The health insurance Open Enrollment Period (OEP) is coming, and you might feel a little lost. It can be hard to sort through all of the different health insurance options in your area, but you know that you and your family need health insurance to stay healthy. Don’t worry though. You can always work with a licensed EZ agent, who will help you find a plan that fits your budget and your needs. Before you do that, let’s look at everything you need to know about the OEP.
What Is The OEP?
The Open Enrollment Period (OEP) is the only time of the year when you can change, cancel, or buy a new health insurance plan. Depending on which state you live in, it starts on November 1st and goes until mid-to late-January. Now is a good time to look at your current health insurance plan, see if it will change in the new year, and decide if it will meet your needs in the future or if you need a new plan.
When Is The OEP?
The open enrollment period for Obamacare plans is from November 1, 2023 to January 15, 2024. Any plan you buy by December 15 will cover you starting on January 1, 2024. If you buy a plan during open enrollment, which is between Dec. 15 and Jan. 1, it should take effect by Jan. 15, 2024, as long as you pay your first premium on time. Also, if you buy a plan between Jan. 1 and Jan. 15, your plan should start on Feb. 1, 2024. Some states’ open enrollment periods are longer than others, but this can change. At the moment, these states have longer periods for signing up:
California – November 1st, 2023, to January 31st, 2024
Idaho – October 15th, 2023, to December 15th, 2023
Maryland – November 1st, 2023, to December 15th, 2023
Massachusetts – November 1st, 2023, to January 23rd, 2024
New Jersey – November 1st, 2023, to January 31st, 2024
New York – November 16th, 2023, to January 31st, 2024
Rhode Island – November 1st, 2023, to December 31st, 2023
If you get your health insurance through your job, your employer can choose when your open enrollment period is.
Marketplace Plan Tiers
Since the Affordable Care Act (ACA) went into effect in 2010, most people buy traditional health insurance plans on the insurance marketplace during the OEP. When you buy plans this way, they come in four levels called “metal tiers.” Bronze, Silver, Gold, and Platinum are the tiers. The plans in these tiers are different in terms of price and how much you’ll have to pay out of pocket, not in terms of the quality of care you’ll get.
Bronze
The monthly premiums for bronze plans are the cheapest, but you have to pay the most out of pocket. With these plans, your insurance company will pay 60% of each of your medical bills. The other 40% will be your responsibility. Also, the deductibles for these plans, which are the amount you have to pay out of pocket for medical costs before your insurance plan starts to pay for them, can be in the thousands of dollars each year. Bronze plans are a good choice if you don’t use medical services very often but need a low-cost plan to protect yourself against the worst-case medical scenarios, like getting sick or hurt badly. Your monthly premium will be low, but since the deductible and cost-sharing percentage are both so high, you will have to pay for most of your routine care.
Silver
The monthly premiums and out-of-pocket costs for silver-tier plans aren’t too high or too low. These plans cover 70% of the cost of your medical care. You pay the other 30%. The deductibles for this tier are often lower than those for Bronze plans, so if you’re willing to spend a little more to have more of your routine care covered, these plans are a great choice. When you qualify for cost-sharing discounts, you have to choose a Silver plan to get the extra savings. If you are on the Silver plan and stop getting cost-sharing reductions, you will have a Special Enrollment Period. If you want to switch plans, you can sign up for the Bronze, Silver, or Gold plan that fits your needs and budget the best.
Gold
Even though the premiums for Gold plans are high, the out-of-pocket costs of care are lower than for the plans above it. These plans have low deductibles, and your plan will pay for 80% of your care while you only pay 20%. If you need a lot of medical care, a Gold plan might be a good choice for you because it will cover more of your care.
Platinum
Platinum has the highest monthly premiums of all the tiers. While the premiums will be high, your out-of-pocket costs will be the lowest of any type of plan, and since the deductibles are so low, your insurance company will pay more of your costs throughout the year. Since these plans cover 90% of all your medical costs, they can be a good deal for people who need a lot of medical services.
In addition to the different types of metal tiers, there are also different types of plans to choose from during the OEP. Some plans only let you choose from a small number of doctors, hospitals, pharmacies, and other health care providers, or they force you to use only those in their network. On the other hand, some plans will pay a bigger share of the bill for healthcare providers outside of the plan’s network. Depending on where you live, you might find plans in any or all of these categories at each metal tier level:
Health Maintenance Organization (HMO) – A type of health insurance plan that usually only pays for medical services from doctors who work for the plan or have contracts with it. Most of the time, out-of-network care is not covered, unless it is an emergency.
