Science / Health

Open Enrollment Basics for First-Time Health Insurance Buyers

If you’re buying individual health insurance for the first time, there is still time to sign upduring open enrollment. Below are some important tips and information you need to know.

When is Open Enrollment?

Open enrollment started November 1 and lasts until December 15, 2020, though there are ten states with an extended open enrollment period this year.If you enroll now, your health insurance coverage begins on January 1, 2021. These dates are for individual policies. If you are covered by your employer, your company sets its own open enrollment dates.

What If I Don’t Enroll by December 15?

If you don’tpurchase insurance during open enrollment, your options are limited.

  • You must wait a year to enroll during the next open enrollment period.
  • If you’ve had a life-altering event, such as losing your employer-based health insurance or divorce, you may qualify for a special enrollment period. This allows 60 days from the time your coverage ended to enroll in new insurance.
  • You can purchase short-term insurance. These plans provide temporary coverage for up to 364 days. Short-term plans protect against major problems but have more limited benefits than regular insurance.

If You’re Under 30

If you’re under 30, there are health plans created for young adults.

  • You can be added to your parent’s health insuranceif you are under 26. Your parents must add you during their open enrollment period at work or through the Health Insurance Marketplace. Coverage ends on your 26th birthday.
  • You can purchase a catastrophic plan. This plan has low premiums and protects you against worst-case scenarios like a serious illness or injury. However, youhave to pay for most routine services yourself.It also has a high deductible, which is the amount you pay for services before the insurance coverage begins.
  • If you’re in school, a student health plan offered by your college or university may be an affordable alternative.

Where Do I Buy Health Insurance?

You can purchase insurance through a state-run health exchange, known as the Health Insurance Marketplace, or directly from a private insurance company. It’s also recommended to speak with an unbiased, licensed agent who can answer questions and provide additional guidance.

Do I Qualify for a Lower Premium?

If your household income is below a certain level, you mayqualify for a tax credit that lowers your monthly premium. Again, speaking to a licensed agent can help provide guidance on this option if you qualify.

What Does the Insurance Cover?

All Marketplace plans cover 10 essential benefits:

  • Outpatient care
  • Emergency services
  • Hospitalization
  • Pregnancy, maternity and newborn care
  • Mental health and substance use disorder services
  • Prescription drugs
  • Rehabilitative services and devices
  • Lab services
  • Preventive services (at no cost to you)
  • Pediatric services

Additional required benefits include birth control and breastfeeding coverage. Some plans cover dental and vision care.

How Do I Choose A Plan?

There are four categories of Marketplace health plans: Bronze, Silver, Gold and Platinum. The difference between themisin how affordable the monthly premium is and how much your deductible will be. Lower priced plans have higher costs when service is received.

  • Bronze plans have the lowest monthly premium, but the highest cost to you if care is needed. With this plan, your monthly cost would be low, but you’ll have to pay for routine care yourself.
  • Silver plans have a moderate premium. The deductible is lower than Bronze. To receive a premium tax credit, you must select a Silver plan.
  • Goldplans have ahigh monthly premium, but low costs when you need care.
  • Platinum plans have the highest monthly premium and the lowest costs when you get care. Deductibles are very low.

Should I Also Look at Private Insurance?

Yes. You can browse the websites of major insurance companies to see options in your area.Alternatively, you can work with an unbiased, licensed insurance agent who can provide information and comparative costs for multiple insurance companies.

If you have never bought health insurance before, it is easy to be overwhelmed by the process. Use the resources here to learn more and get estimates. Start now to give yourself time to find the best plan at the best price. Enjoy the peace of mind of knowing you are covered for whatever health needs 2021 might bring,

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