Are you thinking about individual or family health insurance? Do you need health insurance cover, but not sure how to get it? Now is a great time to start planning for Open Enrollment under the Affordable Care Act – otherwise known as Obamacare.
While the current President may be on the way out, your health insurance issues are still valid and you still need to have health insurance in the US as part of the Affordable Care Act provisions. You can only sign up for insurance using your state’s marketplace or health insurance exchange during one annual period – the Open Enrollment period (unless you get married, have a baby, or experience another “qualifying life event”.)
If you are getting health insurance through an employer then they will let you know about the open enrollment period. But if you want health insurance without an employer, this quick guide is for you.
What can you buy during Open Enrollment? You can purchase a policy direct from the health insurance marketplace in your state. You can get it from a health insurance company directly. You can find a quote and buy health insurance online. Or you can use a health insurance agent.
Here’s what you need to get ready for Open Enrollment 2017.
1. Open Enrollment 2017 begins on November 1 2016 and ends on January 31 2017. This is a relatively short amount of time to get your plan purchased. But bear in mind that your cover does not begin immediately. There are different start dates depending on when you sign up: January 1, February 1, or March 1 2017.
2. You must use the Open Enrollment period to sign up for health insurance if you do not have it from another source. For example, if you do not have any insurance through your job or the employer of your spouse, if you do not have government cover, and if you are now older than age 26 – you cannot still be on your parents’ insurance once you reach this age.
3. You don’t have to get a completely new plan. If you have a current plan you can keep it. But check that your current plan hasn’t changed for next year in a way that makes it less appealing for you. You will receive a notice of changes so make sure you read it so you can be in time to get a new policy if you need to.
4. Now’s the time to do it – if you miss the open enrollment period you have to wait another year to get cover. You need health insurance or you get a penalty at tax time. You may have a life event that makes it possible to use a special open enrollment period during the year, but this should not be relied upon.
5. If you have cover for only dental or vision, workers compensation, insurance for a specific condition, or a plan for medical discounts, these do not count as cover.
6. If you do not have cover, the penalty is 2.5 percent of your income (calculated as $595 per adult if this is more) with a maximum penalty of $2,085.
7. You can’t get life insurance, travel medical insurance, or types of long-term care insurance through the health insurance marketplace. You can get these products elsewhere, at any time.
8. You can buy from four different levels of insurance plans for the individual and the family. These are generally categorized as bronze, silver, gold, and platinum plans. The bronze plan type has the highest deductibles, meaning you pay less on your premiums but more out of pocket. Platinum plans have the lowest out-of-pocket deductibles. Bear in mind that you cannot change from one level to another in the same year, so watch out if you choose the highest deductibles because you are stuck with high bills if you suddenly need surgery.
9. All health insurance plans must cover at least the 10 essential benefits, which include: outpatient care; emergency care; hospitalization; pregnancy and baby care; mental health care; prescription drugs; rehabilitation; lab tests; wellness tests; and dental and vision for children.
10. You may not need to buy health insurance if you suffer a hardship like being the victim of domestic violence, or the victim of a natural disaster, a death in the close family, an eviction, bankruptcy, or incarceration.