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- Open Enrollment is the period when the public can sign up for Obamacare
- Open Enrollment runs from November 1, 2015, through January 31, 2016
- Complete sign up before December 15, 2015, for coverage that begins on January 1, 2016
- After Open Enrollment, the public can sign up only if the government extends time.
- After Open enrollment, Obamacare accepts applicants with a Life Event.
- Private insurance generally accepts the Open Enrollment limit on sign up.
Open enrollment is an opportunity to review the latest plans offered under Obamacare. The current open enrollment period presents plans that will take effect as of January 1, 2016, for those who sign up and pay before December 15, 2015. Open enrollment ends on January 31, 2016, and those who sign before that date will get coverage within thirty days from the date of sign up, and fifteen days or less after payment. Comparison shopping is a method for finding more about insurance plans than prices and premiums; it helps determine the value to the individual applicant or family. Start comparing health insurance rates now by using our FREE tool above!
Outside of Obamacare
Consumers can purchase short term plans and other private forms of health insurance outside of the Healthcare.gov and state health insurance exchanges. To satisfy the legal mandate for insurance coverage, outside insurance must meet the minimum essential benefits of the Affordable Care Act. Many private providers confine signups for annual coverage to the Obamacare Open Enrollment period. This practice makes private insurance pricing and terms more consistent with Obamacare.
Buying Insurance Outside of Obamacare
Consumers can use insurance agents, online marketplace websites, or go directly to the private health insurance providers. Consumers can purchase these policies at any time permitted by the providers. Insurers that provide short-term policies offer them year-round as they are intended to substitute for an Obamacare policy or one that meets the requirements of the Affordable Care Act. These policies leave responsibility for compliance with the ACA to the consumers.
Who Should Shop Outside of Obamacare
Persons with incomes that do not qualify for financial assistance in Obamacare exchanges should shop outside of Obamacare. Shopping outside of Obamacare is the only way to gain exposure to all of the plans available in the area in which one lives. Policies that do not meet ACA standards are not on the exchange, and some providers choose not to place plans on the exchanges. Those who should shop outside of Obamacare to get information include the following groups.
- Individuals and families near the 400 percent of poverty line get very, little subsidy and no payment assistance.
- Individual income greater than $46, 680.
- Families with income greater than $95,400 per year.
Open Enrollment and Plans
The prices and terms of coverage apply to state-wide areas or parts of states such as counties or metropolitan areas. Insurers base coverage and prices on health services resources such as hospitals and clinics, and the likely demand for services. When reviewing Obamacare health insurance plans, it is important to remember that all plans provide essential protections and basic services without extra charges. For example, they all offer mental health screenings including detection and treatment for substance abuse and addictions.
Types of Insurance
Obamacare plans apply to state-wide areas or parts of states. Insurance providers present plans to the federal and state exchanges for approval before offering them to the public during Open Enrollment. Obamacare groups the plans by actuarial value, or the extent that plans cover costs or require payment from the consumer. Obamacare labels these Metal Plans or classes of plans by the amount paid by the plans and the consumers. The overall percentages are described below.
- Platinum Plans- offer the highest percentage of insurance coverage and the lowest percentage of consumer paid costs. These plans cover about ninety percent of costs.
- Gold Plans- These plans cover about 80 percent of costs and the consumer pays about 20 percent.
- Silver Plans cover about 70 percent of costs leaving approximately 30 percent for consumers. Silver plans provide payment assistance for those with incomes between 150 to 250 percent of the federal poverty lines.
- Bronze Plans These plans cover about sixty percent of costs and offer the lowest monthly premiums.
- Catastrophic Coverage is the minimum amount of coverage and the maximum amount of consumer responsibility for costs. The providers intend this coverage for those who have none and need protection against major health events.
The Life Events Exception
The general rule is that enrollment closes at the end of the open enrollment period. There are exceptions built into the law and regulations for changes of status or Life Events that occur after the end of open enrollment. For these limited circumstances, the rules permit an additional sixty-day period for enrollment.
- Birth of a child
- Adoption of a minor
- Moving to a different state
- Loss of coverage as a dependent
- Loss of coverage from a job
Obamacare Benefits Only In the Exchanges
Only policies purchased through the Obamacare exchanges provide subsidies and other financial benefits. The same policy purchased outside of the exchange would not provide subsidies or payment assistance. Further, consumers who do not qualify for benefits can register, shop, and buy policies on the exchanges.
Compare to Be Fair
Obamacare represents a major step for Americans towards greater coverage with fewer denials and restrictions on basic coverage. It is one option that works well for millions of Americans. There are other options including private insurance and getting insurance coverage outside of the federal system and the state marketplaces. Comparison shopping is an excellent way to focus the health care insurance decision on the needs of the individual or family applicants. Comparison shopping permits consumers to set priorities in costs and coverage when selecting health insurance plans. Start comparing health insurance rates now by entering your zip code in our FREE tool below!