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Getting the Coverage You Need

Open Enrollment is the period each year when health insurance plans or HMOs (health maintenance organizations) are required by law to accept applications from new plan enrollees regardless of their health history. This also is the time when you can choose to stay with your existing health plan for the coming year if it still meets your needs. Open enrollment dates vary, depending on the state you live in and whether you get your coverage from your employer, an ACA Marketplace, or another source 鈥 but for many people, open enrollment takes place annually in the fall.

Timing

  • If you get insurance through your job, check with your human resources department to find out when your company鈥檚 open enrollment period begins and ends.
  • If you get your health insurance through the ACA Marketplace, please note that in most states the 2022 open enrollment period will run longer than in past years (Nov. 1 to Jan. 15, 2022). However, in order to have insurance in effect as of Jan. 1, you must sign up by Dec. 15.
  • For people with Medicare coverage, open enrollment runs from Oct. 15 – Dec. 7.
  • Enrollment in Medicaid, for those eligible, is open 365 days a year.

Costs

  • Don鈥檛 just focus on premium costs! Your out-of-pocket spending (deductibles, copays, coinsurance) can end up being substantially more than your premium. Make sure you understand and compare OOP amounts.
  • If shopping on healthcare.gov, don鈥檛 be put off by 鈥渓ist鈥 prices. Most purchasers will qualify for tax credits that lower the cost of premiums. With tax credits factored in, many people qualify for insurance that costs less than $10/month! Depending on income, you may also be eligible for assistance with your OOP spending, so long as you purchase a silver-tier plan.

Scope of Coverage

If you cannot answer these questions, seek help and clarification from your company鈥檚 human resources department (for an employer-sponsored health plan), your HTC social worker, or an ACA Marketplace navigator (if you are selecting a plan via the Marketplace.)

Be an Active Participant

As you consider your insurance options during open enrollment, be an active participant! Simply sticking with your existing plan may mean that you miss opportunities to improve your coverage or even potentially lower your costs. And whether you choose to keep your current health insurance or to 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 that allows you to switch plans.


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