Health Insurance: It’s Open Enrollment Season – Now What?


In case you hadn’t noticed, open enrollment season is upon us!

Open enrollment is the time every fall when you have the chance to either stick with your old health insurance plan or pick a new one. Whether you get health insurance through your job, Medicare, Obamacare, or as an in individual, open enrollment season is important to you. That’s true whether you plan to stay with your current insurance plan or want to shop around for another one or even another insurance provider. Open enrollment is when you need to make sure that you’re not paying more than you should be for the benefits and services you and your family need.

Every year, health insurance companies can make changes to the benefits and services they provide as well as to premiums, deductibles, and co-payments. During this open enrollment season it’s important to review your plan’s 2016 coverage to make sure it still meets your needs.

Why is the Open Enrollment Period so Important?

Think of the open enrollment period as a time when you get to rethink or redo decisions about your health insurance that you made last year. Or to get health insurance for the first time!  If you don’t check your options now, you could miss an opportunity to get better quality coverage for the same amount of money or pay less for the coverage you now have.

Millions of Americans are receiving health insurance through the Affordable Care Act (“Obamacare”) on healthcare.gov (sometimes called the marketplace or the exchange). Millions more will get their health insurance through their employer. Most employers will send out reminders about open enrollment and set aside a two-week period for people to look over the available health plans.

Whether you already had a health plan this year or not, here are some basic tips you should think about:

  • Do your homework. Review your options because with a few clicks could save you hundreds or even thousands of dollars. Make sure you’ve selected the right plan. For example, it may be cheaper for your children to be on your spouse’s insurance plan instead of yours.
  • Double-check that the medications you are taking and the doctors you see are covered by the plan you choose. Choosing a cheap plan may end up costing you more in the long run if your doctor is not in the plan network or if your medications are not covered. Most insurance companies will have a website where you can check which doctors and medications are covered under which plan.
  • Are you going to need specific services that some insurance plans exclude, such as bariatric surgery, certain types of counseling or smoking cessation programs, or surgery to fix complications from cosmetic surgery? These exclusions are often hard to find – until you try to get services that the policy always excludes. You may want to call an insurance company to check before signing up.
  • Don’t forget about specialty benefits like vision and dental plans. These plans cover preventive services like eye exams and teeth cleaning and are sometimes available at low cost. Making sure to regularly get your teeth and eyes checked could help prevent more serious medical problems down the road, but these plans often cost more than you will get in benefits, so consider your own needs before making a decision.

If you are buying an insurance plan through Obamacare on healthcare.gov or state exchange websites:

Remember that if you had a plan on the exchange in 2015 you will be automatically enrolled into the same plan or a similar plan. But, that renewed plan might be a bad one for you in 2016.  So:

  • Make sure you update your household and income information to ensure that you have the right plan choices and savings for 2016. If you are making less money than you did the year before, you may be eligible for smaller premiums or other plans with lower deductibles and co-payments. If you are making more money, that could also change your costs.
  • If you’ve been automatically enrolled in a different plan than you were in 2015, check that the plan covers what you need.
  • Start early!

If you are buying health insurance through healthcare.gov, here are the most important dates for 2016 coverage:

November 1st, 2015: The first day you can enroll in a 2016 insurance plan. Coverage can start as soon as January 1, 2016.

December 15, 2015: The last date to enroll for coverage that starts January 1, 2016.

January 1, 2016: The date your 2016 coverage starts if you enrolled or changed plans by December 15.

January 15, 2016: The last day to enroll in or change plans for new coverage to start February 1, 2016.

January 31, 2016: The last day to enroll in 2016 coverage. If you miss this deadline, you can’t sign up for a health plan inside or outside the exchange for the rest of 2015. The only exception is if you qualify for a Special Enrollment Period. Click here to learn more about the Special Enrollment Period.

To learn more about how healthcare.gov works, check out  https://www.healthcare.gov/quick-guide/

Want to know how much health insurance will cost you? Use this calculator to find out!

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.