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What to expect from Open Enrollment 2018

Edward Neeman | Published: June 14, 2018

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The 2018 open enrollment period is nearly upon us, which means it is now again time to start thinking about your health insurance for the coming year. As part of the Affordable Care Act, more commonly known as Obamacare, the open enrollment period is when you’re allowed to start, stop or change your insurance plan. Although the future of Obamacare is currently up in the air and Trumpcare could possibly take its place, the Affordable Care Act will remain in place for at least 2018. This means that anyone who is considering buying an insurance plan or stopping or changing their current plan is required to do so during open enrollment.

When is the 2018 Open Enrollment Period?

In previous years, open enrollment lasted for a period of three months. However, the 2018 open enrollment period only lasts for a total of 45 days, and the specific dates of the enrollment period differ depending on the type of insurance. For anyone purchasing a marketplace insurance plan through Healthcare.gov or your state insurance exchange or people purchasing any other type of individual insurance plan, the 2018 enrollment period is from November 1 to December 15, 2017. For Medicare plans, the enrollment period runs from October 1 to November 15.

For those with an employer-sponsored insurance plan, the 2018 open enrollment period will be sometime during the fall. However, the specific period is dictated by the employer.

There is no specific enrollment period for those with a Medicaid insurance plan, and individuals with Medicaid can sign up at any time throughout the year.

Marketplace Insurance Plans

Persons who do have no employer-sponsored insurance plan and do not qualify for Medicare or Medicaid will need to sign up for a private, individual plan. It is necessary to sign up during the enrollment period, as otherwise, you will need to be approved for a special enrollment period if you wish to purchase insurance outside of the open enrollment period.

Anyone who wishes to purchase a new plan or change their existing plan during the enrollment period can do so in one of four different ways.

  • By purchasing the plan directly from a local insurance broker
  • Via an insurance company’s website
  • On the phone through the marketplace call center (1-800-318-2956)
  • Through the federal or state marketplace exchange at Healthcare.gov

Advantages and Disadvantages of Buying Insurance on Healthcare.gov

Healthcare.gov is one of the primary components of Obamacare and allows individuals to browse and buy affordable health insurance plans through the federal and state marketplace exchanges. Many Americans qualify for tax credits to help offset the cost of their insurance plans, and these tax credits are only available to those who purchase their insurance through a state or federal marketplace. In fact, the vast majority of people who use the federal marketplace receive subsidized premiums.

If your total household income is equal to or above 400 percent of the poverty level, you, unfortunately, won’t qualify for these tax credits. In this case, a local insurance broker might be able to find you more affordable health insurance plans than you would find on the marketplace exchanges. Generally speaking, you also usually have more plan options when you choose to buy through an insurance broker.

Insurance companies often offer the same plans for the same price on the marketplace exchanges as they do in person or on their website. However, many providers also offer additional plans and options on their websites or in their offices that they don’t offer on the exchanges. This means you can sometimes find affordable health insurance that is a better fit for your specific needs when you choose not to use the marketplace exchanges.

Another issue with the marketplace exchange is that your preferred healthcare providers may not be covered under the plans offered on the exchange. In this case, it may be necessary for you to seek out other plans in order to keep your current doctor. Similarly, people with certain chronic conditions may find that the marketplace plans don’t fully cover their prescriptions or medical equipment, in which case it will also be necessary to choose a non-marketplace plan.

Employer-Sponsored Insurance Plans

If you have an employer-sponsored insurance plan, you will still need to sign up for the plan or change to a new plan during the enrollment period. Although the exact timing of this period varies from company to company, it is almost always in the fall. During this period, you will be free to choose a plan other than the one offered by your employer.

However, you will not be able to qualify for any tax credits should you decline your employer’s plan as long as it costs less than 9.69 percent of your total household income and covers at least 60% of medical bills. Furthermore, if you do decline your employer’s plan, you will need to make sure that you buy a new health insurance plan during the enrollment period for marketplace plans. Otherwise, you will miss out on having insurance for the year and could face a penalty.

Although the Affordable Care Act may change in the future, the fact is that the open enrollment period is your only chance to make sure that you are insured throughout the coming year. Whether you’re looking for affordable health insurance or need something more specific that provides better coverage, it's always a good idea to start considering your options early. Remember, the 2018 open enrollment period only lasts 45 days, and you definitely don’t want to miss out.