Americans can make changes to their health insurance plans every year starting on November 1st. It’s important to take advantage of this because a lot can happen in your life over the course of a year. Like having a child, getting married, or changing jobs. All of which could mean that you need to change your health insurance plan. But what if you haven’t gone through any big changes? Do you have to sign up for a new health plan every year? It depends. If you’re happy with your current plan, you might decide to do nothing at all during the Open Enrollment Period. On the other hand, if you’re not happy or aren’t sure if you should make changes, doing nothing can have some costly consequences.
Getting Stuck In Your Current Plan
If you’re happy with your current plan, this may not necessarily be a negative thing for you. However, if your plan isn’t meeting your needs and you miss the Open Enrollment Period, you’re going to be locked in for another year until the next Open Enrollment Period. If you don’t take the opportunity to review your current plan and do nothing during the Open Enrollment Period, you won’t be able to change your plan. What this really means is that your health insurance might:
Not provide enough protection for the coming year, which will result in additional costs.
Include coverages that you don’t actually require, which would mean that you’d be paying for protection that you wouldn’t use.
Be too expensive. If you don’t change your plan during the Open Enrollment Period, you’ll be stuck with the higher rates and costs.
Inability To Get Health Insurance
The Open Enrollment Period is for people without health insurance to enroll. For example, adults who just turned 26 and have to get off their parent’s coverage. If you miss this opportunity, you may not be able to enroll at all until the next Open Enrollment Period. Without health insurance, you may have to pay for your medical expenses out-of-pocket. Which can be financially difficult especially for major medical procedures or ongoing treatments. Missing the Open Enrollment Period can lead to delayed or inadequate healthcare, potentially impacting your overall health and well-being.
You Could Face Tax Penalties
At first, the Affordable Care Act did have a penalty in place for missing the Open Enrollment Period. Anyone who could get cheap health insurance, but didn’t sign up had to pay a fine every year. The federal fine was taken away, though, in 2018. However, California, Massachusetts, New Jersey, and Rhode Island all have their own rules that penalize people who don’t have health insurance. The amount of the fine depends on your income level and the tax rules in that state.
Less Options
If you don’t have health insurance and want to sign up for a plan, but you don’t do anything during the Open Enrollment Period, you won’t be able to get a Marketplace or exchange health insurance plan, or an ACA-compliant health plan. Even if you miss the Open Enrollment Period, you do have other choices. But you should know that there are only a few options and they come with limits.
Special Enrollment Period
Outside of the Open Enrollment Period, one of the only ways to get a reasonable health insurance plan that complies with the ACA is to be eligible for a Special Enrollment Period. People can only use a Special Enrollment Period if they have a qualified life event, such as:
Marriage – If you get married, you can choose a new plan by the last day of the month. And service will start the first day of the next month.
Children – If you give birth, adopt, or foster a child you can enroll within 60 days of the event and coverage would backdate to the day of the event.
Moving – You are eligible for a Special Enrollment Period if you moved to a new ZIP code or came to the U.S. from another country. You are also eligible if you moved to or from school, a place where you live and work seasonally, a shelter, or other temporary housing.
Losing Coverage – Losing your current health insurance plan due to a divorce, quitting a job, losing coverage through a family member, or losing Medicaid eligibility, qualifies for coverage during a Special Enrollment Period that lasts for 60 days after you lose coverage (or, in some states, 60 days before you lose coverage). After you choose a plan, your plan will start on the first of the following month.
Those are the main events that trigger a Special Enrollment Period, but there are other circumstances. For example, you can get special enrollment if you became a U.S. citizen, got out of jail, or finished a certain service program. If you were hurt or couldn’t sign up because of a FEMA-designated natural disaster, like COVID-19, you have 60 days after the end of the disaster to sign up for a Marketplace plan. Incapacitation can happen if you have a temporary mental condition or if you are in the hospital during open enrollment. You can ask for your plan to start when it would have, if the event hadn’t happened.
Also, if you weren’t able to enroll or get the help you were eligible for because someone helping you did something wrong, gave you bad information, lied to you, didn’t do anything, or because of a technical error, you are eligible for a special enrollment time.
Exceptions
There are a few people who have different rules for the Special Enrollment Period. Native Americans can sign up for a health plan through the exchange at any time, without having a qualifying event. People whose household income is less than 150% of the government poverty level can sign up for health insurance at a special rate until at least 2025. The Basic Health Program covers people who live in New York or Minnesota and don’t make more than 200% of the poverty level all year long. Oregon wants to have a Basic Health Program by the middle of 2024. Like New York and Minnesota, Oregon would let people sign up for the program at any time of the year.
Why You Need To Use The Open Enrollment Period
The last few years have been, to say the least, unpredictable. Covid-19 has caused hundreds of thousands of illnesses and deaths. As well as job loss and financial problems that many people even now, two years later, are still recovering from. As a consequence, it’s more important than ever to make sure you and your family are protected. Now is the time to do that. The Open Enrollment Period for the Affordable Care Act is here, which means you can find a great plan or change the one you already have. Don’t put it off, especially since you need to pay attention to the Open Enrollment Period this year for so many reasons.
More Options
One of the most important reasons to shop around during the Open Enrollment Period is that you might not know about all the plans and savings choices that are available to you. The Affordable Care Act (ACA) is always changing and growing. As a result, more Americans now have health insurance than ever before. This is because more people can get subsidies and some health insurance companies are expanding into new areas and giving new plans all over the country. That means you have more choices than you did before. So, you might be able to find a better, cheaper health insurance plan that covers you better.
Health Insurance is Necessary
The outbreak showed just how important it is to have health insurance. Even though the Covid-19 situation is over, what if you or someone you care about needs to go to the hospital? Without insurance, you or a member of your family could get hospital bills for Covid. Or any other illness that you or they were treated for. This could put you tens of thousands of dollars in debt. If you had the right health insurance, you could avoid that. Also, what if, like millions of other Americans, you lost your job? If you did, you probably lost your health benefits along with your job. However, just because you lost your job doesn’t mean you can’t still find cheap health insurance with the help of an EZ agent.
Don’t Wait
Look at plans! There’s no reason not to check out your options and compare plans before the Open Enrollment Period ends. But we know that researching all the different plans can be a pain, so we’re here to help! Our competent agents will talk with you and explain all of your choices in detail. When you’re ready to sign up, they’ll look through all the plans in your area to find the best one for you. Making sure it meets your needs and fits your budget. You will always have your own personal agent with EZ. So you don’t have to worry about jumping from agent to agent or getting a lot of sales calls. Not to mention all of our services are FREE. Enter your zip code in the box below to start. Or call 877-670-3557 to talk to an agent right away.
About The Author:
Cassandra Love
With over a decade of helpful content experience Cassandra has dedicated her career to making sure people have access to relevant, easy to understand, and valuable information. After realizing a huge knowledge gap Cassandra spent years researching and working with health insurance companies to create accessible guides and articles to walk anyone through every aspect of the insurance process.
