November isn’t just about gobbles and gratitude—it’s also a time to think about your health. That’s because November 1 marks the start of open enrollment, which is when people who rely on insurance from Healthcare.gov—the federal health insurance marketplace—can begin signing up for their individual and family health insurance plans for 2023.
There’s a lot to consider when signing up for a health insurance plan! Read on for answers to some of the most pressing questions. Then, sign up for the right plan for you and your family, so you’ll have peace-of-mind in the new year.
What is open enrollment?
Open enrollment is the period of time when people select their health insurance plan on the insurance marketplace (healthinsurance.gov) for the next calendar year. It runs November 1 through January 15. In order to have an insurance plan in place beginning January 1, you must enroll by December 15. Those who sign up after December 16 will have to wait until February 2023 for their coverage to begin.
Additionally, Medicare open enrollment is October 15 through December 7; and private businesses that offer insurance may have different open enrollment timelines.
What happens if I miss the open enrollment period?
If you don’t sign up for a health plan within the open enrollment period window, you can’t sign up for a plan in the 2023 calendar year unless you have what’s called a “qualifying life event.” Qualifying life events can include—but are not limited to—the following:
- Losing health coverage (because of loss of a job, completing school, aging out of a parent’s plan, no longer qualifying for Medicaid, etc.)
- Household changes (marriage, divorce, death in the family, having or adopting a child)
Further, depending on your income, you may qualify for Medicaid, the Children’s Health Insurance Program (CHIP) or a special enrollment period for marketplace health insurance; if that’s the case, you may be able to enroll for health insurance outside of the open enrollment period.
Will I be able to make changes to my plan after the enrollment deadline?
Only if you experience a qualifying life event. Otherwise, you’ll have to wait until open enrollment next year to select a new plan.
Why should I sign up for health insurance?
Nobody wants to get sick or injured, but unexpected things happen all the time. That’s why there’s health insurance. Your annual policy helps protect you financially, gives you access to health care when you need it and also allows for peace of mind.
Think about it. Doctors’ visits and hospital stays can be incredibly expensive. According to Healthcare.gov, fixing a broken leg can cost $7,000; the average cost of a three-day hospital stay is $30,000; and cancer care can cost hundreds of thousands of dollars. A health insurance plan helps reduce costs and even sets an out-of-pocket maximum to limit your financial burden.
Plus, health insurance can help cover a number of different medical expenses, including prescription medication, visits to the doctor, routine checkups and screenings, vaccines and boosters, maternity care, mental health and addiction services, wellness services, and more. Insurance plans are also available for dental and vision care.
I have a pre-existing condition. Can I even get health insurance?
Absolutely. Health insurance companies cannot deny coverage because of pre-existing conditions.
I don’t think I can afford health insurance. What can I do?
Health insurance subsidies are available for people earning certain income levels. Plus, thanks to the Inflation Reduction Act of 2022, people in Alabama may qualify for a federal tax credit that lowers the cost of their health insurance. To find out cost and savings for your particular situation, visit AlabamaBlue.com/Guide.
Can my children join my plan?
For parents who have insurance from the marketplace, children can remain on your plan through December 31 of the year they turn 26. After that, they’ll need to sign up for their own plan.
How do I choose the right plan for me?
That’s the tough question. Insurance plans can be confusing (here’s a primer on vocabulary to get you started), and everyone has different health needs. That’s why it’s important to consider how your health is now, and how you expect it will be a year from now. When perusing health insurance coverage options, you’ll see that there are different “metal” categories to consider (platinum, gold, silver, and bronze); there are ranges of costs to think about (including monthly premiums, deductibles, co-pays and coinsurance); and there are types of plans to select from (like PPOs and HMOs).
For insights on what the different categories mean, it might help to read our article, How Do You Find the Plan that’s Right for You?
As you narrow down the plans that are the best fit, check to make sure the plan you choose covers the doctors you see and the medications you take. You should be able to ascertain this by looking at a summary of benefits, a provider directory, a plan brochure, and a list of covered drugs for each plan when previewing the plan or comparing them in the marketplace.
Is there any way to lower the cost of my health insurance plan?
Health insurance plans have set costs. However, there are certain choices you can make that may help you select a lower-cost plan. HMOs, for example, tend to cost less than PPOs, and plans with high deductibles will cost less than plans with low deductibles (however, if you need to go to the doctor frequently and you take prescription drugs, you may end up paying more out-out-of-pocket with a high deductible than with a lower deductible—it all depends). A health savings account could also help you save money because the money you put in and take out is tax-free or tax-deductible.
What about catastrophic plans?
Catastrophic plans are an option for people who are interested in only protecting themselves against worst-case scenarios. These plans have very high deductibles and low monthly premiums. They can help if you become seriously ill or injured, but you’ll need to pay for some of your other medical services, yourself. Catastrophic plans are available to people younger than 30; or for people who are older than 30 and have an exemption that allows them to purchase this kind of plan.
How do I sign up today?
Choosing a health care plan is no easy feat. In some ways, it feels like reading tea leaves, as you try and divine what your health needs, and the health needs of your family, might be over the next year. By educating yourself, and by separating myth from fact when it comes to health insurance, know that you’re taking the right steps to choose the right plan.