A Guide to Affordable Health Insurance
Open enrollment has now ended in Kentucky, but there are alternatives and special situations that might allow you to apply for coverage if you missed the deadline!
For 2020 health plans purchased in the individual market, the annual open enrollment period (OEP) started November 1 and ended December 18. Below we will review a few basics of Health Insurance, the Open Enrollment Period and the options available to you beyond the OEP.
When does Open Enrollment end?
Open enrollment for 2020 ACA-compliant coverage has ended in the 38 states that use HealthCare.gov – including Kentucky.
Can I buy coverage after open enrollment ends?
Even though OEP is over, you may still have an opportunity to enroll in an ACA-compliant plan (or switch to a different plan) after open enrollment ends – if you have a qualifying life event.
As HealthInsurance.org’s updated Insider’s Guide to Obamacare’s Special Enrollment explains, there’s a long list of qualifying events that could trigger a special open enrollment window for you. Among them:
- a permanent move
- involuntary loss of other coverage (as long as it was minimum essential coverage)
- divorce, death or separation that results in a loss of coverage
- change in citizenship or lawful immigrant status
- growth of your family due to marriage, birth, adoption or foster care
Most special enrollment periods apply both on-exchange and off-exchange, although it essential for anyone who is eligible for premium tax credits to enroll through the exchange if and when they have a special enrollment period.
Depending on your household income, you may be eligible for premium tax credits (aka, premium subsidies) and possibly cost-sharing reductions (CSR, aka, cost-sharing subsidies). Don’t sign up for an off-exchange plan and miss out on the possibility of much more affordable premiums via a tax credit.
Without a qualifying event, ACA-compliant coverage is generally not available outside of open enrollment (there are some exceptions: Native Americans can enroll year-round, and so can anyone eligible for Medicaid or CHIP).
ACA Open Enrollment Basics
Your options for obtaining ACA-compliant coverage are limited if you don’t enroll during open enrollment. The next open enrollment period will start in November 2020, for coverage effective in 2021.
The November 1 – December 15 enrollment window is for people who buy their coverage in the individual market. If you have employer-sponsored coverage – or if you’re covered by Medicare, Medicaid, Tricare or the Indian Health Service – different enrollment windows apply for your coverage.
Medicare’s enrollment window is similar, but it ended on December 7. And your employer’s enrollment window may very well happen during this time of year, but it will have its own dates. (If you’re eligible for Medicaid or CHIP, you can enroll at any time during the year.)
ACA Plan Shopping Options
People eligible to enroll during the OEP have several options for buying ACA-compliant coverage:
- Through a marketplace – your state’s exchange or HealthCare.gov. These exchanges vary by state, but were designed to make it easy for people to compare plans, determine eligibility for subsidies, and enroll in ACA-compliant coverage. Find out what type of exchange your state uses.
- From agents and brokers who are certified by the exchanges to help explain ACA-compliant coverage options, determine your eligibility for subsidies, and make plan recommendations based on your situation. Learn more about brokers and agents.
- Through online portals – including healthinsurance.org – where you can find a quick health insurance quote or get help enrolling in an ACA-compliant plan from a licensed, exchange certified broker. (Call 1-844-608-2739 to talk to a certified broker.)
Is open enrollment an opportunity to buy ‘cheap health insurance’?
Open enrollment is definitely an opportunity to shop for affordable comprehensive individual health coverage. Thanks to premium and cost-sharing subsidies established by the Affordable Care Act (aka Obamacare), buying an affordable major medical plan is a realistic option for millions of Americans who are eligible.
Premium subsidies – which are actually premium tax credits – can lower the costs of any metal-level ACA-compliant plan bought through the exchange in your state (this includes plans purchased via “enhanced direct enrollment” entities that work with the exchange, as well as brokers and agents who help clients enroll in plans through the exchange). Here’s how to find out whether you’ll be eligible for a subsidy.
If you think it’s likely you’ll be eligible for a subsidy, be sure to familiarize yourself with the basics of ACA subsidies. You’ll want to make sure that you get the maximum subsidy but also that you understand your options for claiming your subsidy. (Your choice in how to receive a subsidy could determine whether you’ll end up repaying some or all of your subsidy.)
How much will health insurance cost?
The cost of your plan will depend on a number of factors, including some that are specific to you (your household income, zip code, tobacco use, and the number of people who will be covered under your plan) as well as things like plan availability in your area, and your state’s efforts to help control the cost of coverage.
Health coverage is sort of like airline tickets: Chances are, you’re not paying the same amount as your neighbor. Roughly half of Americans get their health insurance from an employer — with varying premiums — and more than a third get coverage from Medicare — also with varying premiums — or Medicaid.
This post was originally written by Louise Norris.