OPEN ENROLLMENT IS HERE
SUMMARY
Medicare open enrollment is happening now for 2022, and open enrollment for the health insurance Marketplace is coming soon. Here we highlight important dates and considerations.
A CHANCE TO CHANGE
Health insurance is one of families’ largest annual expenses, but changing your policy isn’t something you can do on a whim. The health insurance Marketplace and Medicare retain their own restricted periods of time during which you can change your plan or provider, called the Open Enrollment Period (OEP). If you’re looking to change your Marketplace or Medicare plan for, or join for the first time in, the 2022 plan year, now is the time to start looking.
MARKETPLACE OPEN ENROLLMENT
The Federal Open Enrollment Period for Marketplace plans depends on the state in which you live. For most states, including in Florida, the OEP runs from November 1, 2021, through January 15, 2022. Be sure to check your own state’s open enrollment period, as a few have deadlines in December 2021. For coverage that starts on January 1, 2022, you’ll need to enroll by December 15, 2021.
You may also qualify for a Special Enrollment Period (SEP) if you have lost your health insurance; you have married, divorced, or had a child; someone in the family has passed away; you have aged out of a parent’s plan; or you have moved. In these cases, you may be eligible to apply for health insurance regardless of the time of year. Be aware that a SEP only lasts for 60 days after the qualifying event. If you miss the opening, you will have to wait for the next OEP if you want a Marketplace plan.
NON-MARKETPLACE PLAN ENROLLMENT
Non-Marketplace plans are available during the same enrollment periods as Marketplace plans. However, if you wish to purchase a non-Marketplace plan outside of the enrollment period and do not qualify for a Special Enrollment Period, you will have to contact insurers, agents, or brokers directly and will have fewer ACA-compliant options. According to Healthcare.gov, most plans sold outside of Open Enrollment are not qualifying health coverage—verify with your insurer that the plan in which you’re interested will qualify. Additionally, you cannot get premium tax credits based on your income for non-Marketplace plans, whether you purchase one during Open Enrollment or otherwise.
If you don’t qualify for a SEP but you need to purchase insurance outside of Open Enrollment, another option is short-term health insurance. This type of insurance can provide coverage during gaps outside of enrollment periods for a length of your choice between 1 to nearly 12 months. Because they are not Affordable Care Act compliant, however, short-term health insurance plans are not required to provide a minimum essential coverage. You are able to cancel coverage at any time without penalties, but deductibles are comparatively high and coverage for services is limited. Furthermore, there is no coverage for pre-existing conditions.
MEDICARE OPEN ENROLLMENT
The Medicare open enrollment—or annual election—period for 2022 coverage runs from October 15, 2021, through December 7, 2021. This is a national window and is not subject to state differences, though those in FEMA-declared disaster zones may be eligible for extended enrollment. During this time, you are able to change your Medicare policy and your Part D prescription drug plan. This period is also intended to give those who did not sign up for Parts A and/or B when they were first eligible a chance to enroll.
Medicare has a few different types of Special Enrollment Periods. For those turning 65, you can sign up for Medicare in the month of your birthday, as well as the three months preceding and the three months succeeding the month of your birthday. If you experience a qualifying life event, you are granted a two-month SEP to switch your Medicare Advantage or Part D plan. Qualifying life events include moving out of the plan’s service region, moving into or out of a nursing home, and receiving financial assistance from Medicaid, among other changes.
If you are part of an employer-sponsored health plan with at least 20 participants, you are not required to sign up for Medicare at age 65 and can be eligible for a SEP that grants you eight months to sign up for Parts A and B once you stop participating in the employer plan. Be aware that if you don’t enroll in Parts C or D within the first two months of the SEP, however, you may be subject to penalties for Part D.
Also note that if you do not sign up for Medicare Part B when you are first eligible and you do not qualify for a SEP, you may be subject to a 10% penalty increase on the premium cost of Part B for each year you fail to enroll.
REVIEW YOUR OPTIONS
Changing your plan isn’t always necessary, but if you’re interested in different coverage or a lower premium, now is the time to shop around.
For more information, you can visit HealthCare.gov or call your insurance company.
Natalie Brown, CFP®
Director of Client Services
Day Hagan Private Wealth
—Written 10.25.2021.
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