It’s Open Season for Open Enrollment: Facts to Know

What to Know About Open Enrollment and Buying Healthcare Coverage

 

When is open enrollment? How can you find the best healthcare policy?

 

Consider these tips when you’re shopping for health insurance during open enrollment:

 

 

1. Know the Open Enrollment Period Dates

 

Each year, the government holds a health insurance open enrollment period that lasts between Nov. 1 and Dec. 15. 

 

Some states, like California, have extended open enrollment periods that consumers can take advantage of. California’s open enrollment lasts until Jan. 31 the following year. 

 

Regardless of which open enrollment period applies to you, it’s important that you apply for health insurance within that time frame. Otherwise, you’ll only be able to sign up for supplemental accounts that act in the place of health insurance.

 

You may also be able to opt into a health insurance plan after open enrollment if you experience a qualifying life event. Take the time to do your research in advance so that you’re ready to jump on a plan as soon as open enrollment is available.

 

2. Know What You’re Shopping For: Group or Individual Plan?

 

If you’re employed and you have the ability to buy health insurance through work, your employer will advise you of your health coverage options. This type of plan is typically called a group plan.

 

If you don’t qualify for coverage through an employer, you will be buying insurance just for you and your dependents. This type of plan is typically called an individual plan.

 

3. If You’re Buying a Group Plan, Check With Human Resources (HR)

 

When you work under an employer and qualify for an employer (group) plan, take the time to get in touch with human resources (HR) regarding your health insurance. 

 

They will explain the terms of the company-wide health insurance plan. You may also be subject to different dates and open enrollment timeframes when purchasing insurance through a place of employment. 

 

Having access to an HR manager is also helpful because they’ll be able to go over your policy point by point with you so that there’s no confusion. They can answer questions related to health insurance in general so that you come away more informed. 

 

4. If You’re Buying an Individual Plan, Determine Whether You Qualify for a Premium Tax Credit

 

If you are buying your individual insurance plan privately (not through your employer) and your household income falls within or below a certain level, you may qualify for a credit on your taxes that can be applied directly to the cost of your health insurance policy.

 

You can find out the amount and specifics of any tax credit you may qualify for when you apply for individual coverage on the Health Insurance Marketplace. (Pro tip: take the time to gather necessary documents and information before beginning your application.)

 

5. Understand What You’re Looking for When Purchasing a Policy

 

Take the time to research every part of the policy to make sure it suits your life. For one, think of your lifestyle, current health needs, and whether you’re putting any dependents on your plan. 

 

If you’re married with kids, you and your spouse should compare plans to see if you should maintain separate plans and to see which children go under which policy. 

 

Get a feel for the foundational aspects of the health insurance plan. This means understanding co-pays, deductibles, premiums, and terms. Learn about insurance networks and research the physicians you’ll get access to. 

 

Leave no stone unturned so you know what out of pocket costs you’re responsible for.

 

6. Research the Reputation and Track Record of Any Insurance Provider

 

You should absolutely vet the reputation of any health insurance company that you’re thinking about doing business with.

 

Look into their grades with the National Committee for Quality Assurance (NCQA) and make sure that the company is properly accredited. It also pays to check them out with the Better Business Bureau (BBB). 

 

Talk to your co-workers and family members and ask them which companies they use for their healthcare needs. It’s best to do business with insurance companies that are easy to work with, attentive, and responsive whenever you need to make a claim or get medical service.

 

7. Figure Out a Backup Plan

 

With the COVID-19 pandemic and in general, it’s good to know what steps you can take if you become unemployed or your circumstances otherwise change.

 

Check with your state to see what resources may be available. Depending on your age and income level, Medicare or Medicaid could be options. 

 

If you qualify for Medicare or Medicaid, you may also qualify for free Lifeline phone service.

 

Many people out of work take advantage of Consolidated Omnibus Budget Reconciliation Act (COBRA), so check to see if this is an option. With COBRA, you can keep most of your health insurance if you’re laid off or otherwise lose a job. 

 

It may also make sense to get on your parents’ or spouse’s plan, depending on your circumstances. Either way, you should always seek alternatives and options if you’re between jobs. This will help you pay for medical treatment without it having to cost you an arm and a leg. 

 

8. Look Into Health Savings Accounts and Prescription Drug Plans

 

When you opt into a health insurance plan you should also look into options like health savings accounts and prescription drug plans. 

 

With a health savings account, you’re consistently setting aside money that generates interest. These accounts can be used to get healthcare when you need it. Having this cash value matched with insurance coverage further solidifies your health plan. 

 

Several health insurance companies also offer you prescription drug plans that make buying your medication cheaper. This can be particularly useful if you take medicine for something on a regular basis. 

 

9. Think About Whether You Need Dental and Vision

 

Finally, consider whether you also want to get dental or vision coverage. These plans are often much less expensive and will cover you for your annual visits and many procedures. 

 

These costs add up if you wear glasses and contacts, or if you need expensive dental work like braces and oral surgical procedures. 

 

Shop Around for the Best Healthcare Coverage

 

When you catch the open enrollment period you’ll be better able to get the healthcare coverage that you need. These are issues that everyone has to tackle each year to get their ducks in a row. 

 

The last thing you’d want is to need medical care and not be able to pay for it. Handle your healthcare insurance needs upfront so that you have peace of mind. 

 

Reach out to us for more information on everything from accepting federal payments to applying for Medicare and Medicaid.