Healthcare is an expense many of us don’t love, but it’s a necessity.  Even if you’re young and healthy, an unexpected medical event can be costly – especially if you don’t have health insurance. Medical debt is the number one reason people file for bankruptcy, so you want to avoid the worst-case scenario.

Open enrollment for health insurance happens yearly in the Fall.  Most employers typically have a month window, generally from September to the end of October, while healthcare exchanges offer a longer window.  Whether you are considering a fresh start with a new plan, adjusting your existing coverage, or even contemplating a change, open enrollment is your moment. If you’re on your parents' health insurance, your coverage ends when you turn 26. Knowing the deadlines for your employer’s or healthcare exchange is essential. If you miss the dates, you must wait until the following year for any changes. Act now and enroll in insurance before it’s too late.

If you are eyeing Individual & Family ACA Marketplace plans, your window opens from November 1 to January 15 in most states. Medicaid offers flexibility and allows enrollment at any time. If you’re using healthcare exchanges, financial assistance programs include premium tax credits and cost-sharing reduction (CSR). Premium tax credit helps lower monthly insurance costs, while CSR reduces deductibles and out-of-pocket expenses when receiving medical care. To access these benefits, you need to enroll in a marketplace plan.

If you qualify, premium tax credits can be applied to the health insurance market's bronze, silver, gold, and platinum plans. Bronze plans have lower premiums but higher out-of-pocket costs, whereas platinum plans feature higher premiums but lower expenses. Cataract plans offer lower premiums and higher cost-sharing if you are under 30 and do not meet premium tax credit requirements.

Specific criteria must be met to claim the premium tax credit for 2024. Your household income should equal or exceed the Federal Poverty Level based on the 2023 guidelines. It is essential to lack access to affordable employer-based coverage, not be eligible for Medicaid or CHIP, and provide proof of U.S. citizenship or legal residency.

The Health Insurance Marketplace also offers cost-sharing reductions (CSR) to lower out-of-pocket expenses, including deductibles, copays, and coinsurance. To qualify for CSR, you must meet premium tax credit requirements and have a household income between 100 and 250 percent of the poverty level. Remember that CSR is exclusive to silver plans, which means that selecting one can provide the benefits of a gold or platinum plan without a high premium.

Consider healthcare spending accounts if you anticipate out-of-pocket healthcare costs, prescriptions, or dealing with a chronic condition.  Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) are tax-free healthcare savings accounts with annual contribution limits. The primary difference lies in the requirement for a high-deductible health plan (HDHP) for HSA. HDHPs have higher deductibles and lower monthly premiums, meaning you pay more upfront costs before your insurance coverage kicks in.

Your choice between FSA or HSA should be based on what best suits your personal needs. With an HSA, any unspent funds roll over year to year, eliminating the "use it or lose it.” Some HSAs offer investment opportunities to increase savings. Conversely, FSAs operate on a "use it or lose its basis, meaning unused funds are forfeited at the plan year's end unless there is a grace period or carryover feature. FSAs typically make the entire contribution available from day one.

As an HSA holder, you cannot spend beyond the deposited funds, but you can save receipts for qualified medical expenses and request reimbursements as your balance increases. You cannot contribute to an HSA or a traditional FSA in the same year. However, HSA holders can also utilize a limited-purpose FSA (LPFSA) for dental and vision expenses and a dependent-care FSA for childcare costs. You, your employer, or others can contribute to your HSA, so the contributions vary.

The Health Insurance Marketplace provides financial assistance through two valuable programs: premium tax credit and cost-sharing reduction (CSR). Premium tax credit helps lower monthly insurance costs, while CSR reduces deductibles and out-of-pocket expenses when receiving medical care. To access these benefits, you need to enroll in a marketplace plan.

If you qualify, premium tax credits can be applied to the health insurance market's bronze, silver, gold, and platinum plans. Bronze plans have lower premiums but higher out-of-pocket costs, whereas platinum plans feature higher premiums but lower expenses. Cataract plans offer lower premiums and higher cost-sharing if you are under 30 and do not meet premium tax credit requirements.

Specific criteria must be met to claim the premium tax credit for 2024. Your household income should equal or exceed the Federal Poverty Level, based on the 2023 guidelines. It is essential to lack access to affordable employer-based coverage, not be eligible for Medicaid or CHIP, and provide proof of U.S. citizenship or legal residency.

The Health Insurance Marketplace also offers cost-sharing reductions (CSR) to lower out-of-pocket expenses, including deductibles, copays, and coinsurance. To qualify for CSR, you must meet premium tax credit requirements and have a household income between 100 and 250 percent of the poverty level. Remember that CSR is exclusive to silver plans, which means that selecting one can provide the benefits of a gold or platinum plan without a high premium.

With open enrollment just around the corner, exploring options and securing the best healthcare coverage is crucial. Protect your health and financial well-being before the window closes.