Preferred Provider Organization (PPO) – A type of health plan that has a network of providers but doesn’t force you to only see those providers. But your out-of-pocket costs will be lower if you use providers in the network. You can use medical professionals, facilities, and suppliers outside the network if you pay extra and don’t have a referral.
Exclusive Provider Organization (EPO) – A managed care plan is one in which treatments are only covered if you go to doctors, hospitals, or other healthcare providers in the network, unless it’s an emergency.
Point of Service (POS) – A type of plan where you pay less if you go to hospitals, doctors, and other healthcare providers in the plan’s network. To see a specialist, you need to get a referral from your primary care doctor.
How To Buy Health Insurance During The OEP
If your employer gives you health insurance, they should tell you when and how to choose coverage for the next year. If you don’t get health insurance through your job, you can use the marketplace to look for and buy a plan. Another way to buy health insurance during this time is to work with an EZ agent who can help you shop through all of the plans available and help you enroll. Most states use the federal marketplace, healthcare.gov, but 17 states and Washington, D.C., have their own state-based marketplaces where people can buy coverage. States that run their own health insurance exchanges may also offer longer sign-up periods. These are the states that have their own insurance markets where people can buy plans for 2024:
Residents of all other states should shop for and sign up for their next health insurance plan on the federal exchange.
Things To Consider During The OEP
As Open Enrollment for Individual and Family Health Insurance in 2024 gets closer, there are a few important steps to take when choosing your plan.
Review Your Current Plan
If you already have health insurance, look it over to see if it still meets your needs. Think about any changes in your health, finances, or lifestyle recently that might mean you need a different health insurance.
Explore Options
During Open Enrollment, it’s important to look at different plan options to find one that fits your healthcare needs and budget. Look for plans that have a network of doctors and hospitals that fit your needs and preferences.
Consider Subsidies
As you look at and compare insurance plans on the Marketplace, make sure to update your personal information, especially your financial information. If you make less than a certain amount of money, you may be able to get health insurance subsidies that can lower your monthly premium by a lot. Also, Silver Marketplace plans offer cost-sharing reductions, which can lower your out-of-pocket costs by lowering your deductible, copays, and coinsurance.
Consider Additional Coverages
Even though Marketplace health insurance plans cover a wide range of medical services and include prescription drug coverage, you may want to think about getting more coverage, like dental and vision plans, to make sure your health is well-rounded.
What If I Miss The OEP?
If you miss the Marketplace’s Open Enrollment Period, you might not be able to sign up for an ACA health insurance plan unless you qualify for a Special Enrollment Period. With a Special Enrollment Period, you can sign up for a plan outside of the Open Enrollment if you have a qualifying life event. This is an event that affects your current coverage, like losing your job or getting divorced. You might also be able to sign up for a health plan through your employer. Some plans offered by employers have their own enrollment periods that may differ from the Marketplace. Also, if you change jobs, you may be able to sign up for your new job’s health plan outside of the normal enrollment period.
Need Help?
The best way to find a cheap plan with the right level of coverage for you is to compare plans. Come to EZ first before you start comparing things on your own. We’ll make the process faster and easier by letting you compare plans in your area in just a few minutes. Our licensed insurance agents work with all of the best insurance companies in the country. They can talk to you about your budget, needs, and help you choose the best plan for you and your family. We compare plans and give you advice for free. Enter your zip code in the bar above to get free quotes or call 877-670-3557 to talk to a real person.
As millions of Americans lose their jobs due to the coronavirus crisis, they also find themselves without health insurance coverage. According to a report by FOX Business unemployment claims have hit a record 3.3 million. Because many Americans get health insurance through their employers, a pandemic is an especially scary time for people who have lost their jobs. However, if you do find yourself without health insurance, there are a couple of options you can look into.
Even though you have lost your job and health benefits due to the coronavirus pandemic, you still have options for health insurance coverage.
Marketplace
Normally a person can only sign up for Marketplace health insurance, or the Affordable Care Act (ACA) exchange, during the open enrollment period from November 1 to December 15. However, under certain circumstances, people can qualify for a special enrollment period, which would allow them to enroll in a plan outside of open enrollment. Losing your job is considered a qualification for a special enrollment period.
There is only a 60 day window to apply for an ACA plan after you lose your job. These plans can be costly, but if you fall into a low-income bracket, then you may qualify for a subsidy.
