5 Things You Need to Know About 2020 Open Enrollment

November 4, 2019

The open enrollment period to purchase health insurance coverage for 2020 is here! Now is the time to make sure that you and your loved ones have access to comprehensive, quality, and affordable coverage through the Health Insurance Marketplace.

1. What is Open Enrollment and why is it Important?

The open enrollment period is a small window of time from November 1 to December 15, 2019 during which consumers can purchase healthcare insurance plans on the Federal Health Insurance Marketplace. Plans sold during this period will begin January 1, 2020. After December 15, you will be eligible to enroll in 2020 health insurance only if you qualify for a Special Enrollment Period, which includes certain life events like losing health coverage, getting married, or having a baby, for example.

This open enrollment period is essential for anyone without access to health insurance. This includes, for example, those who are self-employed, unemployed, or working for a smaller employer that may not provide health insurance coverage.

2. What Plan is Right for me?

Choosing a health plan can be complicated. You may have many questions about the different plans available for purchase, including how to ensure your preferred providers will remain in-network, how much you may pay for out-of-pocket costs, or how premium costs and deductibles should factor into your decision. You can compare health insurance plans on Healthcare.gov, and see an estimate of the costs associated with each plan, like monthly premiums and out-of-pocket caps. You will also be able to see if your income estimate falls in the range for cost-sharing reductions and/or a premium tax credit. While there are plans on the market that may seem to be a better, lower cost option, these may have high deductibles and/or lack coverage for necessary services like prescriptions, so it is important to select a plan that balances cost and benefits. The Cancer Insurance Checklist is an important tool that helps those who have been impacted by cancer compare the benefits and costs of each plan and make an informed decision. Use the checklist on your own, or use it to discuss your health care needs with a navigator, Marketplace representative, care provider, or loved one.

If you use a drug manufacturer copay assistance card/coupon to help cover the cost of your medication, it is important to be aware that several insurance plans will no longer count copay assistance towards a beneficiary’s deductible and maximum out-of-pocket limit, where you could end up additional unexpected costs. CSC’s blog on Copay Accumulator Programs can help you understand what to look for to mitigate these risks. Some states, including Virginia and Illinois, have passed laws that ban copay accumulator programs. Similar bills have been offered in several other states as well.

For more information and tips regarding open enrollment and picking a health insurance plan, you can learn more here.

3. What is new for 2020 Enrollment?

According to the CMS, health insurance premiums for the plans on Healthcare.gov will, on average, decline across the country, with consumers paying 4 percent less on average for the most popular health plans. Additionally, those looking for a plan will have more choices this year. The number of health insurers selling plans in 2020 is 175 compared to 132 in 2018.

Beginning with 2020 plan year, plans on HealthCare.gov in all states are assigned a quality rating, also known as star ratings, which accounts for member experience, medical care, and health plan administration. This may be helpful as your compare plans. You can learn more about the quality ratings of health plans on HealthCare.gov.

4. How can I Purchase 2020 Health Insurance?

Now through December 15, visit HealthCare.gov to preview plans and to apply for the health plan that works best for you and your family. There are six ways to apply for 2020 health insurance: online, by phone, with in-person help, through an agent, through certified enrollment partner websites, or by paper application. For information on how to apply via each means of enrollment, click here.

After you have chosen how you want to apply, you should be aware of the required information about you and your household. For a checklist regarding what you will need to apply for coverage, click here. Once you have compared plans and premiums and filled out an application, you will then enroll for the plan and coverage will begin on January 1, 2020.

5. What if I am eligible for Medicare or another government health care plan?

If you are eligible for Medicare, Medicare Advantage (Part C), and Part D Prescription Drug coverage, the open enrollment period runs through December 7. Make sure to visit Medicare.gov to compare coverage options and purchase or make changes to your Medicare plan. If you already have Medicare coverage, you are not eligible to buy a health plan through the Marketplace.



Medicaid and the Children’s Health Insurance Plan (CHIP) do not have open enrollment periods. If you or your child are eligible, you can enroll at any time of the year.


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