The Health Insurance Open Enrollment Period is one of the few times you can make changes to your healthcare coverage. Since it is a limited window every year, you want to ensure you’re ready when the time comes.
Curious what you can do to prepare yourself for this critical time of the year? Read on for valuable tips on preparing for the open enrollment period, including evaluating your coverage and costs, considering future health needs, and exploring different health insurance options.
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When and What Is the Open Enrollment Period?
The Open Enrollment Period applies to individuals and families shopping for health insurance on the Health Insurance Marketplace. It lasts from Nov. 1 to Jan. 15 each year. During this time, you can sign up for new health insurance, re-enroll in your current plan, shop for a different plan, or add additional coverages like dental insurance.
As long as you sign up for a plan between Nov. 1 and Dec. 15, your coverage begins on Jan. 1. If you sign up for a plan between Dec. 16 and Jan. 15, your coverage begins on Feb. 1 instead.
The Open Enrollment Period is the only guaranteed period each year where you can sign up for health insurance. To get health insurance outside of this period, you’ll need to experience a qualifying life event, such as losing your job or having a baby. These circumstances trigger what’s known as a Special Enrollment Period (SEP).
Make the Most of Open Enrollment
With such a limited window for most changes, preparing for Open Enrollment ahead of time is essential. Before Open Enrollment starts, consider the following tips to ensure you’re getting the health insurance coverage right for you.
Tip #1: Determine Your Priorities
Before selecting a health insurance plan, identify your priorities. Determine what aspects of coverage are most important to you, such as lower premiums, better prescription drug coverage, or access to specific healthcare providers.
Consider your healthcare needs, including any ongoing conditions or expected medical expenses. For example, if you expect changes in your health status that might require more doctor’s visits, a plan with lower copays might be a better pick.
Budget is also an important consideration for many people. If you do not plan on using many of your health benefits, you may appreciate a plan with a lower monthly premium. However, if you know you need to see the doctor frequently, opting for a plan with a lower deductible may be more worthwhile.
Tip #2: Set Your Budget
To set your budget, consider the different cost aspects of a plan. First is the plan premium, which you pay monthly. Lower premiums mean higher out-of-pocket costs, while higher premiums equate to lower out-of-pocket costs.
Plans also come with an out-of-pocket maximum, which is the max amount you pay before your care is free of charge. If you choose a low-premium plan with a lot of out-of-pocket expenses, ensure it does not have a high out-of-pocket limit.
You should also consider your copay and coinsurance costs. Copays are set fees you pay for a service, such as $20 for a doctor’s visit. Coinsurance is a set percentage you pay for a service, such as 20%.
Finally, review your subsidy eligibility, as these can lower your health insurance costs. In 2023, your household income has to be between 100% and 400% of the federal poverty level to be eligible for a premium tax credit.
Tip #3: Review Your Current Plan
Thoroughly review your current health insurance plan during the Open Enrollment Period to see if it’s meeting your needs. Insurance providers use Open Enrollment to adjust the plan so that they can alter your premiums or coverage.
Take a look at the healthcare bills you had this year to see if they’ve increased from the previous year. For example, if you notice you paid a lot more in copays, it might be a good time to find a plan with better coverage.
You might also want to look at your current healthcare coverage network. Health insurance providers partner with specific doctors to get discounted services. You might have to pay higher fees if you seek care outside of this network. To keep your costs lower, you’re better off finding a plan that includes your providers in the network.
Tip #4: Explore Your Options
If you’re using the Healthcare Marketplace to search, there’s an easy comparison tool that lets you look at up to three plans side by side. This comparison assesses the coverage they provide for medical services, hospital stays, prescription drugs, and preventive care. Evaluate the limitations, exclusions, and any additional perks or incentives each plan offers.
Cost is a critical factor in choosing the right health insurance plan. Compare premiums, deductibles, copays, and out-of-pocket maximums to determine the financial impact of each option on your budget. Finally, ensure the plan you choose includes a broad network of healthcare providers, specialists, and hospitals.
In addition to standard health insurance coverage, consider the benefits of supplemental insurance plans. Dental and vision coverage, for instance, can provide additional protection for services not covered by regular health insurance.
Tip #5: Set an Enrollment Deadline
Avoid leaving this critical decision to the last minute. You do not want to feel rushed when you’re choosing a plan. Set a personal deadline for yourself to decide and enroll in a health insurance plan. Doing so can ensure you have adequate time to evaluate your options and make an informed choice.
You can start browsing plans on Nov. 1, so set your deadline at least two weeks after this date to give yourself plenty of time to compare. For many people, Dec. 1 is a good target date. It’s between Thanksgiving and Christmas, so you’re not flustered with holiday plans. It’s also before the Dec. 16 cutoff, meaning you can get coverage that starts on Jan. 1 instead of Feb. 1.
Tip #6: Ask for Help if Needed
Navigating the health insurance landscape on your own can be confusing. If you feel overwhelmed or require assistance during the Open Enrollment Period, do not hesitate to reach out for help. Consult a trusted insurance agent or healthcare advisor, or utilize resources provided by the insurance company or government agencies to clarify any questions or concerns you may have. These experts can help you find the plan that’s just right for your needs.
All in All
Preparing for the Open Enrollment Period can make it much easier to find the right plan for you. First, you need to determine your priorities and set a budget. Next, review your current plan to see if it still meets your needs. If it does not, you can begin exploring your options for a new plan. And if you’re feeling overwhelmed by everything, there’s always help out there in the form of a trusted healthcare agent.