Open Enrollment: How to Find the Right Health Plan
The Affordable Care Act (ACA) is still in place, but you won’t get fined this year if you don’t have health insurance. However, if you do not have a health plan and sustain an injury or come down with an unforeseen illness, you can easily become bankrupt with outstanding bills.
It’s never a wise idea to go without insurance. Even if you’re a young, healthy individual with no dependent family members, having some insurance will put a cap on maximum out-of-pocket expenses and prevent a financial catastrophe if an accident were to happen.
Open Enrollment begins at different times in each state. In most states, the open enrollment period begins November 1 and ends December 15. In California the open enrollment period begins October 15 and ends January 15th. Always check your local deadlines!
In the majority of states, the open enrollment period is only six weeks long and it is the only time of the year you can enroll in a new health plan. There are certain times outside of the open enrollment period that you can sign up for insurance. These exceptions are called qualifying events but not everyone is eligible.
People who qualify for Medicaid or Children’s Health Insurance Program (CHIP) can also enroll outside the open enrollment period.
Below, we show you how to find the right health insurance for Open Enrollment 2020.
What Do I Do During Open Enrollment?
1. During the open enrollment period in your state, you can renew your current individual or family health insurance or make changes to your existing health care plan. Remember that your health insurance automatically renews. You don’t need to re-enroll each open enrollment period but you can’t make changes to that insurance after the enrollment period ends.
If your insurer has changed any of their terms, they will notify you of these changes before open enrollment. If you decide you want a different tier of protection with the same insurer, you need to report these changes before the start of the year. Each state has a different open enrollment term so make sure you don’t miss your deadline!
2. You can choose a new health insurance plan in one of two ways, using the HealthCare.gov Marketplace in your state if you qualify for Medicaid, Medicare or CHIP. Otherwise, you’ll need to buy private insurance. You can start the process of buying insurance by filling out a brief online form here to be matched with a dependable insurance agent who can answer all your questions and help you find the right health insurance plan that fits your budget.
What Is Private Health Insurance?
Private health insurance is not offered by a state or federal government. If you have health insurance through an employer you have private group health insurance. Insurance that you buy that is not offered by an employer is called an individual private health insurance plan. You can also add family members to your private health insurance plan.
Who Needs Private Health Insurance?
If your employer doesn’t supply you with health insurance, if you just turned 26 and are no longer eligible to be on your parents’ insurance, if you’re unemployed or self-employed, work part-time, have your own business or are recently retired and don’t qualify for Original Medicare, you will need to buy private health insurance. If you do qualify for original Medicare, you’ll need to buy private Medigap insurance to cover Medicare copays and other out-of-pocket expenses. If you are ineligible for Medicare, you can buy private Medicare, which is called Medicare Advantage. You cannot buy Medigap along with Medicare Advantage because coverages overlap and it’s unnecessary to have both.
How Do I Choose a Health Plan, It’s So Confusing!
Buying private health insurance is confusing! This is why we suggest filling out a form here and being placed with a trustworthy agent. Some things to keep in mind when comparing what insurers offer are the following factors:
Prescription Drug Coverage: If you take medications, you will have a copayment on these medications. If you take many medications, this could add up to be a lot. Be sure to keep prescription drug coverage in mind and see if an insurer only covers generics, if you need an on-name brand drug.
Co-pays: Copayments for doctors’ visits, lab tests and x-rays and can also make the cost of your health care more or less expensive. Jot down how often you see doctors a year on average and consider how much that will cost in copayments per year to compare plans.
If you’re pregnant and will be seeing doctors an unusual number of days in the coming year, take these copays into consideration when choosing a plan. You may be better off buying a more expensive plan with a cheaper copay if you’re having weekly doctor visits. Better yet, see if there’s a plan that fits your budget that has pregnancy benefits.
Note that there is no copay for your annual checkup if you buy an ACA-qualified plan.
What are the hospital copays? How about for an emergency room visit? These are often unanticipated expenses.
Your Doctor: If you feel you need to keep a certain doctor, ask them if they belong to an HMO or PPO plan. If they do not, you may want to choose an EPO or PPO plan so that you can be covered, if only partially, to see this doctor. Some physicians do not belong to an HMO plans. If you choose a doctor that is a part of your HMO or PPO network of providers will save you money.
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Everyone likes knowing they have the option to elect COBRA insurance but no one really seems to understand how it works or how to get started or if they should.
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; anyone who with Medicare Parts A or B can join, drop or switch a Part D prescription drug plan; and anyone with Medicare Part C can switch to a new Part C plan.
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A 65-year-old retiring in 2019 will spend about $135,000 to $150,000 in out-of-pocket medical costs during their retirement. This astronomical figure has gone up about $2500 since last year. Of course, these costs would be higher if you have an existing condition or if you live longer than the average American.
Like auto and homeowners insurance healthcare insurance also has a deductible which needs to be paid before insurance begins to cover expenses. However, healthcare deductibles work a little differently. For instance, your healthcare insurance will pay for some services even before you meet your deductible.
You may be shopping for health insurance because you got a new job, which doesn’t offer health insurance. Some people even prefer to have a health plan separate from their jobs. It’s usually a more expensive option to buy an individual health insurance policy when an employer offers to pay a portion of your premiums each month. However, some people prefer to choose their own insurance company and a plan that fits their needs.