida offers free help enrolling in health insurance through the Health Insurance Marketplace. All services are offered completely free of charge. Contact a Certified Marketplace Navigator to get started today.
