The healthcare system in the United States remains very much up in the air, as Republicans led by President Trump continue with their attempts to repeal and replace Obamacare. However, any actions that Congress might take would not go in to effect until at least the beginning of 2019, and the basic provisions of Obamacare are set to remain in place for the upcoming year. With this in mind, it is important to look at the upcoming open enrollment period to ensure that you don’t miss out on your chance to purchase health insurance.
What is Open Enrollment?
Under Obamacare, also known as the Affordable Care Act, individuals who wish to purchase a new health insurance plan or those who want to cancel or change their existing plan must do so during the open enrollment period. This specific period is the only time that it is possible to purchase or change health insurance plans, and anyone who misses out on signing up during this period will then need to be approved for a special enrollment period or otherwise will be without insurance throughout 2018.
As part of the Affordable Care Act, anyone who does not have health insurance may face a tax penalty. There are a number of groups that are excluded from paying this penalty, but in most cases, if you can afford health insurance but still choose not to purchase it, you will be forced to pay a fee for being uninsured. Often referred to as the Obamacare individual mandate, this penalty is applied for every month that you or your dependents are uninsured, and the penalty will be applied when you file your yearly federal income tax return.
When is the 2018 Open Enrollment Period?
The original version of the Affordable Care Act stipulated that the enrollment period should last for a total of 90 days. However, Congress recently made a change to Obamacare that lowered the enrollment period from 90 days to only 45 days. This means that those who wish to change or purchase health insurance plans now only have half the amount of time to do so.
As with previous years, the enrollment period to buy health insurance for 2018 depends on the specific type of insurance plan, i.e. whether you have a private, individual marketplace plan, a company-sponsored plan or are on Medicare or Medicaid.
Enrolling in Individual Marketplace Plans
For 2018, the enrollment period for individual marketplace plans runs from Nov. 1 to Dec. 15, 2017. Anyone who does not have an employer-sponsored insurance plan and does not qualify for Medicare or Medicaid needs to make sure that they purchase or change their existing plan within this time period. As with previous years, these private, individual plans can be purchased in any of the four following ways.
- Through private health insurance companies
- Online through a state or federal marketplace exchange
- Directly through a health insurance company’s website
- In person at a local insurance broker
Obamacare provides tax credits to help offset the cost of health insurance premiums, and a large portion of Americans qualify for this type of subsidized insurance premiums based on their total yearly income. However, if you do qualify for these tax credits, it is essential that you purchase a marketplace plan from either your state or the federal marketplace exchange at Healthcare.gov. Only plans purchased through Healthcare.gov qualify to receive these tax credits, which means you will be forced to pay the full price for your insurance premiums if you choose to purchase directly from health insurance companies.
If your total household income is equal to or greater than 400% of the poverty level, you will not be able to qualify for the tax credits. In this case, you might be better to shop for insurance plans directly from health insurance companies. No matter whether you speak with a local insurance broker or buy a policy directly from the insurer’s website, the fact is that you will generally have greater options than you would if you only shopped on the state and federal marketplace exchanges.
Most health insurance companies only list a small selection of insurance plans on the marketplace exchanges, and you will generally be able to find a much wider range of policies by speaking directly with the health insurance companies. Although all health insurance policies must meet minimum coverage standards, you can often find a higher level of coverage by speaking directly with the insurers. This is especially true for those who suffer from chronic health conditions, as the policies you find on the marketplace exchanges might not provide full coverage for your necessary treatments or medical equipment.
Enrolling in an Employer-Sponsored Insurance Plan
Employer-sponsored insurance plans also have their own specific open enrollment period. Although this enrollment period usually occurs sometime during the fall, the specific dates are set out by the employer. Nonetheless, you will still only have a total of 45 days in which to sign up for your company’s plan or change to a new plan.
If you choose not to purchase your company-sponsored insurance plan, it will then be necessary for you to sign up for a different plan during the standard open enrollment period (Nov. 1 – Dec. 15). If you fail to purchase a new plan during this time, you will then potentially have to pay the individual mandate penalty as stipulated under the terms of the Affordable Care Act. For this reason, it is important to decide ahead of time whether you plan to go with your company-sponsored insurance plan.
The fact that there is no specific date set for enrolling in company-sponsored plans means that your company’s enrollment period could potentially occur after the enrollment period for individual marketplace plans. If this happens, you could be left without the ability to purchase insurance for the upcoming year due to the fact that you didn’t act during the standard enrollment period. Enrollment Period for Medicare and Medicaid Recipients Individuals who qualify for Medicaid are not limited by any enrollment period. If you qualify for Medicaid, you are allowed to sign up any time of the year. However, there is a specific open enrollment period for Medicare recipients, which runs from Oct. 15 to Dec. 7, 2017. During this time, you are allowed to enroll in a Medicare plan, but there are also additional periods in early 2018 when recipients are allowed to change their benefits.
Understanding the open enrollment period is the only time of the year when you can purchase or change your health insurance coverage through the marketplace is something that all Americans need to be aware of. No matter what your specific feelings are on Obamacare, the fact is that the Affordable Care Act is still the law of the land. Therefore, if you want to be guaranteed of having health insurance throughout 2018 and also ensure that you don’t have to pay the individual mandate penalty, it is imperative that you pay close attention to the enrollment period. Health insurance companies are usually willing to work with you to find the best plan for your needs, but there is nothing that they can do if you don’t remember to act during the enrollment period. Jump to top