Open Enrollment: What Should You Do About It?

Over the next several months you will see and hear a lot about “Open Enrollment” for various kinds of health insurance coverage. Depending on your situation, open enrollment periods give you a chance to:

· Get insurance if you don’t have it

· Change insurance plans if there is something better, or

· Stick with what you already have

Even if you eventually decide to stick with your current plan, you should use each open enrollment period you have as an opportunity to review your coverage and see if there is something better for you.

Why Is There an Open Enrollment Period?

Open Enrollment (OE) periods are created to provide insurance companies some certainty regarding those who are enrolled in their plans. For example, prior to the Affordable Care Act (ACA, also known as Obamacare), individuals could enroll in a major medical health plan any time during the year. However, those plans typically did not cover pre-existing conditions and included a cap on how much the insurer had to pay out. The ACA changed the rules to eliminate pre-existing conditions from consideration, remove caps on insurer payouts, and impose a cap on the insured person’s out of pocket costs. In response to these expansions in coverage, the insurance companies were granted their wish for a requirement that these plans be for one calendar year and that enrollments would also only happen once a year. Unless a person had a Qualifying Life Change Event triggering a Special Enrollment Period, there was only the annual opportunity of OE to enroll in these full benefit plans.

The open enrollment period for ACA plans in Colorado will be November 1, 2019 through December 15, 2019 for plans starting January 1 and through January 15 for plans starting February 1 (for people who miss the December 15 deadline).

The open enrollment period for Medicare is called the Annual Enrollment Period (AEP) and runs from October 15, 2019 through December 7, 2019.

ACA/Obamacare Open Enrollment

The ACA insurance market experiences change from year to year-- the insurance companies offering plans; the plan design; the networks; and the subsidies on premiums for qualifying individuals. So, even if you already have an ACA plan, you generally will have to take some action to change or renew your plan for the new year.

Medicare Open Enrollment

The Medicare insurance market has also changed over the last few years with new and often innovative plan types being rolled out and new insurance companies in the market. However, unlike ACA plans, Medicare plans automatically renew if the insured person does nothing. Typically, there is not a reason to change Medicare plans for a covered individual. For people with Medicare Supplement (Medigap) plans, there are limitations on a person’s ability to switch between plans. When a person does desire a change, the Medicare Annual Enrollment Period is the time to do so.

Let’s Talk

In order to provide my clients the full range of options, I am an independent broker representing the major insurance companies in Colorado. I do not charge clients for my brokering work. Rather, I am paid a commission by the insurance company when I sell a plan. There is no cost, no risk and no pressure when you call me to get acquainted and find out how I can help.

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