When is enrollment open for health insurance? – Forbes Advisor

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Health insurance is essential, no matter your age or stage of life. Although there are a few exceptions, most health insurance plans require you to follow them for an entire year. If you wish to change your coverage or enroll in a new plan, you can do so during the annual open enrollment period. Here’s everything you need to know about open enrollment for health insurance.

What is open registration?

“The open enrollment period is a select time each year when you can choose or change your health insurance plan option. However, the timing varies depending on which plan you enroll in,” says Anand Shukla, senior vice president of individual markets at Aetna, a CVS Health company.

For example, the annual Medicare enrollment period runs from October 15 to December 7 each year. Meanwhile, the Affordable Care Act (ACA) open market/exchange registration period begins on November 1st.

“If you have health insurance from your employer, the company likely has an annual enrollment period during which you can enroll or change your coverage. Be sure to confirm these dates with them,” says Shukla .

How to maximize open registration periods

There are several ways to get the most out of open registration. First and foremost, know when you qualify. “Your open enrollment period depends on how and where you purchase insurance,” says Koleen Cavanaugh, vice president of marketing at Independence Blue Cross in Philadelphia.

Next, take the time to assess your health needs and your lifestyle. To do this, Kyu Rhee, MD, senior vice president and chief medical officer of Aetna, recommends answering the following questions:

  • Do you have a regular doctor or do you call on specialist doctors?
  • What medications do you take?
  • What diagnostic tests, such as blood tests or imaging, do you need?
  • Do you need to pass key preventative screenings like vaccinations and cancer screenings?
  • Do you manage one or more chronic illnesses?
  • Are you planning any surgeries or procedures?

Once you’ve identified what you’re looking for, shop around for coverage. Dylan H. Roby, associate professor of health, society, and behavior at the University of California, Irvine Public Health Program, recommends finding a plan that meets your needs for the coming year, as far as price of monthly premiums and in terms of health needs.

“You can also speak to a trusted local broker or licensed insurance advisor to help you find out more about the different plans available in your area. Many insurers also offer local seminars that provide an overview of the plans and allow questions to be asked,” says Shukla.

“When choosing a plan, consider the 4 Ds (doctors, drugs, diagnostics and deductibles). Make sure your doctors are in-network, your medications are covered, key diagnostic tests like blood tests and imaging are accessible, and your deductible meets your financial needs,” says Dr. Rhee.

He adds that you should also consider vision, dental and hearing coverage. This is ideal if your plan also covers telehealth visits and virtual care. “Your health plan is your ticket to getting and staying healthy,” he says.

Managing open enrollment for different types of health insurance

No matter what health insurance plan you have, Roby suggests going beyond premiums when weighing the details of any given plan. “Deductibles, co-payments, co-insurance, maximum spend and provider network are also very important aspects,” he says.

Here are some additional tips for maximizing your open enrollment period based on your health insurance plan.

AAFC

If you opt for an ACA Marketplace plan, for which open enrollment begins November 1, you should be aware of the Early Premium Tax Credit (APTC). “Depending on your household income, you may qualify for APTC which can significantly reduce the amount of premium you pay for insurance coverage,” says Shukla.

“It’s wise to check your options during each open enrollment period, as the tax credits and grants available to you may change due to changes in health insurance policies and plans offered in your area. “, adds Roby.

Nearly 90% of consumers in states that use HealthCare.gov for health insurance received APTC during the 2021 open enrollment period. Among those who received APTC, the average amount of l APTC covered 85% of their total premium during the 2020 and 2021 open enrollment period.

Health Insurance

If you get your health insurance through Medicare, the initial open enrollment period is seven months, according to Carrie Jardine, revenue cycle manager at Heading Health, a mental health clinic in Austin, Texas. It begins three months before your initial Medicare eligibility (usually when you turn 65), continues through the month of your birthday, and ends three months later.

However, the annual Medicare enrollment period runs from October 15 to December 7 each year. “During this time, you can choose to stay with the traditional Medicare plan or opt for a Medicare Advantage plan through a variety of commercial payers,” says Jardine.

Employer-sponsored insurance

“If you obtain health insurance through an employer, initial open enrollment is the period during which you are first eligible with your employer’s health insurance company and is generally determined at the discretion of the individual employer,” explains Jardine.

Your employer may have an annual open enrollment period during which employees have the opportunity to choose a different plan, but this period is not mandatory for all companies.

“Joining a plan with lower premiums and a higher deductible can make sense, especially if your employer contributes money to a health savings account on your behalf,” says Roby.

Can I make changes outside of open registration?

After the open enrollment period ends, you can only make changes to your coverage options if you qualify for a special enrollment period due to a qualifying life event: birth, marriage, adoption or foster care, loss of coverage, change of residence, etc. income change or becoming a US citizen. Depending on your situation, you may have 60 days before or 60 days after the event to enroll in a new plan.

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