Health insurance can be pretty confusing to understand. Like, you’d think you can just sign up for a plan as soon as you need it, but actually, there are specific times you can sign up to get health insurance coverage unless you have a "life event," such as marriage or having a baby. Plus, not everybody gets their insurance through their job, so there's no one-size-fits all way to get insured. According to Healthcare.gov, the primary time you can get coverage is during the health insurance open enrollment period, which typically falls around Novemberish, to be applied the coming year. There’s a lot to know about how to get coverage during open enrollment, so here’s an overview to help you navigate how to make sure you get the health insurance that’s right for you.
So what exactly is open enrollment? According to a Cigna representative in an email to Bustle, this is the time when you can buy a health insurance plan or make changes to your existing plan. But you’ll be able to pick more than just medical coverage, says Cigna. Other benefits to choose from include dental, vision, disability, and life insurance plans.
There are actually a few different open enrollment periods depending on where you get your health insurance. Health insurance open enrollment on the marketplace or individual state exchanges runs from Nov. 1 to Dec. 15, says Healthcare.gov.
Rebecca Madsen, chief consumer officer at UnitedHealthcare, tells Bustle that Medicare open enrollment is Oct. 15 through Dec. 7, and Medicaid enrollment is year-round. If you receive health insurance through your employer, Madsen says employers typically set aside two weeks between October and November for their open enrollment periods.
“For people with employer-sponsored coverage, they’ll receive information at work about their plan options,” Madsen tells Bustle. “To help improve the enrollment process, some employers are adopting online platforms designed to personalize and simplify the experience to help people select a health plan based on their personal health and financial needs.”
If you don’t get your health insurance through work, you can find information on open enrollment through Healthcare.gov or UHCOpenEnrollment.com. Cigna also has a tool through Amazon Alexa called “Answers by Cigna” where you can ask common health insurance-related questions, like “what’s an HSA?” (it's a health savings account, or a special savings account that can only be used for health expenses, including things like acupuncture, or even band-aids, according to Investopedia).
It’s important you don’t miss the open enrollment period because “once open enrollment closes, you can’t change your coverage until the next open enrollment period,” a Cigna representative tells Bustle, “unless you have certain life changes. These are called ‘qualifying events’ and includes things like having a baby or getting married that would require you to update your coverage.”
If you lose your insurance coverage, that also counts as a qualifying event, Madsen tells Bustle. Healthcare.gov says other qualifying events are divorce, legal separation, or if someone on your plan has died. If you have a qualifying event, you might qualify for a special enrollment period that let’s you sign up for coverage outside of the open enrollment period, according to Healthcare.gov.
When signing up for health insurance, Madsen says it’s really important to take your time to explore your options so you understand what benefits you’ll be getting for the price you’ll be paying. “People should pay attention to more than just the monthly premium and instead take into account the plan’s out-of-pocket costs, including the deductible, copays, and coinsurance,” Madsen tells Bustle. “It’s also good for people to consider any health changes during the last year or if they have any major health events planned for 2019 — such as having a baby or surgery — to determine if the current coverage is still appropriate.” Madsen also recommends checking to make sure your doctor is in-network with whatever insurance plan you're considering so you don't pay out-of-network fees.
That means you're going to have to crunch some numbers, but it's worth it so you don't have any surprise medical bills. Do you have regular doctor appointments you have to go to? Regular prescriptions you need to fill? What if you get sick and need to go to urgent care or the emergency room? What if you need surgery? These are the out-of-pocket costs Madsen is talking about. You can't predict the future, but you do need to think about the what if's.
Every plan has different premiums, copays, deductibles, and coinsurance, so it's a good idea to go through the plan descriptions to see what these types medical services would cost. The monthly premium might be low, but is it more expensive to get medical treatment? You won't know unless you compare the plans.
If you're not sure how to go through this process, most employers provide on-site resources who can help you figure out what plan is right for your personal circumstances. If you don't get your insurance through your employer, you can work directly with an insurance company or through an insurance broker. It's totally normal if all of this health insurance stuff seems a little intimidating at first. But with a little legwork, you’ll be ready to pick the insurance plan that’s right for your needs.
Correction: This story has been updated to show that an HSA cannot cover co-pays.