If you’re one of the nearly 17 million Americans planning to buy health insurance for you or your family for 2023, exploring your coverage options might seem daunting. Understanding the basics behind the healthcare insurance marketplace can help cut through the confusion.
Commercial individual health insurance plans are primarily for people who don’t have insurance coverage through their employers and don’t qualify for coverage through other options like Medicare, Medicaid, or the Children's Health Insurance Program (CHIP). Toward the end of each year, there is an “open enrollment period” (OEP) for buying individual coverage for the coming year. For benefits to begin in 2023, OEP runs from Nov. 1, 2022 through Jan. 15, 2023. (You must enroll by Dec. 15, 2022 if you need coverage to start on Jan. 1, 2023.)
The best place to start shopping depends on where you live. In Pennsylvania, for example, the online marketplace is called Pennie. If you do not live in Pennsylvania, you can start with the federal Health Insurance Marketplace at healthcare.gov.
You’ll likely find multiple coverage options depending on your healthcare needs and budget, but here are a few things you might want to consider:
Are the doctors or hospitals I prefer to use part of the plan’s network?
Does the plan offer telehealth services so I can access care remotely if needed?
Do I need prescription drug coverage?
How much are the copays for visits to my primary doctor, specialists, urgent care, or emergency rooms?
If you’re looking for individual or family coverage, Capital Blue Cross has affordable, high-quality plans that provide no-cost preventive care, access to an extensive network of doctors and hospitals, and even wellness rewards for reaching certain personal health goals.
If you’re concerned about affordability, you may be eligible for a subsidy or cost-sharing reductions when you purchase your coverage through Pennie, which may help make coverage more affordable. Financial assistance is based on factors like your household income, how many people are in your household, and where you live. For information on whether you may be eligible for assistance, visit the Pennie website.
Still need help? Here are some useful places to start:
Visit Capital Blue Cross’ website for more details on individual and family plans.
Call Capital’s toll-free assistance line at 800.451.1181.
Quality healthcare coverage is important not just to your overall health, but also for your peace of mind. Understanding your healthcare needs, and your coverage options, can help you and your family make the best decisions to stay healthy.