Obama Care :
Enrollment Period
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ENROLLMENT PERIODS

There are only two different periods where you can enroll in Obamacare. The two primary options are the Open Enrollment Period and the Special Enrollment Period.

OPEN ENROLLMENT PERIOD

Open Enrollment is a set time every year where everyone is free to enroll in a healthcare plan. It is the time set aside to renew old plans and start new ones. There are no restrictions on signing up during this time. Open Enrollment runs from November 1, 2020, until December 15, 2020

If you miss enrolling during this period, you will be ineligible to enroll until the open enrollment period the following year. The only exception to this is if you qualify for a Special Enrollment Period.

Special ENROLLMENT PERIOD

Special enrollment is not open to the public and only applies to people who qualify. There is no set time of the year for Special enrollment. It is triggered by certain life events that inherently change the healthcare needs of an individual.  Some of the qualifying events that could make someone eligible include:

Those who qualify have 60 days from the first day of the qualifying event to enroll. With some events that are predictable, such as losing health coverage, it is possible to enroll in the 60 days prior to the event. If you are curious if you qualify, then consult our special enrollment page to learn more or learn how to speak to an agent who can help personally guide you.

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Why is enrollment only open for specific periods?

These limits are enforced to make healthcare more equal for everyone and discourage adverse selection. Adverse selection is when people who are sick are the only ones who sign up for healthcare, while healthy people avoid it. If this were allowed, it would drastically change the amount of risk that insurers were under. The insurance industry tries to prevent this so that they can provide coverage without having to raise premiums. Otherwise, health insurance would be unaffordable for many people. This is further discouraged by the fact that coverage won’t begin for some time after the signup period.

Do I need to sign up even if I already have coverage?

You will need to re-enroll in your healthcare plan every open enrollment period. Even if you want to keep the same plan, you need to re-enroll in the same coverage. This is also your opportunity to explore options and adopt a new plan. If healthcare is provided through an employer, then the Open Enrollment period continues to apply. Employers are not legally obligated to help employees who miss the open enrollment deadline. Some plans even stop companies from making exceptions for workers who don’t make a choice during the given period.

If you were eligible for a special enrollment period earlier in the year, you would still need to re-enroll when the open enrollment period comes up later. Again, this applies even if you are keeping the same plan

Why enroll in healthcare?

The added expense of healthcare may seem unnecessary, while everyone in your family is healthy. But that’s not how life happens, and by the time you realize you need insurance, it’s probably too late. A healthcare coverage plan will provide essential health services, covering things like:

  • Prescription drugs are covered, and at least one medication in each federal category will be eligible.
  • Pediatric Services are included for any child under 18, giving them access to dental care, vision, well-child visits, vaccinations, and immunizations.
  • Chronic Disease Management and Preventive and Wellness Services cover procedures that maintain a person’s level of health.
  • Emergency Services cover emergency room visits and ensure that being out of network won’t result in more expensive care.
  • Hospitalization is included along with the treatment received as part of inpatient care.
  • Mental Health and Addiction Services help people with behavioral issues, giving counseling, and psychotherapy when needed.
  • Pregnancy, Maternity, and Newborn Care are services given for expecting parents immediately surrounding the birth of a child.
  • Ambulatory Patient Services is care given without having to be admitted to the hospital.
  • Laboratory Services include testing that can diagnose, take preventative measures, or gauge the effectiveness of particular treatments.
  • Rehabilitative Services allows patients to recover in a supportive environment.

taking care to enroll in the right plan

Health insurance doesn’t have to be expensive. The government gives savings to households based on gross income, which is calculated based on expected income for the year of coverage.

Households with incomes between 100% and 400% of the federal poverty are eligible for a premium tax credit. The credit uses a sliding scale to find an amount that is take off of your premiums every month. For qualifying households, there are also cost sharing reductions that work to reduce out-of-pocket costs like deductibles, copayments, coinsurance, and the out-of-pocket maximum.

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