Health Insurance Open Enrollment 2021: You May Not Have to Wait

Fran
Fran Majidi
July 8, 2020

Yes, you need health insurance, now more than ever. Even young, healthy people are coming down with coronavirus, which has surged again in recent weeks. Everyone needs to get insured -- young, old and in-between. You may be thinking it’s summer, and you have plenty of time before Open Enrollment starts and ends, but you may be able to get insured even sooner. For one thing, Open Enrollment is a little wonky this year due to coronavirus, but to your advantage. In many states, people enrolled as early as April 2020, and those markets are still open. It’s also unclear if those same states will close their markets at the end of the scheduled Open Enrollment period, which is usually from October through mid-December. We have all the information you need to start shopping for the right health insurance today.

What About Health Insurance Through a Job?

If you get your health insurance through your employer, your Open Enrollment falls in whichever month the company chooses. That can be during the national Open Enrollment dates or it can be in the middle of any month.

When Can I Buy Health Insurance if I Don’t Have It?

If you’re buying private health insurance, you must do so during the Open Enrollment period if the state you live in has not opened up the health insurance marketplace due to COVID-19. If you’re not sure whether your state will allow you to buy health insurance now you can call one of our call center reps at 855-214-2291 to see if you’re eligible to buy today.

It’s important to ask questions now because you may be able to buy health insurance before Open Enrollment begins in fall. Also, you may have what’s called a “qualifying event” which allows you to buy health insurance regardless of what time of year it is. Common qualifying events include losing a job, getting married, having a baby and more. Basically, a qualifying event is based on four kinds of life changes:

  • Sudden loss of health coverage
  • Changes in household
  • Changes in residence
  • Other qualifying events.
    There are many situations that can be defined as a qualifying event, like the death of a loved one, a divorce, or age qualifications change (for Medicare, you may turn 65; for a regular health plan, you cannot be on your parents’ healthcare plan after you turn 26).

Changes in Health Benefits 2021

The good news is that this year, states have more options for flexible plans. This means you will have more options, but it’s important to compare plans carefully. If you’re new to the health insurance tier system, brush up on what the different levels means in terms of coverage. It’s important to compare apples to apples with these plans. For example, don't compare the cost of a silver plan with the cost of a bronze plan. Expect to always pay more for a silver plan, which pays for more of your medical costs. Figure out which tier level makes sense based on your history of doctor visits in the past year and what you anticipate it will be like in the following year.

Do I Have to Buy Health Insurance for 2021?

There is a penalty if you live in Massachusetts, New Jersey or Washington D.C. As for the other states, no, the individual mandate in the Affordable Care Act was repealed in 2018. There is no penalty or fine for not buying health insurance, but if you get sick and don’t have any health coverage, it may cost you thousands of dollars. If you are infected with the coronavirus, you can easily become medically bankrupt. The cost of a hospital stay, not to mention ventilators and other life-saving procedures and medicines, will be insurmountable. It’s not a good year to be uninsured, especially with medical experts raising doubt on whether or not there will be COVID-19 vaccine by January 2021.

When Is Open Enrollment 2021 for Medicaid or Medicare?

Medicare and Medicaid work differently because different people turn 65 at different times of the year. With Medicaid, an income-based state-subsidized health plan, you have to sign up during the regular open enrollment period, unless the healthcare marketplace is open in your state. Make sure you understand the difference between Medicaid and Medicare before you make any buying decisions.

If you’re a senior, you can apply for Medicare during a 7-month Initial Enrollment Period which begins 3 months before you turn 65 and ends 3 months after the month you turn 65. Remember that Original Medicare is Part A or Part A & B. If you fail to sign up in time for Medicare Part B, you may get a late enrollment fee, which you’ll have to pay for the duration of your coverage. If you wait to apply for Medicare until the month you turn 65 or in the 3 months after you turn 65, you may have a gap in health insurance due to a delay.

Open Enrollment (October 15 - December 7) applies to seniors who have Medicare and want to switch to private Medicare (Medicare Advantage or Part C) or if they want to buy Medigap to help pay towards copays and prescription drugs.

Before shopping, learn the difference between Medicare Advantage and Medicare Supplements because you can’t buy both.

Medicare Advantage Open Enrollment

January 1 - March 31 is Medicare Advantage’s open enrollment period, and coverage begins in July. This individual Medicare Advantage Open Enrollment period is limited to new Medicare beneficiaries with both Medicare Part A and B, who enroll in a Medicare Advantage plan during their initial coverage period.

Medicare Open Enrollment

From October 15 - December 7, anyone with Medicare Parts A & B can switch to Medicare Part C (Medicare Advantage); anyone with Medicare Part C can switch back to Medicare A & B. During this period, anyone with Medicare Parts A or B can:

  • Join Medicare
  • Drop Medicare
  • Switch from Original Medicare to Medicare Advantage
  • Switch a Part D prescription drug plan
  • Drop Part D altogether
  • Anyone with Medicare Part C (Medicare Advantage) can switch to a new Part C plan.

Beginning January 2021 changes will be in effect.

Can I Open a Flexible Savings Account (FSA) with Private Insurance?

Unfortunately, you can only apply for an FSA with job-based health insurance plans.

Can I Open a Health Savings Account (HSA) with Private Insurance?

If you want a tax-advantaged account, an HSA may help you save money for medical expenses. You must have a high-deductible health plan. You can open an HSA with a number of financial institutions. What’s great about an employer-sponsored one is that you can contribute to it and your employer can as well. But yes, you can open an FSA even if you buy your own health insurance. You cannot be enrolled in Medicare if you want to open an HSA. You also cannot be a dependent on anyone else’s tax return. In 2021, contribution limits to an HSA are $3,600, employer contribution included if applicable.

Are Dental and Vision Included in a Private Health Insurance Plan?

In most cases, you have to buy dental and vision separately from health insurance, even when you elect to buy it through an employer. However, many insurers offer supplemental dental plans and vision plans. You will have to pay extra for these coverages, but much less than you will for your primary health care.

It’s important to buy the right insurance plan. If you’re not sure what you need, SmartFinancial can help you speak with an agent who can help. Start by entering your zip code below.

Get a Free Health Insurance Quote Online Now.

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