Open Enrollment: Only 2 Weeks Left for Jan 1st Coverage (Video)

On Monday, November 2, 2015, Errol Pierre sat down with Arise America’s news anchor, Debbye Turner Bell to discuss the tips for the Open Enrollment seasons since the deadline for January 1st coverage is December 15th; only 2 weeks away.

Tip #1: Understand the Health Options Available to you for 2016

  • Every year health companies make changes to their benefit plans. This includes price changes and sometimes even changes to the doctors and hospitals you are able to visit.
  • Always shop around to see if there are better deals in the new year. Some health companies expire plans, some launch new ones, and others make benefit changes to current plans.
  • It is always important to reassess the market before renewing with your current health plan

Tip #2: Validate Your Doctors Are Still In The Network

  • Health insurance companies have a wide array of health plans. All these health plans come with their distinct network of doctors and hospitals.
  • Before choosing a new plan, confirm that your doctors accept the health plan you are planning to buy.
  • Double check that the doctor just does not accept the health insurance company, but they actually accept the health plan you are purchasing. Example: Does the doctor accept “ABC Insurance” as well as ABC Insurance’s “HMO Silver Plan”?
  • It is always good to verify their name and use the health plan’s online tool to look up the doctor as well.

Tip #3: Think About Whether You Are Eligible for Financial Help

  • 75% of Americans who enrolled through Healthcare.gov were able to get financial help.
  • It is important to not leave money on the table when purchasing coverage so you can get the best plan for you and your family.
  • Also, if your income changes throughout the year, its important to go back to Healthcare.gov to share that information. Fluctuations in your income can impact not only your financial help but also your tax liability at the end of the year.

There are two types of financial help available through Healthcare.gov:

  1. Advanced Premium Tax Credits (or APTC) that provides tax credits upfront to lower the price of insurance to the members monthly. This is available to members who earn less than ~$45,000 individual/95,000 family of 4 (or 400% of federal poverty level).
  2. Cost Sharing Reductions (or CSR) that lowers the costs you have to play for getting services (e.g.: copayments and deductibles). This is available to members who earn less than ~$25,000/year (or 250% of the federal poverty level)

Tip #4: Maximize Your Health Plan Before the Year Runs Out.

  • Every health plan sold on Healthcare.gov provides $0 preventive care visits to your doctor. This benefit is for everyone including women and children.
  • It is important to take advantage of your free office visits. It allows your peace of mind to know you are healthy as the year comes to an end.
  • Additionally, many plans have deductibles where you have to pay money first out-of-pocket before the health plan kicks in. In those instances, your deductible may reset on January 1st. If that is the case, make sure you pick up any of your prescriptions and see any of your doctors before December 31st.
  • This will enable you to use your plan wisely before you have to select another that will start January 1st.

Tip #5: Pay your first bill!

  • This seems obvious, but you would be amazed how many people sign up for coverage and never pay the first month’s bill.
  • If the first month is not paid, your policy cancel you will have no insurance coverage.
  • If a new health plan is not purchased before January 31st, you will have to go the entire year without coverage unless you have a “qualifying event”.
  • A “qualifying event” is an event in your life that allows you to buy insurance or change your insurance during the year after the open enrollment period has ended.
  • “Qualifying events” include: change in income, moving, having a baby, getting married, getting divorced, or losing your health insurance coverage.
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