Open Enrollment: Why You Shouldn’t Wait

Open Enrollment: Why You Shouldn’t Wait text overlaying image of a man questioningAmericans 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.

Don’t Qualify For a Subsidy? EZ’s Got You Covered!

Qualifying for health insurance subsidies has gotten much easier these days, now that President Biden has extended premium subsidies to those who earn up to 400% of the federal poverty level. That means that millions more Americans can save hundreds of dollars a year on insurance – but it doesn’t mean that everyone qualifies. So what if you don’t qualify for a subsidy? Can you still save money? When you work with an EZ agent, you will! Find out what the qualifications are for a subsidy and how we can help you save even if you don’t qualify.

Who Qualifies For A Subsidy?white silhouette of a person with their hand on their chin and a red question mark behind it

Because of Biden’s American Rescue Plan Act (ARP), qualifying for subsidies is not as difficult as it used to be. To be eligible, you now must either:

  • Have an income at or below 400% of the Federal Poverty Level. 
  • Have premium payments that exceed 8.5% of your overall household income. 

Individuals whose income is lower than 400% the Federal Poverty Level will receive higher subsidies.li

Because of this expansion, more than a third of the people who bought health insurance during the COVID/ARP Special Enrollment Period this year purchased plans for less than $10/month! So it is definitely worth it to take a look and see if you are eligible for a subsidy; an EZ agent can check for you at no cost. It can be confusing trying to figure out what you qualify for, but we can help you every step of the way. 

If You Don’t Qualify…

You can still save money! There are still ways for you to save money when purchasing a health insurance plan, by working with a licensed and trained EZ agent: we know all the ins and outs of finding people affordable insurance that works for them. For example, did you know that if you are under 30, or if you qualify for a hardship exemption, you can get a catastrophic plan? These plans are ACA-compliant, and have high-deductibles, but low monthly premiums. They are generally for healthy people who do not foresee ever meeting their deductible because they are in good health. 

illustration of a woman with a laptop screen and money next to her

But what if you are over 30 or don’t qualify for a hardship exemption, or have health issues and need a more comprehensive health plan? Well, you can still save money! EZ can help you because we offer a wide range of health insurance plans from top-rated insurance companies in every state. Because we work with so many companies and can offer all of the plans available in your area, we can help you enroll in a plan that saves you a lot of money – even hundreds of dollars – even if you don’t qualify for a subsidy. There is no obligation, or hassle, just free quotes on all available plans in your area. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890.

Does Your Health Insurance Plan Cover Your Basic Needs? Find Out If It Is ACA-Compliant

When former President Obama came into office, one of his top priorities was to make sure all Americans were insured, and thus the Affordable Care Act (ACA), or Obamacare, was enacted in March 2010. The ACA has not only made health insurance easier to get for millions of Americans, but it has also meant that now all health insurance plans must cover certain basic needs, as long as they are ACA-compliant. Knowing if your plan is ACA-compliant or non-compliant will help you to get the most out of your health insurance plan, and to know if you need to switch your plan to one that is compliant.

What Does ACA-Compliant Mean?

ACA-compliant health insurance plans are known as qualified Major Medical health plans, and  cover the 10 essential health benefits with no annual or lifetime coverage maximums. These essential benefits include:illustration of a man laying in a hospital bed with a doctor standing next to him

  1. Hospitalization
  2. Ambulatory services (visits to doctors and other healthcare professionals and outpatient hospital care)
  3. Emergency services
  4. Maternity and newborn care
  5. Services to treat mental health disorders and problems with substance abuse
  6. Prescription drugs
  7. Lab tests
  8. Preventive services, including things like contraception, blood pressure screening, breast cancer screening, colorectal cancer screening, obesity screening and counseling, tobacco use counseling and interventions, and breastfeeding counseling
  9. Pediatric services for children, including dental and vision care
  10. Rehabilitative and habilitative services

ACA-compliant plans are also guaranteed issue during the open enrollment period, which means that any pre-existing conditions will not play a role in your eligibility for a health insurance plan.

Non-Compliant Plans

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Short term plans are not ACA-compliant, but are cheaper and temporary for when you can sign up for an ACA-compliant plan.

Other types of health plans that do not cover the 10 essential benefits, sometimes called traditional plans, are considered non-compliant with the ACA. Non-compliant plans include short-term health insurance, fixed indemnity plans, and healthcare sharing ministry plans. These types of plans do not have to abide by the ACA’s consumer protections and are exempt from federal regulations.

Of non-compliant plans, short-term health plans are probably the most commonly purchased, because they are generally much cheaper than ACA-compliant plans. They provide temporary coverage when you are not eligible for a major medical plan or are waiting for coverage to start. Unlike ACA-compliant health insurance plans, these plans can use your pre-existing conditions against you; short-term policies were created for healthier individuals who need some sort of emergency coverage for a short amount of time, so they only cover the basics. Therefore, people with pre-existing conditions, or who are in need of medical care should not consider a short-term health plan.

Looking For More Coverage?

ACA-compliant plans offer more coverage, and thanks to Biden’s American Rescue Plan Act, premium subsidies have been extended to more people, so everyone can save money on health insurance. Before you start doing the work of comparing plans on your own, come to EZ: we will make the process quicker and easier by comparing available plans in your area in minutes. Our licensed agents work with all the top-rated insurance companies in the nation and can go over your budget and needs, and find the best plan for you and your family. We compare plans and offer guidance at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak directly with an agent, call 888-350-1890.