As I write this, the election results are not known, so let’s concentrate on something you can control: open enrollment season for health coverage. I hear you groaning, but this is your not-so-gentle nudge to pay attention, because there is serious money on the line. For the 157 million Americans who receive their health-insurance benefits through their employers, workers will shell out $5,588 for family coverage ($1,243 for single), not including deductibles, according to the annual Kaiser Family Foundation survey.
To get started, review your existing coverage, what you spent this past year, and then try to project what your health care costs will be in 2021 — that may sound crazy amid a pandemic, but do your best. Then compare available plans to see what they cover; how much they cost, including copays and deductibles; and whether your doctors are in the network. Don’t forget to factor in regular medications that you take, and make sure that the plan covers them.
You may want to consider a high-deductible health plan, which offers lower premiums and is paired with tax-advantaged health savings accounts. If you’re generally healthy and want to save for future health care expenses, the high-deductible plan may be an attractive choice. Or if you’re near retirement, it may make sense because the money in the health savings account can be used to offset costs of medical care after retirement. The maximum contribution for 2021 is $3,600 for an individual and $7,200 for a family. Those who are older than 55 can make an extra $1,000 contribution.
Amid COVID-19, the IRS has made changes to some high-deductible plan rules. The CARES Act provides “flexibility for health care spending that may be helpful.” Specifically, high-deductible plans temporarily (from Jan. 1 through Dec. 31, 2021) can cover telehealth and other remote-care services without a deductible or with a deductible below the minimum annual deductible otherwise required by law.
In addition to high-deductible plans, many companies also offer flexible spending accounts, which allow you to set aside $2,750 pre-tax in 2021 to help pay for unreimbursed medical expenses. Some flexible spending accounts can be “use it or lose it,” which means you have to incur eligible expenses by the end of the plan year or forfeit any unspent amounts. Employers may, if they choose, allow you to carry over up to $550 of unused flexible spending account funds to the following plan year, but some of those rules have been loosened due to the pandemic, so check with your human resources department.
Medicare
Open enrollment has begun for the nation’s health care plan for those older than 65 and runs through Dec. 7. Because insurance companies often change what they cover from year to year and your health or regular medications also may have changes, all enrollees (maybe with the help of family or friends) should review and potentially update their coverage.
Affordable Care Act
The 2021 ACA Open Enrollment Period has started and runs to Dec. 15. However, if you lose your job-based benefits, whether due to COVID-19 or other reasons, you may qualify for a Special Enrollment Period. Additionally, if your income has dropped, don’t forget to update your ACA application — doing so may allow you to qualify for federal tax credits. If you are having problems paying for premiums because of a hardship due to COVID-19, ask your insurance company to extend premium-payment deadlines, or ask that they delay terminating your coverage if you can’t pay your premiums. For more information about COVID-related changes to the ACA, go to http://healthcare.gov/coronavirus.
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Jill Schlesinger, CFP, is a CBS News business analyst. She welcomes comments and questions at askjill@jillonmoney.com.