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What to know about open enrollment for individual and family plans

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BCBS Credit: Getty Images

By Blue Cross and Blue Shield of Texas

Blue Cross and Blue Shield of Texas (BCBSTX) – the only statewide, customer-owned health insurer in Texas – is the largest provider of health benefits in the state, working with nearly 80,000 physicians and health care practitioners, and 500 hospitals to serve more than 6 million members in all 254 counties. BCBSTX is a Division of Health Care Service Corporation (HCSC) (which operates Blue Cross and Blue Shield plans in Texas, Illinois, Montana, Oklahoma and New Mexico), the country's largest customer-owned health insurer. Health Care Service Corporation is a Mutual Legal Reserve Company and an Independent Licensee of the Blue Cross and Blue Shield Association.

The annual time to shop for coverage in the Affordable Care Act marketplace is underway.

Like holiday shopping, you can go online (www.healthcare.gov) to compare your options. You also can get one-on-one assistance — almost like a personal shopper — through healthcare.gov, or through the Blue Cross and Blue Shield of Texas website.

BCBSTX is again offering coverage options in every county of Texas to meet many budgets and health care needs. Some things have changed, though, and important deadlines are coming.

Here are a few things to know:

Don’t wait to enroll

Consumers have until Jan. 15, 2023, to select coverage — but they need to sign up by Dec. 15 for benefits to take effect on Jan. 1, 2023.

Find a plan that meets your needs

Health insurance isn’t one size fits all. Explore your options and choose a plan that best meets you and your family’s health care needs and budget. A few things to consider beyond the monthly premium:

  • Price: What will you pay out of pocket? What are the deductibles and copays? Is there co-insurance?
  • Prescriptions: Look at what medication brands are covered.
  • Providers: Are your doctors in-network?
  • Virtual: Is telehealth offered and covered?

There are new opportunities for financial help

Families that have found employer coverage too expensive may have new opportunities to reduce their costs.

That’s because a new federal rule fixes what’s known as the “family glitch,” helping an estimated 1 million people become newly eligible for premium tax credits.

Under new regulations, if an employer health plan is deemed affordable for an employee alone but not for the family, the family members may now qualify for financial help for marketplace coverage.

Financial assistance may help more than you think

In 2021 and 2022, the federal government enhanced the subsidies for marketplace plans to help people stay covered during the COVID-19 pandemic. With the passage of the Inflation Reduction Act (IRA), Congress extended those enhanced subsidies through 2025.

That means people may qualify for help even if they didn’t before. About 4 in 5 consumers will be able to find health care coverage for $10 or less per month for 2023 after premium tax credits, according to the Centers for Medicare & Medicaid Services. BCBSTX’s options include plans for $0 a month after premium tax credits.

Learn more with the premium tax estimator on the BCBSTX website.