You may have heard: the health insurance Open Enrollment Period for 2019 runs from November 1 to December 15. Get covered soon – your time is running out!
If you’re like most people, you dread the thought of dealing with anything related to health insurance. Your healthcare benefits confuse you. And, now, smack dab in the middle of open enrollment season, you’re not sure what you have to do. Currently covered by COBRA? Your employer? Or starting off with no coverage whatsoever? Whatever your current situation, in this quick guide we’ll walk you through what (if anything) you’ll need to do during this health insurance open enrollment period.
How Does ACA Open Enrollment Affect You? Most People Don’t Know.
If you currently aren’t covered under a Marketplace health insurance plan and don’t buy health insurance on your own, you’re probably unsure as to whether you have to do something or take action during the ACA open enrollment window. You’re not alone on this boat. According to an October 2017 Kaiser Health Tracking Poll, nearly 80 percent of Americans are unaware that problems plaguing the ACA Marketplaces only affect those who buy health insurance on their own.
If You Currently Have a Health Insurance Plan That You Found on Your Own (from the Exchanges or Privately)
The Open Enrollment Period you keep hearing about, the one happening November 1 to December 15, applies only to:
- Individuals who will purchase or make changes to their Marketplace health plans (health insurance plans purchased through the federal and state Obamacare exchanges), and
- People who buy health insurance plans directly from private insurers.
If you don’t get health insurance through work or through programs such as Medicare or Medicaid, open enrollment is your time to review plan options. Don’t wait until the last minute to assess what’s available on the ACA Marketplace and private exchanges. You need to sign up for coverage by December 15 and because you’re buying insurance on your own, it’s your responsibility to enroll in a plan before the open enrollment deadline.
If You Currently Have Employer-Sponsored Healthcare
For those currently with employer-sponsored health insurance, you won’t need to do anything or take care of anything during the health insurance open enrollment period. So, if you currently get health insurance through 1.) your job, 2.) your spouse’s job, or 3.) your parent’s job, then you likely don’t need to do anything during open enrollment.
Unless open enrollment for benefits at your workplace takes place during the same time, there’s nothing you need to do if you are already covered through your employer. While most major health insurance plans have an open enrollment window once a year, the specific dates of your open enrollment will depend on how you get your health insurance coverage; in your case, your open enrollment period is dependent on your company – they decide when you can make changes to your health insurance policy.
In other words, open enrollment for employer-sponsored benefits can happen during any time of year. Most employers hold their open enrollment period during a two-week period in the fall; your employer will let you know specifically when this occurs.
For example: At Company X, open enrollment for health insurance might occur during the first two weeks of October. Or, open enrollment for Company X employees may occur during another discrete time period arranged by Company X and their group plan provider.
If You’re Currently Covered by Another Kind of Plan
Of course, not everyone gets healthcare coverage on the ACA exchanges or through their job. So, how does this year’s ACA open enrollment period (November 1 – December 15) affect people who have neither an Obamacare plan nor employer-sponsored coverage? Do people who get health coverage from elsewhere need to do anything between November 1 and December 15? People without Obamacare coverage include individuals with COBRA coverage, people on Medicaid, and seniors covered by Medicare. Let’s take a closer look at the open enrollment dates for healthcare plans that aren’t Obamacare.
People who qualify for Medicaid or the Children’s Health Insurance Program (CHIP) can apply and enroll in those programs at any time of year. If you’re currently on either program, you don’t need to do anything during this open enrollment.
Medicare has an annual open enrollment period, called its “annual election period,” from October 15 to December 7 each year. When Medicare beneficiaries make changes to their Medicare coverage during this time, those changes take effect on January 1 of the following year. If there are changes you want to make to your Medicare coverage (say, you want to change from Medicare Advantage to Original Medicare), then you can use this annual election period to make that change.
If you have COBRA coverage through a former employer, you can make changes to your COBRA coverage during your former employer’s open enrollment or “benefits selection” period. Note: when you’re covered by COBRA, you enjoy the same benefits as you did while working at your old job – you’ll just be paying more for the coverage.
- COBRA beneficiaries may add a new dependent to their plan during their former employer’s open enrollment period. This allowance is the main way in which open enrollment for COBRA differs from initial enrollment for COBRA; during initial enrollment, COBRA beneficiaries cannot add new dependents to a plan – they are only allowed to keep or drop dependents who were already covered under their plan.
- If a COBRA enrollee does not make any changes to their coverage during open enrollment, the enrollee will continue being covered under the same plan (assuming all premiums are paid).
- If at any point the employer decides to switch to a new insurance provider, former employees with COBRA coverage will need to enroll in a plan with the company’s new carrier. Going through the employer’s open enrollment selection process is especially important in this situation, as coverage for COBRA beneficiaries doesn’t continue automatically under the new provider. In other words, if someone with COBRA coverage does not actively select a new plan being offered by the new provider during their previous employer’s open enrollment, that person will lose their COBRA coverage.
Short-Term Medical Plans
Though they are not ACA-compliant and do not offer comprehensive coverage, short-term health insurance can be purchased during any time of year. If you currently have short-term health coverage, you don’t need to take any action during open enrollment – unless you want to switch to a major medical health insurance plan. Assuming you do not have access to employer-sponsored coverage, you’ll need to select a plan through the ACA exchanges or a private insurer before December 15.
Keep Calm and Know What Kind of Plan You Have
The urgent tone of open enrollment messaging tends to make people feel as though they are supposed to take some kind of action, or confirm their health coverage in some way – even if they’re not covered by an Obamacare plan. Let’s be clear: open enrollment for 2018 – the sign-up period happening from November 1 to December 15 – applies only to people who fit the following descriptions:
- People who have, or plan to shop for, a Marketplace health insurance plan on the federal or state Obamacare exchanges, or
- People who have, or plan to buy, healthcare coverage on their own, either through a broker or directly from the provider on a private exchange.
The Clock Is Ticking…Are You Covered?
“Time is running out!” You may have noticed that the ads for this year’s health insurance open enrollment period take on somewhat of an alarmist tone, in spite of the Trump administration’s slashing of the Obamacare marketing budget (and, maybe, as a result of it). This year, marketing and outreach efforts to promote open enrollment consistently emphasize its shortness; ad campaigns warn that “your time to get coverage is running out” and focus on the health insurance open enrollment period’s halved duration. But with your opportunity to enroll in health coverage reduced to just 45 days, this urgent tone is important – before you know it, you may find yourself with no health insurance coverage in 2018.
Consider what kind of coverage you have. When is open enrollment for you? The chart below lists open enrollment dates for various types of coverage:
Taking the Next Steps
Approximately 20 million people will shop for health insurance during this Open Enrollment Period. If you’re shopping for healthcare coverage on your own, check out HealthCare.com to see what Marketplace and off-Marketplace plans are available to you.
For More Reading:
- A Step-by-Step Guide to Buying Health Insurance
- 6 Major Changes to This Year’s Health Insurance Open Enrollment Period
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