With just a few days left for the open enrollment period to commence for the 2021 health plans, you need to prepare well. No matter whether you are looking to purchase a new health plan or need to switch to a different plan, you must make use of the open enrollment period to choose the best option available. The open enrollment period is the best time when you can find some good options offered by leading insurance carriers in your area.
Health Insurance Carriers Available in your Area
Depending on the area you live in, you will find the health insurance companies offering health plans in your area. You can start your search by collecting quotes from your preferred health insurance companies or through leading health insurance portals that help you obtain quotes from reputed health insurers. The health insurance portals not only help you in obtaining quotes but also help you compare popular plans of multiple carriers that will help you pick the best available option.
Significance of the Open Enrollment Period
The open enrollment period is the time when you can enroll in a new health insurance plan for the coming year. You need to know that you are free to drop your coverage any time during the year but you can sign for a new health plan or make changes in your existing plan only during the open enrollment period. If you are looking for individual plans, you can browse health insurance plans available to you on the Affordable Care Act Marketplace during the open enrollment period.
During this period you need to visit Healthcare.gov and need to complete your profile providing your location, age, and insurance needs. You will be then directed to your state’s exchange and explore the health plan options available. You have the option of either directly signing up for a new plan through your state’s exchange or by contacting the health insurance providers offering plans in your state.
In most of the states, general open enrollment starts on November 1 and ends on December 15. States that have their own exchanges offer extended and flexible enrollment periods. The plan purchased during the open enrollment period become effective on January 1 of the following year.
Scenario Triggering Special Enrollment Period
There are circumstances when you may need to change your plan outside the open enrollment period or may need to enroll in a new health plan due to the loss of your health coverage. However, if you lose the coverage you may be eligible for a Special Enrollment Period. During the Special Enrollment Period, you can access the ACA marketplace outside the open enrollment period to choose a plan of your choice. Special Enrollment Period is triggered due to the following qualifying life events:
Change in your Area – If you move out from your zip code or shift to a permanent house, then you will qualify for a Special Enrollment Period.
Change in your family – Change in your family like if you have got married, given birth to a child, or got divorced, then you may qualify for a Special Enrollment Period.
Loss of Health Coverage – If you or anyone in your family has lost coverage in the past 60 days or expect to lose coverage in the next 60 days, then you qualify for a Special Enrollment Period. For example, on turning 26, you will lose coverage from your parent’s plan or if you lose your job, in both these cases Special Enrollment Period will be triggered.
Other qualifying life events – Some of the other qualifying life events include coming out of imprisonment, obtaining citizenship status, or gaining membership in a federally-recognized tribe that will qualify you for a Special Enrollment Period.
The Average Cost of Health Insurance
Your health insurance price depends upon your age, the area you live, and whether you smoke or not. People who smoke and older people usually pay more for health insurance because they are more likely to have a critical health issue that may require them to use health insurance. The average health insurance monthly premium for individuals of different age groups are:
- Individuals under 18 years of age pay around $150 per month.
- Individuals in the age group of 18 to 24 years pay around $180 per month.
- Individuals in the age group of 25 to 34 years pay around $240 per month.
- Individuals in the age group of 35 to 44 years pay around $300 per month.
- Individuals in the age group of 45 to 54 years pay around $400 per month.
- Individuals in the age group of 55 to 64 years pay around $580 per month.
These are the average monthly premiums for individuals in different age-group and if you qualify for a government subsidy by meeting the income standards, then your monthly premiums will be lowered. As soon as you complete your profile at Healthcare.gov, you will be automatically informed by the system if you qualify for a subsidy.
Essential Health Insurance Benefits
Any health insurance plan you purchase on the marketplace include the following essential health benefits:
Emergency Medical Services – Emergency medical services are covered under your plan, and in case of a medical emergency, you should visit the nearest hospital, regardless of the plan or network. You are not required to contact your health insurance provider or use a specific hospital or network during an emergency, as it is against the law.
Hospitalization – If you are required to stay overnight at the hospital, irrespective of whether it is urgent or planned medical surgeries.
Ambulatory patient services – Any type of outpatient care that you receive outside of a hospital is referred to as ambulatory services.
Prescription Drugs – Health insurance providers are required to provide some form of coverage for all classes of prescription drugs. Though insurance carriers are not required to cover every individual prescription on the market. If you are taking a particular medication then look for a plan that covers that medication.
Laboratory Services – Specialized lab tests like x-rays or mammograms are included in the laboratory services.
Rehabilitative and habilitative services – Physical therapy and devices to help you regain physical and mental health after an injury.
Wellness and Preventative Services – Annual physical exams, along with ongoing treatments for chronic conditions and routine blood work are included in the preventive and wellness services.
Pediatric Services – For any child enrolled in your plan, your carrier must provide all the above mentioned medical services and treatments. The insurers besides all these benefits are also required to provide dental and vision insurance for children on your plan.
Medical Services that are not covered under a Health Plan
Health insurance plans available in the health insurance marketplace provide coverage for essential health benefits. There are some medical services that are not covered under your plan like:
- Adult vision and dental insurance
- Cosmetic procedure
- Travel vaccinations
- Nursing Home Care
- Male birth control
- LASIK surgery
Compare and Search Best Coverage Option
You should find the right health plan by comparing multiple quotes from the leading health insurance providers of your area. You can start searching and comparing by entering your ZIP code and you will get the quote from the leading carriers of your area.