Should I Stay, or Should I Go?

October 30, 2014

“Should I stay, or should I go?”

It’s that time of year again. Yes, it’s Halloween on Friday. But it’s also almost time for open enrollment for Covered California. And that’s exciting because it’s an opportunity for millions of people to get affordable health insurance. It’s also decision time for consumers who enrolled in plans during the last open enrollment. Many will be evoking my college roommate’s favorite band by asking, “Should I stay, or should I go?”


Now is a good time for enrollees to take a few minutes to think about their experiences with their current plans. Were the premium, deductible, and co-pays manageable? Was the provider network a good fit? What about the prescription drugs that the plan covered? If you’re happy, you might decide that it’s a good idea to stick with your plan. If you’re not, maybe it’s time to go. In any case, it’s always a good idea to shop around.

Even if you’re pleased with your plan, virtually all Covered California plan premiums have changed at least a little, and other plans may be more affordable than your current plan will be in the upcoming year. Other plans may also have more providers in your neighborhood. Even if they don’t, it’s good to check these things out. Earn that smart shopper gold star and make sure that you’re making the best choices for yourself and your family for the next year.

Still, many people who are happy with their plans may prefer to be more, um, demure. Some of these folks are asking, “What will happen if I do nothing? Can I automatically stay enrolled in my plan?”

Covered California will send you a letter, if they haven’t already, informing you of your current plan choice and the information that they have on file for you. And you have until December 15 to update that information or make any changes. If you don’t respond by that date, Covered California will reenroll you in the same plan and use the details on file to determine your eligibility for premium and cost-sharing assistance. Still, keep in mind that your current plan may not be offered in the upcoming year. For example, the insurance company might change its offering from a PPO to an HMO—just another good reason to check out your options.

So, yes, you can do nothing. However, if being informed about your options isn’t a good enough reason to do some life homework, we still need to talk about everyone’s favorite topic—taxes.

The household information in that letter from Covered California is really important. It will include your household income, how many people live in your household, and your address. You should make sure that all of these particulars are accurate and up-to-date because it will affect how much you will receive in premium subsidies in the upcoming plan year. It could also affect how much you owe, or the refund that you receive, when you file taxes.

If you do nothing to update that information, Covered California will use the what they currently have on file about you, or they will use the data that you provided to the federal hub when you last filed taxes (if you gave them permission to do that when you first enrolled in a Covered California plan). If this information is outdated or inaccurate, you may end up paying a bigger share of the premiums than you need to, which is a bummer. (Cue the sad trombones.) Alternatively, you might be stuck with a large tax bill in the future if you receive more premium assistance than the amount for which you were actually eligible. And that’s a pretty serious bummer, too. (More sad trombones.)

So, turn up the Clash when you get that letter from Covered California. (Here’s a YouTube link.) Do a little thinking about whether you should stay or go. And make sure that information about you and your household is correct. These are just a few good steps to make sure that you enroll in the right plan for yourself and your family, get the right amount of premium assistance, and avoid any unpleasant surprises when you file taxes in 2016. Happy shopping!