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Open enrollment Q&A

Staff Writer

July 8, 2019

Open enrollment for 2020 Marketplace health insurance plans is quickly approaching. Not quite sure what Open Enrollment is and why it’s important? No worries. We’ve got you covered with this simple Open Enrollment Q&A!  Ready to learn everything you need to know about Open Enrollment? Let’s get started.

Q: What is Open Enrollment?
A: The Open Enrollment Period, or OEP, is a yearly period when people can enroll in a Marketplace health insurance plan. Whether you need to buy Marketplace health insurance for the first time, or you want to change Marketplace health insurance plans, the Open Enrollment Period is your one window of opportunity to do so this year. The OEP is the only time of year to purchase health insurance from the Marketplace, unless you experience a qualifying event. A qualifying event is a life event, like getting married, having a baby or losing your health coverage.

If you have health insurance through your employer, your company may also offer an Open Enrollment Period. Many companies do this in the fall so that benefit elections can begin at the start of the new year, although your OEP may be at a different time. Check with your employer to learn more.

Q: When is Open Enrollment?
A: OEP for 2020 Marketplace health plans runs from November 1, 2019, to December 15, 2019. If you purchase a plan during this Open Enrollment Period, your new plan will start January 1, 2020.

If you have employer-sponsored health insurance, check with your employer to learn when their enrollment period is.

Q: Who does Marketplace Open Enrollment apply to?
A: Open Enrollment for Marketplace health insurance plans applies to Americans who are aged 18–64 who aren’t already covered by Medicaid, their employer, their parents or Veterans Affairs.

Q:  Why do we have an Open Enrollment Period?
A: The reason that there’s a set period of time each year for Open Enrollment is to prevent people from only buying insurance when they’re sick. When an insurance company keeps a balance of healthy people and sick people, there’s enough money from premiums to pay out claims. If people only bought insurance when they were sick, insurance companies wouldn’t have money to pay claims. The Open Enrollment Period protects both you and your insurance company.

Q:  What happens if I miss the Open Enrollment Period? A: The deadline for enrollment to buy a Marketplace health insurance plan is 11:59 pm on December 15, 2019. Set alarms and reminders, and do not miss this deadline if you need to purchase a Marketplace health insurance plan! However, if life gets in the way and you forget, you may possibly have options:

• If you experience a qualifying life event, like getting married or having a baby, you may qualify for coverage.
• If you qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can apply any time.
• If you live in a state that runs its own exchange and extends the OEP, you may be in luck. States with extended OEPs in 2019 included: California, Colorado, Massachusetts, Minnesota, New York, Rhode Island and Washington D.C. Check your state-specific enrollment information to see if there’s an extended enrollment window.
• You may be able to purchase a private health insurance plan outside the Marketplace Open Enrollment. You can purchase these plans through insurance companies, agents, brokers and online.

Q: What if I already have a Marketplace health insurance plan?
A: If you already purchased a Marketplace health insurance plan, you’ll be automatically re-enrolled for 2020. However, be sure to read up on your plan and how it may be changing. Oftentimes, premiums (what you pay each month for insurance coverage) change, prescription coverage can change, or your doctor may no longer accept your plan. If you’re not pleased with changes to your plan, the enrollment period is your opportunity to cancel your current plan and switch to a new plan. Do your research—because you may find something more affordable or get coverage that better meets your needs!

Q: Is Open Enrollment for all types of insurance?
A: No. it is only for Marketplace health insurance plans. However, many people also enroll in dental, vision, life insurance, accident insurance, disability insurance and other supplemental policies during this time period to help protect their peace of mind and well-being all at once.

Q: How will I afford health insurance?
A: Currently, Marketplace health plans provide subsidies through premium tax credits and cost-sharing reductions to make health care more affordable. When you apply for coverage in the Health Insurance Marketplace, you’ll find out if you qualify for subsidies that lower your premium. Your premium depends on your income and household size.

Q: How do I apply for Marketplace health insurance coverage during OEP?
A: You have several options for applying for coverage. If you are applying for Marketplace coverage, visit Healthcare.gov to find a broker, apply online, get information to enroll by phone, or find out how to apply via mail. You may also use a certified enrollment partner’s website.

If you have employer-sponsored health insurance, check with your employer to learn how to apply during the OEP.

We’re here to help! We hope this Q&A helps you enter this year’s Enrollment Period more confidently!