If you’re unhappy with your current coverage, or you have lost employer-sponsored coverage or were unable to secure a plan last year with one of the best health insurance companies, help is at hand. A one-time, new sign-up window opened this week for government health insurance markets, and is set to run until Sunday May 15 in most states, according to guidelines published by the Centers for Medicare and Medicaid Services.
Government health insurance markets ended their annual enrollment periods in December but, due to the ongoing pandemic, last month President Biden ordered them to reopen. While the order covers 36 insurance markets operated through the federal government platform, the majority of states running their own exchanges have followed suit, though the specifics vary by state.
The new enrollment window is open to anyone who qualifies to enroll in a plan through HealthCare.gov. That includes people who are uninsured (or who are covered via a plan that isn’t considered minimum essential coverage, such as short-term plans), in addition to people currently enrolled in a plan through HealthCare.gov.
It is hoped that the new enrollment period will benefit Americans who a) recently lost their job and/or coverage, b) were unable to secure a plan last year, c) are unhappy with their current HealthCare.gov plan, d) have recently developed a health condition and are now seeking better access to regular medical care. Any new coverage purchased will begin on the first day of the next month, and is a separate cost to taking out one of the best Medicare Part D plans for prescription drugs coverage.
The crucial thing to remember is that mid-year plan changes means beginning again at $0 on your new plan’s deductible and out-of-pocket maximum. So any out-of-pocket costs you’ve incurred this time cannot be transferred to your new policy.
Executive order opens new enrollment period
The announcement of the special enrollment period due to COVID came shortly after President Biden signed an executive order to strengthen Medicaid and the Affordable Care Act. While most of those changes will have to go through a federal rule-making process, the order to open the new enrollment window was immediate.
Before the new enrollment period was announced, Americans traditionally had a six-week window in November and December during which to select a new plan.
Unless you experienced a life-changing event such as job loss, birth or marriage, which would then qualify you to change plans during the year during a special enrollment period (SEP), you had to stick with your chosen plan for the full year. Thanks to the more flexible new enrollment window ordered by President Biden, this isn’t necessary.
Selecting the right coverage can be confusing, but the federal government runs a call center via which you can get advice on choosing a suitable plan, whether that’s an HMO, PPO, POS or EPO. We’d recommend using this helpline if you’re unclear about what is right for your health needs and budget, as you could be faced with dozens of plans to pick from, each with different premiums, deductibles, and networks of doctors covered.
Don’t forget, if you have lost your job and currently have no income, you might qualify for Medicaid. If you do qualify for Medicaid or the Children’s Health Insurance Program (CHIP), you can apply any time throughout the year.
Reaching out to America’s uninsured
One of the biggest challenges America has faced during the ongoing pandemic is the fact that over 26 million non-elderly Americans are without health insurance. According to research published by the Kaiser Family Foundation, this number grew ‘by 2.2 million from 26.7 million in 2016 to 28.9 million in 2019, and the uninsured rate increased from 10.0% in 2016 to 10.9% in 2019.’ The majority of uninsured Americans have at least one worker in the family, though these are likely to be low-paid jobs.
Many of these people might be eligible for free coverage if they applied, but they are unaware of their options. The Trump administration made deep cuts to federal funding for outreach and enrollment assistance compared to how it stood in 2017, but last month the Biden administration announced plans to spend $50 million on outreach, with "a mix of tactics to increase awareness, including advertisements on broadcast, digital, and an earned media."
It is hoped that boosted funding will extend awareness and enrollment assistance to more uninsured Americans who, until this point, have remained unaware of their insurance options.