The enrollment period for 2025 health insurance has begun. Those wishing to join Medicare (commonly known as the red and blue card) must complete their registration by December 7th to avoid penalties for late registration. Individuals planning to apply for Covered California must do so by January 31st next year to retain their subsidy eligibility.
Every year-end, Americans have the opportunity to update their health insurance. The red and blue card is a federal insurance program operated by the U.S. government for seniors, disabled individuals, or those with certain illnesses, while Covered California is the largest state health insurance marketplace in the U.S., offering low-cost health insurance plans for individuals who cannot obtain coverage through work.
Government-subsidized health insurance is income-based and must be applied for during a specific enrollment period each year, with policy changes occurring regularly. For example, Medicare is set to undergo significant changes in 2025.
The enrollment period for Medicare in 2025 is from October 15th to December 7th. One of the major changes for 2025 Medicare is in its Part C, known as Medicare Advantage (welfare provided by private insurance companies), as well as Part D, the prescription drug plan.
Firstly, some Medicare Advantage plans may be terminated in 2025, affecting approximately 2 million seniors nationwide. However, applicants can choose other plans within a limited enrollment period.
Secondly, the number of independent Part D prescription drug plans will decrease by about a quarter in 2025, with some plans raising drug copays. On the positive side, starting from 2025, the maximum out-of-pocket spending for prescription drugs will be reduced from $8,000 to $2,000.
Overall, there are significant policy changes for the 2025 red and blue card. Insurance professionals advise all applicants to carefully review the details of various plans.
For Californians, the requirement of “no health insurance results in a fine” remains unchanged. Residents are mandated to have qualifying health insurance each month, with those without insurance facing fines when filing taxes, except in special circumstances.
As per usual practice, Covered California is open for enrollment from November 1st, allowing individuals to switch or apply for health insurance for 2025 until the deadline of January 31st next year. To have health insurance starting from January 1st, 2025, one must renew or purchase new insurance by December 31st this year. Missing the deadline will result in losing eligibility for purchasing in 2025.
Covered California announced that the insurance rates and plans for 2025 will receive the largest financial support ever, causing subtle changes in rates. Many low-income applicants can still benefit from zero-cost health insurance plans.
In 2025, Californians with incomes above 200% of the federal poverty level (FPL) are eligible for the Enhanced Silver 73 plan, which has no copays, while those with incomes below 200% of FPL can continue to enjoy higher subsidy health insurance plans. For example, in Los Angeles County, a single adult with an annual income of $22,590 qualifies for the Enhanced Silver 87 plan with a monthly premium subsidy of zero, meaning no out-of-pocket expenses for healthcare and medication.
Insurance brokers in Southern California remind the public that the amount of government health insurance subsidies depends on individuals’ income. Therefore, when purchasing or renewing insurance, it’s essential to provide a realistic income figure rather than aiming solely for “zero-cost” or “ultra-low premiums,” as overestimating may require repayment of government health insurance subsidy fees during tax filing.