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What is Open Enrollment and How to Choose the Best Policy

If you are currently not happy with the policy you have now or simply would like to make some minor changes, the open enrollment period is a great time to do it. While the exact timeframes will depend on your individual type of insurance, it is usually from the start of November to mid-December. However, if you have Medicare, your open enrollment will start earlier from October 15 and last all the way to December 7. These are general guideline and you should double-check the requirements of your state since you may have open enrollment. If your job provides you with insurance , they will determine when you have to renew the policy.

Let’s take a Look at Open Enrollment More Closely

What is an Open Enrollment Period?

The law stipulates that everybody needs to have health insurance either from their employer or from the government. Open enrollment is the period of time they give you to get covered and avoid fines. Usually, this is a window of 2-3 months. While this may seem like a long time, it is can be very time consuming to compare and contrast all of the various plans, so if you plan on making changes this year, it is better to start early. If you get health insurance from your job, they will tell you that your plan is up for renewal, but if you get insurance from the government, you need to be aware of the deadlines. You have between the New Year and March 31 to buy a policy from the government, which is the general enrollment period.

When it comes to coverage, you certainly have plenty of choices and you need to be aware of them to find the right one for you. Let’s take a look at those next.

open-enrollment time-frames

  • California – Oct. 15, 2019-Jan. 15, 2020
  • Colorado – Nov. 1, 2019-Jan. 15, 2020
  • D.C. – Nov. 1, 2019-Jan. 31, 2020
  • Massachusetts – Nov. 1, 2019-Jan. 23, 2020
  • Minnesota – Nov. 1, 2019-Dec. 23, 2019
  • New York – Nov. 1, 2019-Jan. 31, 2020
  • Rhode Island – Nov. 1-Dec. 23, 2019

What Choices Do You Have in Terms of Coverage?

The first option you have is to renew the policy you already have. It is possible to stick with whatever you currently have if it is still valid. If this is the case, then absolutely no action may be a requirement from you. Still, you should always keep in mind that changes could be made to your current plan so when the renewal letter comes in the mail, be sure to read it carefully to make sure you understand all of the changes.

Some of the changes may not be all that convenient for you and may even be unacceptable. For example, if you like the primary care physician you have now, they might become out of network, which means that the insurance will no longer cover them. Since there are so many options out there in terms of healthcare, why not choose a policy that suits all of your needs. Open enrollments are the best time to find such a policy.

Make Sure You Have Insurance By Whatever Means You Can Get It

All states have their own exchanges through which they offer health insurance and they could be your provider as well if you let them know about it. While you may not receive a subsidy, the law still requires you to be covered. If your income is anywhere between 2-4 times above the poverty line as determined by the government, you will receive a subsidy.

In other words, a family of four can qualify for a subsidy, if the total income is no more than $100,300, but not less than $25,750. Another thing that you should check out is whether your state offers Medicare expansion. If it does, the income level will be even lower to qualify.

Adjust the Employer-Based Coverage

The open enrollment period is only critical for those people who are getting coverage from the states. If this does not apply to you, then you just need to make sure that you have coverage in general, from your employer. When your policy is up for renewal, do not simply sign the paperwork and forget about it. It is important that you actually read it and understand all of the changes, if any, so that you can feel comfortable living with it.

Why is this so important? Whatever decisions you make now, you will have to live with for the rest of the year. Be sure that you have peace of mind knowing that you have something to fall back on and this will make it more comfortable for you to go about your day-to-day life.

Get a Short-Term Health Plan

These types of plans have been previously reserved for young people and for those who could not afford to get insured in any other way. All of this changed in 2019 and now such plans are available to everybody. If you decide to purchase such a plan, do. Not be surprised if they are not of the same quality as the ones offered through the exchanges. They will not cover services like maternity, prescription, or mental health. Therefore, be sure to study everything the plan has to offer before deciding to buy it.

Again, we come back to the cost vs the reward. Whatever you pay is what you get out. So if you buy a plan that is really cheap, don’t expect it pay for your injuries or health issues when you need to go to the hospital. If you don’t want to roll the dice, it’s better to just pay more for a good policy.

How to Choose a Health Plan

The government offers four health packages:

  • Bronze
  • Silver
  • Gold
  • Platinum

Before deciding on a policy you will need to do some research into the costs of each plan. Each one has a tradeoff i.e. they will give you a cheaper premium in exchange for less coverage. This is why you need to sit down and carefully think about how often you go to the doctor and will this continue into next year. If the answer is yes, then you better get something that covers all of those trips.

If you usually do not have a whole lot of medical issues, therefore it would not make sense for them to pay a high premium. Still, the reason that you have insurance, to begin with, is because there is always a chance you will need it. This is why you should consider overprotecting yourself just in case because if something happens you might be left to deal with it alone.

What Do the Health Plans Offer?

The Affordable Care Plan requires that all plans provide ten basic benefits:

  1. Managing recurring health issues and caring for patients released from the hospital
  2. Emergency room treatment
  3. Trips to the hospital that require admission or surgery
  4. Prenatal care and pregnancy care
  5. Provide care for mental conditions
  6. Limited amount of medications
  7. Rehab from surgery, disability or chronic condition
  8. Lab tests such as blood and urine tests
  9. Wellness and preventive care
  10. Dentist and optometrists visits for children under the age of 18

The ultimate plan that you end up choosing might offer a lot more benefit than what we have above, but you should still know that this is the bare minimum so that nobody will be able to take advantage of you. If you go through your coverage and see that even one of the ten things mentioned is not included, then something is wrong and it is better to look for coverage elsewhere.

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