Recently, the Trump administration decided to not create a special coronavirus-related re- enrollment period for the uninsured in 38 states. Only 11 states and the District of Columbia run their own exchanges, and have opened enrollment to allow laid-off workers to get subsidized health insurance. These 11 states are:
California
Colorado
Connecticut
Maryland
Massachusetts
Minnesota
Nevada
New York
Rhode Island
Vermont
Washington
It is important to note that just because these 38 states will not re-open enrollment for everyone, does not mean that you do not qualify for special enrollment. If you were laid off from your job, you can enroll into the ACA exchange because that is one of the qualifications for a special enrollment period.
COBRA
You can choose to extend your employer’s health insurance for up to 18 months following unemployment.
There is also a way to keep your employer-based coverage even if you lose your job. Under the Consolidated Omnibus Budget Reconciliation Act of 1985, or COBRA, you can extend your coverage for up to 18 months. However, it is important to note that COBRA can be quite expensive, because you are required to pay your entire premium. For example, if individual health insurance coverage costs roughly about $600 monthly, then normally your employer would pay for about $500 of that. Without an employer contributing to the cost of monthly premiums, you will be left to pay for it all.
Medicaid
If you lose your source of income, you may qualify for Medicaid. Medicaid is government sponsored, and offers coverage for low-income individuals and people with disabilities. States look at your current income when deciding if you qualify for assistance from the program. Eligibility varies by state, but the monthly income limits are about $1,470 for an individual, and $3,000 for a family of four. You can apply online, or call your state’s Medicaid office, and will usually receive a response within 24 hours.
If you have recently lost your job due to the coronavirus pandemic, EZ will help you find an affordable plan to cover your health needs. We will provide you with a personal agent who will compare all the available plans in your area, and find one that fits your needs. To get started, enter your zip code in the bar above, or to speak with an agent, call 888-350-1890. Our promise to you is to help you find a plan, so you can remain healthy and safe during these hard times. EZ’s services are free of charge, because our service is focused on making sure that you feel supported throughout your health plan shopping journey, not on making money off of you.
Nothing beats being your own boss! If you are self-employed, then you are probably wondering about your health insurance options. Don’t worry, you do not have to break the bank to get a plan for yourself. There are many affordable options.
When you are self-employed, you have different options for health insurance.
Health Insurance Coverage Options
Let’s talk about the options of health insurance for the self-employed. There are different routes to go when looking for the right plan.
Marketplace– If you work as a freelancer, run your own business, or self-employed without employees, then you qualify for the Individual Marketplace. There are a variety of different plans you can choose from, but you can only enroll during the annual Open Enrollment Period, unless you have a qualifying life event. When you fill out an application, you will find out if you qualify for premium tax credits and other savings, which we will further elaborate on later.
Private Insurance– Private insurance has plans that provide good coverage at an affordable rate. Private insurance companies have many plans to choose from with a variety of coverage and costs. You can find a plan tailored to your needs and budget.
SHOP Marketplace– If you own a business and are looking for coverage for yourself, a spouse, or have an employee, then Small Business Health Options Program (SHOP) Marketplace is the way to go. Enrolling in a SHOP plan offers small business or non-profit a Small Business Health Care Tax Credit.
Marketplace Savings
Now back to those savings we talked about earlier. When you fill out a health insurance Marketplace application, you will estimate your net self-employment income. The premium tax credit or reduction qualifications rely on the year you’re getting coverage, not the prior year’s income. You will have to estimate your household income for the year and submit it. During the year, you can change your estimated income if the income changes.
If you qualify for the tax credit, you are allowed to deduct 100% of your health insurance premiums for your adjusted gross income every year.
Tips On Choosing A Plan
Before choosing a plan, make sure to do some research, so you pick the best plan for your situation.
There are a lot of different plans you can choose from, both on the marketplace and through private health insurance companies. You can choose a high deductible plan with lower monthly premiums, and benefit from an HSA account. You can choose a low deductible plan with higher monthly premiums, or even a catastrophic plan. Whichever you choose, make sure to compare plans to choose the one that meets your needs and budget.
Comparing plans and their prices can take a long time, and can be frustrating. The most important tip when choosing a health insurance plan is getting expert advice from an insurance agent. EZ.Insure offers highly trained and knowledgeable agents all around the U.S. that specialize in their region. You can speak to one of our agents, and they will do all the comparing of available plans for you and provide you with the quotes. It comes at no cost to you, which is a win! You get free help, and get directed in the right path to save money, double win! To speak to an agent by emailing replies@ez.insure, or calling 888-998-2027. No gimmicks, no hassle, and no cost. Just simple, free health insurance quotes.
