What you Need to Know About 2021 Open Enrollment

November 2, 2020

The open enrollment period to purchase health insurance coverage for 2021 through the federal marketplace 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. 

What is Open Enrollment and Why is it Important?

The open enrollment period is a window of time from November 1 to December 15, 2020 when consumers can purchase health care insurance plans on the Federal Health Insurance Marketplace. Plans sold during this period will begin on January 1, 2021 and coverage will end on December 31, 2021. After December 15, you will be eligible to enroll in 2021 health insurance only if you qualify for a Special Enrollment Period (SEP). A few examples of how you could qualify for a SEP is when certain life events happen such as losing health coverage, getting married, or having a baby. 

The open enrollment period is critical for anyone who does not have access to health insurance. For example, this could include people who are:

  • Self-employed;
  • Unemployed; or
  • Working for a smaller employer that may not provide health insurance coverage. 

The COVID-19 pandemic has revealed how unexpected events can quickly impact your life. We are living in unprecedented times and unexpected events like becoming unemployed is now a reality for many people. If you have recently lost your job-based coverage or are currently covered through COBRA, visit Healthcare.gov to check out the different health care plan options that are available to you. You can also compare the costs for various health insurance plans as well as see if your estimated income falls in the range for cost-sharing reductions and/or a premium tax credit. 

What Plan is Right for You? 

It is important to consider all parts of a health insurance plan before it is time to select the one that is right for you and your loved ones. For example, some available plans that have a lower initial cost may have high deductibles and lack essential services like prescriptions so it may be better to choose a plan that has a balance of cost and benefits. When selecting a plan, there are many important questions to consider like:  

  • Do the doctors, hospitals, and pharmacies I prefer fall within the plan’s network?
  • How much will I pay per month for coverage (premium)?
  • What is the plan’s deductible (amount you must pay out of pocket before coverage kicks in)?
  • What other costs may I be required to pay to access care?
  • Are my prescriptions covered by the insurance plan?
  • Do I qualify for cost-sharing reductions and/or a premium tax credit?
  • Do I mind getting a referral to see a specialist?

A useful tool that can help people who have been impacted by cancer compare the benefits and costs of every plan is the Cancer Insurance Checklist. You can use this checklist on your own or you can talk about your health care needs with a care provider, Marketplace representative, navigator, or loved ones.  

If you use a drug manufacturer copay assistance card or coupon to help cover the cost of your medication, it is important to know that many insurance plans will no longer count copay assistance towards a beneficiary’s deductible and maximum out-of-pocket limit, so you could end up with additional unexpected costs. CSC’s blog on Copay Accumulator Programs can help you understand what to look for to minimize these risks. Some states, including Virginia, West 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 about open enrollment and choosing a health insurance plan that is right for you and your family, you can learn more here. 

How can You Purchase 2021 Health Insurance? 

Visit HealthCare.gov now until December 15 to compare plans and apply for a health plan that works the best for you and your family. There are several ways to apply for 2021 health insurance:

After you choose the way you want to apply, you should make sure you are aware of the required information about you and your household. For a checklist regarding what you will need to apply for coverage, click here.

What if You are 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 is open through December 7, 2020. This time provides an important opportunity for individuals over the age of 65 to review their Medicare coverage to determine if a different plan may better meet their needs. If a beneficiary decides that they do not want to make any changes, then no action is required. It may be helpful to think of open enrollment as an annual ‘check-up’ for Medicare coverage and benefits. Visit our recent blog to learn more about Medicare open enrollment, why it’s important to review your Medicare plan, and vital questions to consider. If you are already covered through Medicare, then you are not eligible to buy a health plan through the Marketplace.

Medicaid and the Children’s Health Insurance Plan (CHIP) are two other possible coverage options to choose from. Both Medicaid and CHIP do not have open enrollment periods, so you can enroll at any point during the year. 

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