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Dear Addy: Open Enrollment Period

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Note: This article was updated on 11/10/2015 to reflect Open Enrollment dates for plans beginning in 2016. 

 

Dear Addy,

I am not happy with my current health insurance. My work told me that I can’t change my plan until the “Open Enrollment Period” starts. What is an open enrollment period and why do I have to wait?

Signed,

Ready for a Change

______________________

Dear Ready,

First, an Open Enrollment Period is the time during the year when health insurance companies or HMOs (health maintenance organizations) are statutorily required to accept applications from new plan enrollees regardless of their health history. This also is the time when you can choose to stay with the health plan you have if it is the right one for you. Generally, open enrollment is held once a year.

There are several reasons for an open enrollment period, but it is mostly related to money. Having people commit to a specific plan for one year helps employers budget for any share of the premium they might pay as part of employees’ compensation. Also, insurers are better able to manage costs when they know how many people each plan will serve for the coming year.

This is not to say that people can’t change insurance outside an open enrollment period. There are many circumstances, or “qualifying life events,” that allow people to change health insurance plans outside of the enrollment period. For example, if you get a new job you are able to change insurers, in order to be covered by the plans offered by your new employer. Your company will have a complete list of qualifying life events that allow you to change your coverage.

Check with your human resources department to find out when your company’s open enrollment period begins and ends. For people who have health insurance through the Marketplace, the next open enrollment period runs from November 1, 2015 to January 31, 2016. For people with Medicare, open enrollment runs from October 15-December 7 annually. 

Remember, whether you keep your current health insurance or enroll in a new plan, READ YOUR POLICY. This is critical because the health insurance plan you choose, will be yours for 12 months unless you have a qualifying life event.

Sincerely,

Addy

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HFA frequently receives questions from the bleeding disorders community related to advocacy issues. The questions often impact the entire community. In an effort to reach the largest audience possible with our responses to these widely applicable questions, HFA developed “Dear Addy.” Questions submitted to this column are edited in order to protect privacy and should be considered educational only, not individual guidance.

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