Health Insurance Open Enrollment Checklist
It’s Crucial You Don’t Miss Open Enrollment
If you happen to miss open enrollment, you can still get insurance, but you’ll need a reason to buy it. This is called a Special Enrollment Period (SEP). So if you moved, got married or divorced, had a new baby, changed jobs or are on the dreaded and expensive COBRA plan, then you qualify for SEP.
If you qualify for a SEP, you usually have up to 60 days following the event to enroll in a plan. If you miss that window, you have to wait until the next Open Enrollment Period to apply. Job-based plans must provide a special enrollment period of at least 30 days.
If you still fail to get health insurance, you will be subject to Obamacare taxes, which could be as much as 2.5% of your income.
There are Four Tiers of Plans
To offer you the most options to meet your financial needs, there are four types of plans.
- Bronze: Health plan pays 60% of the medical bill, you pay 40%. Out-of-pocket costs are the highest but have the lowest monthly costs
- Silver: Health plan pays 70% of the medical bill, you pay 30%. The most common choice because their costs fall in the middle compared to the other plans.
- Gold: Health plan pays 80% of the medical bill, you pay 20%. They have high premiums, meaning that you’ll have less out-of-pocket costs in the form of deductibles, copays, and coinsurance.
- Platinum: Health plan pays 90% of the medical bill, you pay 10%. Out-of-pocket costs are the lowest but have the highest monthly costs.
Keep in mind that these percentages aren’t always that clear-cut. You might pay more or less for a service. It all depends on what’s detailed in your insurance terms.
Employer Health Insurance Has Different Guidelines
If you qualify for employer-sponsored health insurance, you will likely want to buy health insurance through your employer and will not be affected by the fall open enrollment period for the government-run marketplaces. Ask your employer when its open enrollment period is.
Open Enrollment is Only for Health Insurance
Open enrollment is not for auto, life insurance or long-term care insurance. Those are completely separate products that you can buy on your own any time of year. It's also not for Medicare, which has its own separate enrollment period.
