Tis the Season…for Open Enrollment

Obamacare open enrollment begins this year on November 1. If you’re in the market for comprehensive health insurance, open enrollment is your opportunity to shop for and choose a plan that meets your healthcare and budget needs.

Here are a few things to keep in mind if you’re shopping the health insurance Marketplace this year:

  • Generally, open enrollment for 2021 is November 1 through December 15, 2020. Check with your state, though, as some states have extended open enrollment periods. Then, your new insurance will become effective on January 1, 2021.
  • You can find most of the information you need about open enrollment and what’s offered at HealthCare.gov.
  • Depending on your income, you may qualify for premium tax credits, which could lower your monthly premium payment.
  • If you can’t afford Marketplace insurance, depending on which state you live in, you may be eligible for Medicaid or your children may be eligible for the Children Health Insurance Program (CHIP). You can enroll in Medicaid or CHIP at any time.
  • Marketplace insurance is comprehensive medical insurance and must meet Affordable Care Act (ACA) requirements, which means it has to cover things like pre-existing conditions, mental health, and pregnancy.
  • Make sure you shop around to compare prices and benefits offered. If you don’t qualify for premium tax credits, your best option may not be on HealthCare.gov or your state’s official exchange. You can also buy comprehensive health insurance “off-exchange” directly from the insurance provider.
  • As of 2019, the federal tax penalty for not having qualifying insurance coverage was set to $0. However, California, Massachusetts, Rhode Island, Washington DC, and New Jersey do have penalties if you don’t have health insurance.
  • You can apply for Marketplace insurance online, over the phone, by filling out a paper application, or through an insurance agent.

So, now you’re all set to apply for Marketplace health insurance, but what do you do if you don’t currently have any health insurance coverage?

  • If you have what is called a “qualifying life event,” you may be able to enroll on the Marketplace outside of open enrollment. Qualifying life events include losing health coverage (for example, you changed jobs and are waiting for your new job’s insurance), changes in your household (for example, you got married or divorced), or you moved. These are only a few qualifying life events. You can contact HealthCare.gov to see if you’re eligible for a special enrollment period.
  • You can apply for non-Marketplace insurance as a stopgap until your Marketplace coverage becomes effective. Short-Term Medical is one option with coverage similar to comprehensive health insurance, including deductibles, copays, and coinsurance. If you feel like you don’t need something that extensive, a limited indemnity policy may be sufficient until your Marketplace coverage begins. It’s important to keep in mind, though, that these types of insurance plans do not have to comply with ACA requirements and usually exclude pre-existing conditions, preventive care, and mental health care as well as other benefits included in Marketplace plans.

Regardless of what route you take, SGIC encourages you to have some sort of healthcare coverage rather than none at all. If you’re interested in learning more about Short-Term Medical or limited indemnity policies, please give one of our friendly Member Services representatives a call, (888) 912-4767, Monday through Friday, 8:00 a.m. to 5:00 p.m., and they’ll be happy to put you in touch with a licensed agent.