What’s Different About My Plan In 2025?
If you’re enrolled in a health insurance plan for 2025, you may be wondering if anything is different in the coming year. Here are some key tips from The Insurance People to stay in the know about your plan come January 1.
-Deductibles reset on January 1. Regardless of purchase date or policy year, the deductible on your plan will reset on January 1, 2025. There is no rollover that happens from the previous calendar year, so plan your expenses accordingly.
-Don’t miss your January payment! Once you enroll in a health insurance plan, you must complete what is called an effectuation payment. It’s essential the first payment on your policy, and it lets the policy begin. If you don’t pay the effectuation payment in a timely manner, it’s like you never enrolled. In the individual market, you have a 30-day grace period to make your first payment. If you don’t make that payment in 30 days, your policy will be terminated. In the group market, you have a 60-day grace period to make your effectuation before termination.
-Your out-of-pocket maximum decreases slightly in 2025. As of January 2025, carriers can set the maximum out-of-pocket expenses to be $9,200 for individuals and $18,400 for families, which are surprisingly lower than last year. These rates are new for 2025 and determined by the Affordable Care Act. Some policies—especially Bronze level policies—use the maximum out-of-pocket cost. Don’t forget that you can utilize an HSA for these out-of-pocket costs.
-Same carrier? Your ID number stays the same. If you changed or renewed your policy yet stayed with the same carrier, your old ID number will still work. However, you will be getting a new ID. If you need health care but haven’t received your new ID number yet, you can still use your old one. Be sure to purge the old ID number when the new one arrives.
-Call in your prescriptions early! Whether you stay on the same policy or make a change, it’s prudent for people who are on a continuing regiment of medications to call in their scripts early. If there are any approvals that need to be completed for 2025, giving pharmacies extra time to do this is helpful. This allows clients not to miss out on important medications being available to them when needed. Also, it’s critical that you use an in-network pharmacy. If you change carriers, make sure your current pharmacy is in your new carrier’s network.
Have questions about your plan for 2025? Contact The Insurance People today! We’re here to help.
