Open enrollment is here. Starting November 1 through January 15, you have options when it comes to finding the best health insurance for an individual or health benefits for families.
Under the Affordable Care Act (ACA), anyone who needs insurance for any reason can obtain health insurance coverage during this time. Coverage would then be effective starting in January 2022.
But be warned. If you don’t secure your policy by January 15, 2022, you can’t get 2022 health insurance coverage on the Marketplace unless you qualify for some other special enrollment period. And you must enroll by December 15, 2021 for coverage that starts January 1, 2022.
Take a deep breath. There are no medical questions, and you don’t need proof of prior coverage. Also, when it comes to paying for the health insurance many people qualify for a subsidy to help offset the cost of the monthly premium.
Requirements for Health Insurance under the Affordable Care Act
The requirements to obtain health insurance under the ACA are simple and straightforward. You must be a citizen of the United States or be a national that is in the country legally. You must live in the United States, and you can’t be incarcerated. One important note – if you have health insurance via Medicare coverage, you are not eligible to use the Marketplace to purchase a health or dental plan.
ACA health insurance plans offer robust medical coverage
Under the Affordable Care Act, there are 10 categories of services that health insurance plans are required to cover. These include doctors’ services and prescription drugs along with inpatient and outpatient hospital care. Insurance policies must also cover pregnancy and childbirth as well as several other health services. We recommend considering your needs because specific services will vary based on each state’s requirements. That’s why it’s important to compare plans.
Essential benefits include:
-Ambulatory patient services (outpatient care you get without being admitted to a hospital)
-Emergency services
-Hospitalization (like surgery and overnight stays)
–Pregnancy, maternity, and newborn care (both before and after birth)
–Mental health and substance use disorder services
-Prescription drugs
-Rehabilitative and habilitative services and devices
-Laboratory services
–Preventive and wellness services and chronic disease management
-Pediatric services, including vision care
Don’t stress about pre-existing conditions when searching for health insurance under the ACA
If you suffer from a health problem like asthma, diabetes, or cancer, insurance companies can’t refuse coverage for treatments for your pre-existing condition. And they can’t charge you more either.
Under the Affordable Care ACA, all Marketplace plans must cover treatment for pre-existing medical conditions.
The same goes for pregnancies. If you’re pregnant when you apply, the insurance company cannot reject you or charge you more because of the pregnancy.
Open Enrollment for Medicare
The open enrollment period for Medicare is also underway for people who are age 65 and older. This open enrollment period runs from October 15 through December 7, 2021.
This period is the opportunity for you to change your current Medicare Advantage plan for 2022.
We also recommend that you call your insurance agent to re-evaluate your drug coverage during this time. Be warned. Many drug cards change formularies and premiums for the following year. So even if nothing is changing in terms of your needs, check your policy to ensure nothing is changing. This open enrollment period is the time to change your current drug card (Part D) for January 1,2022 as well.
Help finding health insurance during open enrollment
Our team of experts are here to help you find the best health insurance coverage for yourself, your family, and even for your employees. We work with clients throughout the year, not just during open enrollment.
Our services do not cost you additional fees, so call us today for help navigating this process. We are here to help!
