Top 10 Biggest Mistakes for Texas Health Insurance Open Enrollment

 

We've guided thousands of Texans through the often confusing and overwhelming experience of Health Insurance Open Enrollment in Texas.

There are plenty of pitfalls, and unfortunately, many people only find out after the fact.

Around 50% of the people who come to us for help after self-enrolling or renewing have issues in their accounts that can seriously affect their tax credits, plan choices, or even their ability to enroll.

We'll dive into the 10 most common mistakes we see, but first, a bit about our credentials:

 

 

For years, we've been helping Texans secure the right coverage with ease, and there's no cost for our assistance. Now, let's cover the most common mistakes.

 

Here's what we'll discuss:

• Waiting until the last minute
• Auto-renewing without reviewing
• Not updating your income
• Assuming your doctors are still in-network
• Failing to reauthorize eligibility verification
• Using last year's income as a guide
• Forgetting to update household changes
• Missing out on enhanced plan options
• Being too close to Medicaid income limits
• Trying to navigate it all alone

Now, let's break down each of these.

Remember, we offer our services at no cost and can assist with existing accounts to get you back on track, save you time, and avoid headaches.

Let's get started!

1. Waiting until the last minute

 

Open Enrollment in Texas generally runs from Nov 1st to Jan 15th, but to ensure changes take effect by Jan 1st, you need to act by Dec 15th.

In the past, there's a mass of people around Dec 15th, but it's always safer to make changes in November.

If you enroll or make changes after Dec 15th, your new plan won't start until February 1st, unless you're losing other coverage.

The end-of-year rush is real, and the system can slow down or even crash. We can help you get through the process in 5-10 minutes over the phone.

Zero cost for our assistance:

 

2. Auto-renewing without reviewing

 

Many people don't want to deal with reviewing their plan, especially during the busy holiday season.

If your plan is still available, the system will auto-renew your coverage for the next year if you don't make any changes.

While this can be convenient, it's not always the best option.

Plans, prices, and networks change each year. Texas plans in particular often see significant shifts in doctor networks and premiums during Open Enrollment.

We can handle the details for you. For existing accounts, just delegate, let us know of any changes (especially income), and we'll run the numbers, highlighting potential savings.

3. Not updating your income

 

A common mistake is not updating your income for the coming year.

At Open Enrollment, we need to estimate your income for the next year, and it must be done carefully, so it doesn't impact your current coverage or tax credits!

If you need help estimating next year's income or have questions, reach out to us.

For example, if we're in Open Enrollment for 2025, we need to estimate the income you'll report on your 2025 tax return, filed in 2026. Confusing, right? Let us make it easier for you.

More on what income is used for the Texas Exchange plans.

4. Assuming your doctors are still in-network

 

Every year, we see changes in which doctors and hospitals are part of which networks.

It's crucial to confirm your doctors and hospitals are still in-network during Open Enrollment...especially in Texas, where network changes are common.

Many people don't realize until it's too late that their doctor is no longer in-network.

We can help you check doctor networks based on your plan right through our quote system:

5. Failing to reauthorize eligibility verification

 

There's a system in Texas health exchange that requires you to reauthorize access to verify your income through government systems like the IRS.

You typically authorize this for 1-5 years, but when that period expires, your subsidy can suddenly disappear!

The result? A shockingly high bill for the full amount of your health insurance.

We can check your account's status and extend your authorization for you. It's tricky to find in the system, but we've got it covered.

6. Using last year's income as a guide

 

This is a common mistake.

We're trying to estimate next year's income during Open Enrollment.

Many people just finished figuring out this year's income, so they use that number...but that's not always accurate.

Income can fluctuate, especially for the self-employed or those with irregular income sources like asset sales.

We can help you fine-tune your income estimate and avoid surprises at tax time.

7. Forgetting to update household changes

 

Household changes...like marriage, divorce, or having a child...can significantly impact your tax credits and plan options.

In Texas, household size is based on who files together on the 1040 tax form, even if not enrolling.

Even if changes are planned for the next year, they can still affect your Open Enrollment decisions. Reach out to us, and we'll help strategize around these changes to avoid surprises.

8. Missing out on enhanced plan options

 

There are enhanced versions of health plans that offer better coverage based on your income estimate for the coming year.

In Texas, these enhanced plans can make a huge difference in out-of-pocket costs for the same premium.

 

 

 

We can help you identify income thresholds and fine-tune your estimate so you don't miss out on valuable plan options.

9. Being too close to Medicaid income limits

 

If your income is too low, you or your children could lose the subsidy because you're in the medicaid range.

Each year, income thresholds for Medicaid are updated during Open Enrollment.   If you find yourself in the Medicaid range, your current subsidy may be canceled, leading to severe sticker-shock.

This can be especially difficult to fix once it happens, so let us help keep you out of that range if you want to avoid Medicaid.

10. Trying to navigate it all alone

 

Why go through all of this by yourself?

As certified Texas health insurance agents, our help is completely free, and we have the experience to guide you through the process with ease.

With over 25 years of experience and thousands of ACA enrollments, we can quickly identify problems and solutions.

If you need changes or adjustments throughout the year, just email us...we'll handle the rest.

In 5-10 minutes, we can figure out where you stand and what steps to take next.

Zero cost for our assistance: