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• Obamacare has a once per year Open Enrollment period
• Open Enrollment for 2016 runs from November 1, 2015 through January 31, 2016
• Life Events are changes in status like having a baby, or losing job coverage
• Life events extend the time for enrollment by sixty days from time of the event.
Open Enrollment for New and renewed Coverage
Obamacare opens once per year for enrollment and renewal of health insurance. Each year, insurance companies prepare plans and prices for health care coverage. Once approved, the state exchanges and healthcare.gov offer these plans to consumers on the health insurance exchanges.
When reviewing Obamacare plans, consumers should use comparison shopping to determine whether there are better options outside of Obamacare and open enrollment.
Price and premiums alone will not show the best fit for an individual or family. Comparison shopping helps focus on the features that are most important when making a choice.
Open Enrollment is the time each year when consumers can renew or select new health plans through Obamacare. It begins in November and ends in the following January, and it is the time when every consumer can shop for individual health insurance coverage through federal and state exchanges. For coverage that begins in 2016, the open enrollment dates are November 1, 2015, through January 31, 2016.
The Open Enrollment Deadline
To get coverage in 2016, consumers should start now by going online to the federal or state exchange that serves their location. The end of the open enrollment period is the deadline for getting health insurance coverage through Obamacare. Once past the deadline, the open enrollment closes until the following month of November.
Sign-up Outside of Open Enrollment
Obamacare had permitted sign ups outside of the deadline when it appeared that people who had begun the process were not able to complete it due to factors such as overloaded systems. These are not regular or required exceptions to the deadline of the enrollment period. The government has used special enrollment periods for particular purposes and to resolve problems that occurred during the enrollment period
What are Life Events
Life events are changes that affect health insurance. Some are things that cause a person to become uninsured due to a change in status. To determine the whether one can apply after Open Enrollment, consumers should contact healthcare.gov or the state agency. Life Events include the below-described changes:
- Giving birth to a child
- Adopting a child
- Losing coverage by losing a job
- Moving to a different state
Life events provide an additional sixty period from their occurrence for individuals to get health insurance coverage through an Obamacare exchange.
The federal government and states that run exchanges provide public information on the enrollment process and they emphasize the need to act within the deadline period. One cannot overstate the importance of the enrollment period’s advertising; public awareness is a critical element in ensuring fairness to the public in the application process. There is a limited time for participation, and some access depends on online systems that can become overloaded by a rush to complete near the end of the enrollment period.
Assistance to Applicants
Federal and state exchanges offer telephone and in-person assistance to applicants that request it. The states and federal government based the array of health plans on localities and the economic conditions of the home area for each applicant. For first time applicants, the appearance of many options can be confusing. For experienced users, there may be important changes from previous years that require explanation or which cause confusion. The assistance can be in-depth as counselors explain plans and describe benefits in addition to answering questions.
The purpose of the enrollment period is to have a time when the plans are available and presented in a similar way. The system of metal plan classes was meant to help consumers compare plans with similar coverage percentages. The metal labels group plans by the amount of coverage paid by the insurance policy as opposed to the amount paid by the consumer. For example, Bronze Plans cover a minimum of 60 percent while the consumer must pay the remaining 40 percent. Bronze plans offer low premiums but high out of pocket expenses.
Medicaid and CHIPs
There are no open enrollment limitations for Medicaid or the Children’s Health Insurance Programs(CHIPs).
Open Enrollment Goals
The goal of the open enrollment period is to help consumers find solutions to their health care insurance needs. This evaluation includes the following items:
- Coverage of services – some important services may be covered at low levels
- Out of pocket expenses – coinsurance can add to large amounts on frequently used items like costly prescriptions or procedures
- Deductible limits – high deductibles can mean lower contribution from insurance than desired
- The availability of services or facilities – some services or locations can have particular importance to the applicant.
For some providers, there are extreme cost consequences for using out of plan service providers. Each provider sets terms of services with a view towards meeting the anticipated demand for services. Open enrollment helps educate consumers and that contributes to improvement in services as consumers take advantage of changes and additions to healthcare plans. Private health plans outside of Obamacare are another option for consumers. They too often have the open enrollment period deadlines.
Compare and Save
The plan with the lowest monthly premium is not always the best value for the consumer. Low premiums often leave high out of pocket costs. The best selection may not be the highest percentage of coverage such as a Platinum plan; some consumers need a health care service location that is near a home or place of business. These examples point out the differences between price and value. Getting the best fit for one’s needs adds value. Comparison shopping is the ideal way to find value in health insurance plans. The best selection for health insurance coverage may not be in the Obamacare system, rather one may have to shop outside. Comparison shopping can help determine whether Obamacare plans are the best choice to meet needs and preferences. Start comparing health insurance rates now by entering your zip code in our FREE tool below!