Editor’s note: This post was originally published on 10/12/17 and has been updated for accuracy and comprehension.
The 2020 Affordable Care Act Open Enrollment Period is quickly approaching.
Now’s the time to start re-evaluating your health insurance needs for the new year.
It can seem like a major headache to deal with wading into the health insurance coverage waters again, but it’s well worth your while.
2020 has brought about changes in carriers and coverage that could have an impact on your current health insurance coverage.
Add to that any changes you or your family have experienced in terms of income or health status and it’s easy to see why you need to take a fresh look at what you have and what you need.
Here are 10 things you need to know about the ACA Open Enrollment Period (OEP) for 2020.
1. The Open Enrollment Period is shorter.
The OEP begins on November 1, 2020, and lasts until December 15, 2020.
Your coverage will begin on January 1, 2021.
It’s important to note that you can enroll for Medicaid or the Children’s Health Insurance Program at any time during the year if you qualify due to limited income or disability. Call the Medicaid office for assistance.
2. It’s not optional if you don’t have coverage from another source.
Here are a couple of reasons you should sign up for coverage during ACA Open Enrollment:
- Your current plan is being eliminated.
- You don’t have coverage through an employer.
- You don’t have any form of government coverage.
- You’re turning 27 and can no longer be covered under your parents’ health insurance..
- You are eligible for tax credits to help you cover the costs of healthcare.
3. Now’s the time to make changes to your current plan.
There are a couple of things that you can do during the ACA Open Enrollment Period.
- Review your options.
- Renew your current plan.
- Choose a new plan.
Your plan will automatically renew without any action on your part, but be aware that the plan could make changes to providers, copays, or drug coverage so you need to do your homework!
4. If you miss the window for ACA Open Enrollment, you have to wait.
If you miss the OEP you will have to wait a year to sign up or make changes to your healthcare unless you qualify for a special enrollment period.
There are a number of reasons you could be eligible for the special enrollment period, but they are generally situations such as divorce, marriage, birth, death of a spouse, or losing a job through which you were receiving health insurance.
5. You won’t be penalized for not getting coverage.
This is big news for those without coverage.
In the past, the penalty was 2.5 percent of your income with a cap that changed for inflation. The maximum penalty was $695 per adult for 2017, just to give you an idea.
The penalty was taken from your tax refund.
While you won’t be given a penalty for not having coverage in 2021, there are a couple of important things you need to know.
- The new tax bill that abolished the no-coverage penalty has no effect on 2020. If you don’t have coverage in 2020, you WILL be subject to the penalty, unless you qualify for one of the accepted exemptions.
- Not having health insurance coverage is still a bad idea. The fact is, without it, you’re less likely to visit a doctor regularly – if at all. But what if you have an accident and end up in the ER? Or become seriously ill? You need the safety net that health insurance provides.
6. There are four levels of health insurance plans.
They are Bronze, Silver, Gold, and Platinum, with Bronze having the lowest premiums and higher out-of-pocket expense and Platinum having the highest premiums and lower deductibles and coinsurance.
The personal health histories of each of your family members may help you determine which level is best for you.
7. All health plans have to cover these 10 benefits.
These 10 essential benefits must be covered no matter the level of coverage:
- Outpatient care including chronic disease management
- Emergency care
- Pregnancy and newborn care
- Mental health and substance abuse services
- Prescription drugs
- Rehabilitation services and devices
- Lab tests
- Preventative and Wellness services
- Dental and vision care for children
8. Eligibility for tax credits is determined by income and family size.
You may qualify for a tax credit if your income and family size fall within 138 and 400 percent of the Federal Poverty Level.
For example, a family of four would need to make between $32,499 and $98,400 to be eligible.
9. A hardship may exempt you from having to buy health insurance.
These are the reasons you could be excluded:
- If you were uninsured for less than three months of the year.
- You’re the victim of domestic violence or you suffered from a natural or human-caused disaster such as a fire or flood that caused significant damage to your property.
- You experienced the recent death of a close family member or you had unexpected expenses related to caring for an elderly, ill or disabled family member.
- You filed for bankruptcy or were evicted from your home.
- You’re an illegal alien.
- You’re currently in prison or in custody.
- You’re a member of a recognized religious sect that objects to carrying insurance.
- If you lived out of the country for more than 330 days out of the year.
10. Get started now
With the ACA Open Enrollment Period approaching in November, you need to start making plans for the next year now.
Let to pros help
When it comes to navigating the often-murky waters of the ACA Open Enrollment Period and health insurance in general, you probably need some help.
Fortunately, you don’t have to go it alone.
At InsureOne Benefits we’re prepared to help you review your current coverage and find a plan that best suits your needs – physical and budgetary – for the future.