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A Look at Health Care Reform

Compare and Buy Plans

If you get your health insurance from your employer, little, if anything, about how you get your insurance will change.

How you purchase Individual Coverage, when you buy your own health insurance, may change a little. Except in Washington, D.C., if you buy your own health insurance, you can buy your next plan directly from CareFirst on our private online Exchange-all of our ACA-compliant plans will be available for sale.

In D.C., everyone who buys their own health insurance must buy it on the public Exchange. On our own private exchange If you’re more comfortable using a broker, he or she can certainly help you. Each state with a public Exchange will have specially trained Navigators, to help answer your questions and guide you through the process of buying your health plan on the public Exchange. When purchasing directly through the CareFirst private exchange, we will have dedicated resources to answer your questions, and help you make the best decision about your new health insurance plan.

The ACA has attempted to make comparing different plans easier by requiring that every plan (except high-deductible Catastrophic plans) fit into one of four categories, called Metal Levels. Bronze, Silver, Gold and Platinum plans all cover the same core benefits, but each level, differs in how much of your care you’ll pay. Different plans have different monthly premiums and different out of pocket costs for you.

Metal Level
What the Health Plan Pays
What You Pay
Platinum 90% 10%
Gold 80% 20%
Silver 70% 30%
Bronze 60% 40%
Your monthly premium rate is a separate cost and is not included in these calculations.

Open Enrollment

Whether you want to buy your plan on the CareFirst private Exchange, or need to use the public one, you have a limited period of time during the year you can enroll. The first open enrollment period related to ACA is October 1, 2013 - March 31, 2014. Be aware of the renewal date of your current plan, and make sure you have enrolled in an ACA plan during Open Enrollment that will take effect when your current plan expires. If your current plan renews between April and September of 2014, you can purchase at that time.

After 2013, Open Enrollment will be limited to just three months, October 15 – December 7. If you miss it, you can’t get health insurance until the next year with a few exceptions.

Early Renewal

There is one short-term option that could delay you having to buy a more expensive ACA plan until December 2014. If you renew your existing plan during 2013, you’re entitled to lock in those rates for a full 12 months. So if you renew your current plan by November, to take effect on December 1, 2013, you won’t have to choose an ACA plan until December 2014.

A few things to keep in mind if you want to renew by November:

  • You’ll have the regular premium increase when you renew your plan this year
  • Your deductible will re-set on December 1, 2013
  • December, 2014 you’ll have to buy one month’s worth of coverage from an ACA plan, and its deductible will begin then, too.
  • You’ll then have to buy another ACA plan that begins on the universal effective date of January 1, 2015, at which point your deductible for that plan will start over, too.