Open enrollment is here, so it’s time to think about your healthcare coverage.
Practically, open enrollment is the only time of year, outside qualifying life event changes, when you can choose or change a healthcare plan. In reality, this often means stressing over your options and muddling through a confusing mass of various plans.
No worries, though; we’ve made it simple by answering the most commonly asked questions about open enrollment 2019.
When is open enrollment?
Before you start reviewing your plan, familiarize yourself with the key dates of this year’s open enrollment.
- Nov. 1, 2018: Open enrollment begins
- Dec. 15, 2018: Open enrollment ends
- Jan. 1, 2019: Plans sold during open enrollment become effective
Several states have extended their open enrollment period:
- California: Oct. 15, 2018 to Jan. 15, 2019
- Colorado: Nov. 1, 2018 to Jan. 15, 2019
- Massachusetts: Nov. 1, 2018 to Jan. 23, 2019
- Minnesota: Nov. 1, 2018 to Jan. 13, 2019
- Rhode Island: Nov. 1, 2018 to Dec. 31, 2018
- Washington D.C.: Nov. 1, 2018 to Jan. 31, 2019
How do I apply for a Marketplace plan?
Starting Nov. 1, 2018, you can apply for a new Marketplace plan online, by phone, through a paper application, or through an insurance agent or broker. You can find out more information about Marketplace plans here.
Can I purchase a plan through the Marketplace if I’m insured through my company’s healthcare plan?
If you’re covered through a job-based insurance plan, you can still purchase a Marketplace plan. However, since most workplace insurance plans meet Marketplace standards, you’ll need to pay full price for your new plan. If your company’s plan fails to meet these standards, though, you’ll likely qualify for a subsidized plan.
Can I purchase a plan through the Marketplace if I have Medicare?
If you have Medicare, you cannot switch to a Marketplace insurance plan, supplement your coverage with a Marketplace plan or purchase a Marketplace dental plan.
Were there any major healthcare changes made this past year that I need to know about?
There were two important healthcare changes made this year:
Benefit standard changes
Since the establishment of the Affordable Care Act (ACA), insurers in all 50 states were required to meet 10 essential health benefits. For 2019, insurers are allowed to choose from 50 essential health benefits. This provides consumers with more flexible plan options to choose from in 2019. However, each insurer’s coverage may vary considerably. It’s also likely that your existing plan will have significantly changed its terms and range of coverage.
For this reason, it’s imperative that you carefully review the coverage offered by any existing and new plans to ensure they meet your needs.
You are no longer required to obtain healthcare coverage
ObamaCare has not been repealed, but one major facet of this act has been eradicated: It is no longer considered unlawful not to have health insurance. Uninsured Americans will not be hit with a federal tax penalty at the end of the year. However, if you live in Massachusetts, New Jersey or Washington, D.C., you’ll still be subject to a state-level mandate.
What are qualifying life events?
There are four primary categories of qualifying life events, each of which can happen at any time of the year. A qualifying life event will allow you to enroll in a new health insurance plan throughout the year, even when it’s not open enrollment season.
These are the four qualifying life events:
- Loss of health coverage, due to job loss, losing qualification for Medicare or Medicaid coverage or aging out of a parents’ plan.
- Household changes, including marriage, divorce, birth, death or adoption.
- Changes in residence. This event is only applicable if you’ve moved to a new region that is now outside your previous insurer’s coverage base.
- Other qualifying events such as obtaining U.S. citizenship, freedom from incarceration and joining or leaving the AmeriCorps.
Do I need to apply for Medicare, Medicaid or the Children’s Health Insurance Program (CHIP) during open enrollment?
If you are newly qualified for Medicaid or CHIP, you do not need to apply for them during the open enrollment period; you can apply at any time throughout the year.
If you are newly qualified for Medicare, though, you do need to apply during a specific enrollment window, beginning on Oct. 15, 2018, and ending on Dec. 7, 2018. Coverage for all Medicare plans opened during this time will begin on Jan. 1, 2019.
During the Medicare open enrollment period, individuals with existing Medicare plans will also be able to make changes to their coverage and apply for additional coverage, such as Medicare Parts C or D.
Should I choose a cheaper, high-deductible plan?
Plans that come with high deductibles are not for everyone. However, if you don’t anticipate any major, recurring medical expenses this year, and you and your family are in blessedly good health, you may want to consider one of these plans. You’ll have to pay out-of-pocket for each doctor’s visit, but if you don’t tap into your benefits before your deductible is paid up, you’ll save a whole lot on your healthcare costs throughout the year.
If you do go this route, consider pairing your plan with a Health Savings Account (HSA). An HSA is only available to individuals with a qualifying, high-deductible plan. HSAs allow you to set aside pre-tax money for medical needs throughout the year. It can help lower your tax bill at the end of the year while also allowing you to save money in the event of a major medical expense.
If you expect to spend a considerable amount on medical care throughout the year, you’re better off choosing a low-deductible plan and paying the higher premium, as it will end up costing you less in the long-term.
Open enrollment doesn’t need to be stressful. Follow these guidelines to make an informed and responsible decision that will serve you well throughout the year.
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