Open Enrollment Period

Open Enrollment Period Dates and Information

 

The annual Open Enrollment Period for Individual and Family Health Insurance is the one time of year when those who do not have coverage can apply and enroll in a health plan. You don’t have to apply through the Health Insurance Marketplace, or on-exchange. You can sign up directly with your Health Insurance Company of choice, or off-exchange.

 

Apply On-Exchange

You can decide to apply on-exchange, or through the Marketplace in your state, if you think your income is within range to receive discounted rates and medical costs. Most states use HealthCare.gov, the Federally Facilitated Marketplace. Even if you’re not sure, you can provide a ballpark estimate of next year’s projected modified adjusted gross income (MAGI), or income before tax is withheld, when you apply.

Those who qualify for financial assistance may receive reduced premium rates only, or discounted monthly payments in addition to lower coinsurance, copays and deductibles based on income level.

You will be required to furnish copies of income tax returns (Form 1040), pay stubs or other documentation listing your income sources and amounts.

You can also apply for Marketplace coverage without providing income information, which allows for a simpler, faster application process.

If you choose not to provide income details, you will pay for the full premium amount and not receive any discounted healthcare services through your plan. If you apply during Open Enrollment, you will not be required to provide proof of income or risk losing your coverage as a result of not providing income verification documents. Please note that you may still be required to provide proof of citizenship or Social Security Numbers for yourself and/or a family member listed on your application.

 

Apply Off-Exchange

Enrollment for coverage is faster and easier when you forego the exchanges. Coverage is more costly, yet you may gain access to a slightly better set of benefits and better network than a Marketplace plan. Many consumers and healthcare professionals still generalize off-exchange plans as “Obamacare”, which you will want to be aware of and clarify when you’re shopping for plans and trying to find in-network providers.

Applying during Open Enrollment comes with the anticipated delays of carriers having thousands of applications to review and process, yet coverage is still Guaranteed Issue – you won’t be turned down.

 

How to Apply if You Miss Open Enrollment or Experience Changes

Special Enrollment Period

If you apply outside of enrollment, you must have a Special Enrollment Period to qualify for coverage. You will be required to show documentation of your qualifying life event in order for your application to be approved, in addition to proof of income, citizenship, and/or SSN. Your policy will start on the first of the following month based on your life event. We have gone into more detail regarding qualifying life events and effective dates in our Obamacare section. Under Trumpcare, the same rules apply and you will be asked for specific documents in order for your application to be approved.

While you will have to show proof of your prior coverage ending to apply for an SEP, you don’t have to worry about being turned down due to your medical or prescription history. Keep this in mind if you call to check your application status and find out it’s with Underwriting. All SEP applications will be reviewed by the carrier’s Underwriting Department, yet only to check accuracy of documents, and termination dates for prior coverage. This can take several days up to several weeks, depending on how many applications an insurer has to review.

If you have additional questions about special enrollment and qualifying events, please feel free to contact a licensed health insurance agent at 888-803-5917.

 

Open Enrollment Dates 2018

Trumpcare reduced the window to apply for health insurance on or off the Marketplaces. For 2018 enrollment, you must sign up for a plan between the following dates:

November 1, 2017

Open Enrollment Begins: Start shopping for plans and apply for your 2018 policy.

December 15, 2017

Open Enrollment Closes: You must select a plan and submit an application to secure 2018 coverage.

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