Buying Health Insurance during Open Enrollment Period

Health Insurance Open Enrollment Period

Open enrollment commences in the fall, which also happens to be the time of your favorite pastimes. While enrolling in a health plan might not be as interesting as dressing up for the Halloween parade, still enrolling in a health plan during open enrollment is incredibly significant. Open enrollment is the annual period during which you along with your family can enroll in individual health insurance plans in the marketplace. You can either purchase a health plan, switch to a different health plan, include family members in your plan, or apply for subsidies to receive help in paying for health insurance during the open enrollment period. Due to COVID-19 open enrollment, 2021 will look a little different this year, so you need to get a head start on the process to make this busy yet crucial time of the year smooth and hassle-free.

Before Enrollment Checklist

If you are looking to sign up for a new individual or family health insurance plan for 2021, you need to be prepared for an open enrollment period that usually starts in most of the states from November 1. Find below the checklist which you need to carry out in the month before the open enrollment period.

  • You need to carefully review and analyze your medical activity and expenses in the year 2020 so that you can anticipate your medical expenses for the next year.
  • If you think that you will qualify for Medicaid or tax credits then get an estimate of your household income for the year 2021.
  • If you have any preference for doctors, drugs, and medical facilities, then you should make a list of it and make sure that these things are covered in the health plan which you are looking to buy, you can be flexible with the rest of the things. This will help you in saving money.
  • You need to decide whether your spouse and children should be included in your plan or you will benefit by having an individual health plan. If your spouse and kids can obtain health coverage through another source at a reduced price, then having an individual health plan will financially make sense for you.
  • If you wish to include your family members in your plan, then you should collect personal ID numbers of the members whom you wish to include in the plan.
  • You need to extensively research the health insurance carriers, types of health plans available, along with several other vital information related to plans, and carriers.
  • Depending upon your health and budgetary needs choose a plan of a specific tier, as health plans are categorized as Bronze, Silver, Gold, Platinum, or Catastrophic.
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Checklist for Open Enrollment Period

In most of the states in the U.S., the open enrollment period begins on November 1 and generally ends on December 15. It means that U.S. nationals can start enrolling in a health plan as early as November 1. You can enroll in a health plan in any of the following ways:

  • You can either enroll through HealthCare.gov or your state’s health insurance marketplace. This will be the best place to buy a health plan especially if you qualify for financial aid.
  • You can also enroll in a health plan through a private health insurance carrier.
  • The other option to purchase a health plan is through a health insurance broker.
  • If you are considering buying an HSA-compatible plan then choose your HSA contribution amount for the year 2021.

Checklist for Post Enrollment Period

  • You should timely pay your first health insurance premium simply because if you fail to pay your premium on time then your plan will not be effective and you won’t be covered during the year.
  • You should pay your first health insurance premium by December 15, if you wish to receive your physical ID card by early January.
  • If it is feasible for you, then you should make the provision of auto-pay so you do not miss paying any of the premium in the future. This will ensure that you have health coverage in plan throughout the year and your coverage will never be at risk.
  • You should make an effort and get acquainted with all the benefits and perks that come with your health plan so that you are aware of the benefits that you will receive and can make the best use of those benefits.

Consequences of Missing the Open Enrollment Period

After the open enrollment period ends, you need to know that you will not be able to sign-up for a health plan until and unless you experience a qualifying life event like moving to another state, getting married, having a baby, or leaving or changing jobs. In all these conditions, you will have a 60-day special enrollment period to choose a new plan. If you don’t experience a qualifying life event, and you missed the open enrollment period, then you will have to wait until next year’s open enrollment period to sign-up for a plan, and your health care will not be covered in the coming year.

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FAQ on 2021 Open Enrollment Period

Open enrollment is the period during which you can either enroll or opt-out of health, dental, and vision insurance plan for the coming year. If you are already enrolled in a health plan and wish to make some changes in the plan, then you can make changes in your plan during the open enrollment period. Once the open enrollment period closes, you will not be able to enroll or make changes in your health plan for the coming year, unless you qualify for a life-changing event like getting married or expanding your family.

Open enrollment for 2021 ACA-compliant individual health plans in the majority of the states will start on November 1, 2020, and will end on December 15, 2020. The deadline of December 15 is applicable in states that use Healthcare.gov and is also applicable in some of the states that run their exchanges. However, the 15 states that have their exchanges have the option to extend their open enrollment period and most of the states do extend their open enrollment window. As of 2020, 15 states are having fully state-run exchanges, among which California, Colorado, and DC have permanently extended their open enrollment periods.

  • In California, open enrollment will start from November 1, 2020, and end on January 31, 2021.
  • In Colorado, open enrollment will start from November 1, 2020, and end on January 15, 2021.
  • In the District of Columbia open enrollment will start from November 1, 2020, and end on January 31, 2021.

Some of the other states that have extended the open enrollment deadline are:

Minnesota – Open enrollment for the 2021 health plan will begin on November 1, 2020, and will end on December 22, 2020.
Pennsylvania – Open enrollment for 2021 health plans will begin on November 1, 2020, and will end on January 15, 2021.
Nevada – Open enrollment for the 2021 health plan will begin on November 1, 2020, and will end on January 15, 2021.
New Jersey – Open enrollment for the 2021 health plan will begin on November 1, 2020, and will end on January 31, 2021.

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Irrespective of the method through which you are enrolling in a health plan, you will require the following information on hand:

  • You will require proof of legal resident status like name, address, email address, social security number, birthday, and citizenship status.
  • Proof of income like pay stubs, W2s, or your recent tax return along with the household size and income, if you are planning to apply for premium subsidies or cost-sharing reductions.
  • Premium and coverage details of any employer-sponsored plan available to your household, whether you have enrolled in that plan or declined it.
  • Mode of health insurance premium payment.
  • Name of your doctor along with zip codes to ensure that whether they are in-network with the health plan which you are considering to purchase.
  • Medications list that is taken by you or anyone who will be covered under the plan. As every plan has its formulary, so you will need to check which plan covers the medications taken by you or your family member.
  • If you are 30-year of age or older and wish to enroll in a catastrophic plan then you will require hardship exemption. You should think of enrolling in a catastrophic plan only if you don’t qualify for a premium subsidy but fulfill a hardship exemption requirements.

Generally in all the cases, your coverage will take effect from January 1, 2021, if you sign-up during the open enrollment window in the fall of 2020, if you will pay your premium on time. However, if you reside in a state where open enrollment extends past December 15, and you enroll after December 15, then your coverage will become effective on February 1 or March 1, depending on when you have applied for the plan. If you were already enrolled in a plan for 2020, then the plan will renew from January 1, and then the new plan will replace as of February or March.

Medicare unlike Medicaid does have an annual open enrollment period. This year the Medicare open enrollment period will begin on Oct. 15, 2020, and will end on Dec. 7, 2020. The coverage for your Medicare plan will start from Jan. 1, 2021.

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