ACA Marketplace Withdrawal: What Consumers Need to Know

Presbyterian Health System’s Recent Announcement

Recently, Presbyterian Health System, one of New Mexico’s largest healthcare providers, announced its withdrawal from the Affordable Care Act (ACA) marketplace. This news has raised concerns among consumers about their health insurance options and coverage. In this blog, we will explore the implications of Presbyterian’s departure from the ACA marketplace and provide consumers with guidance on navigating this transition.

ACA Marketplace Basics

The ACA marketplace, also known as HealthCare.gov, is a federally run online platform where individuals and families can purchase health insurance plans that meet the minimum standards set by the ACA. The marketplace offers a variety of plan options from different insurance carriers, allowing consumers to compare coverage and prices.

Presbyterian’s Departure: What It Means for Consumers

Presbyterian’s decision to leave the ACA marketplace means that its current and prospective customers will no longer have access to Presbyterian health insurance plans through the marketplace. This can have significant implications for those who rely on Presbyterian for their medical care.

Options for Affected Consumers

Consumers affected by Presbyterian’s withdrawal from the ACA marketplace have several options:

Shop Other Marketplace Plans:
Consumers can explore other health insurance plans available on the ACA marketplace. There are several carriers offering plans in New Mexico, and consumers can use the marketplace to compare coverage and prices.

Contact Insurance Agents:
Licensed insurance agents can help consumers find suitable health insurance plans that meet their specific needs and budget. Agents can also guide consumers through the enrollment process and assist with any questions.

Consider Non-Marketplace Options:
Consumers who do not qualify for ACA subsidies or do not wish to purchase insurance through the marketplace can consider private individual health insurance plans or employer-sponsored coverage if eligible.

Important Considerations

Enrollment Deadline:
The open enrollment period for ACA marketplace plans typically runs from November 1 to January 15. If affected consumers wish to enroll in a new plan, they should do so by December 15, 2022, to avoid a gap in coverage.

Special Enrollment Period:
In certain circumstances, consumers may be eligible for a special enrollment period outside of the open enrollment period. This includes events such as loss of coverage or a change in income.

Subsidies and Tax Credits:
ACA marketplace plans are often accompanied by subsidies and tax credits that can reduce the cost of insurance. Consumers should verify their eligibility for these programs before enrolling in a plan.

Conclusion

Presbyterian’s withdrawal from the ACA marketplace is a significant development for healthcare consumers in New Mexico. While this may cause uncertainty, it is important to know that there are still options available to maintain health insurance coverage. By understanding their choices and seeking professional guidance if needed, consumers can navigate this transition and secure the necessary medical coverage.