It’s that time of year again. The leaves are turning, the red cups are back at Starbucks, scarves and boots are back in style, and people are talking about Open Enrollment Period (OEP). Ok, maybe you haven’t seen the last one, but it’s pretty important.
Open Enrollment is the time of year when you can buy or change your health insurance on the marketplace exchanges. At Catch, we’re here to help you build your own your own safety net, including tackling the health insurance marketplace.
We’ll start by asking you some questions to guide. Think of this like a “Choose your own Adventure” for health insurance. Then we’ll ask some questions you’re probably thinking. It’ll be fun. Let’s do it.
Do you get health insurance from an employer, family member (spouse or parent), or the US Government (Veterans, Medicare, Medicaid)?
Yes? Well good news, there’s no need for you to read further. Open enrollment is designed for people who don’t have access to plans from other sources.
No? Not a problem. Welcome to the OEP Squad.
Do you know when you can buy your health insurance?
Yes? Ok, smarty pants. Gold star for you. No? For most states, the Open Enrollment window is November 1 - December 15, 2018.
If you live in the following states, you’ve got a longer period during which to enroll. Thank your state legislators.
- California: October 15 - January 15
- Colorado: November 1 - January 15
- Massachusetts: November 1 - January 23
- Minnesota: November 1 - January 13
- New York: November 1 - January 31
- Rhode Island: November 1 - December 31
- Washington D.C.: November 1 - January 31
Why do you have to buy insurance during this time period?
It’s weird right? The basic concept of open enrollment is to require all people to buy health insurance during a fixed time period so the risk is balanced between those who are sick and those who are healthy. Insurance companies can then keep a stable pool of sick people and keep prices predictable. If anyone could sign up for insurance at any time, the theory goes, people would only sign up when they needed to file claims - not when they are healthy.
Do you know what you’re going to pay?
Trick question. This is one of the hardest things about the health insurance market. What you pay, under what circumstances, to whom is harder than rocket science. Mostly because rocket science is at least logical.
So what can we do to help? A few things.
First, you should know if you qualify for subsidies (premium tax credits or through cost-sharing). If you qualify, you may end up paying less for health insurance than you thought. In fact, in February 2018, nearly 90 percent of those who got health insurance from an exchange qualified for subsidies.
Second, you should think about what type of care you need. Understand that most insurance premiums are calculated on a sliding scale: higher premiums mean you pay less when you receive care (known as platinum plans), and lower premiums mean you pay more when you receive care (scaling down as gold, silver, and bronze plans).
There are a lot of details to understand in subsidies and plan types, which is why they’ll be the topics of our next update.
If you already have a plan, do you need to change it for 2019?
You don’t have to change your plan each year, but you may find it helpful. Your premiums may go up more than you expect, prescriptions may no longer be covered, or your doctor may elect to not accept your plan next year. Checking out what’s available in the marketplace may help you find a plan that better fits your needs.
One last question: where do you get your health insurance for open enrollment?
You now know a lot of the basics about Open Enrollment for 2019, but there’s one thing left - where do you actually purchase the insurance? The answer is that it depends what state you live in.
You can go to the federal exchange and enter your state to find out exactly where you can purchase plans through Open Enrollment.
No doubt, getting your own health insurance is difficult and too expensive, but the first step to getting the coverage you need is understanding the marketplace. Catch is here to help you do just that.
Questions? Chat with us or send an email to firstname.lastname@example.org