Affordable Care Act
The nationwide enrollment period for individual and family health insurance for 2020 will begin November 1, 2019.
To help you understand open enrollment and make the most of it, we’ve compiled answers to some of the most common questions we receive from health insurance shoppers like you.
The Obamacare law (also known as the Affordable Care Act or ACA) created specific nationwide open enrollment periods during which you can enroll in individual and family major medical health insurance plans. Open enrollment is your chance to sign up for a new health insurance plan or compare your options in the market.
Open enrollment for coverage for 2020, is scheduled to begin on November 1, 2019 and continue through December 15, 2019 in most states.
During open enrollment you can shop for new individual or family health insurance plans through different sources, including government-run health insurance exchanges, health insurance companies themselves, or through private online health insurance agents and brokers, like eHealth
In most cases, coverage under a new plan selected during the 2020 open enrollment period can begin no sooner than January 1, 2020.
If you have employer-based health insurance, you don’t need to worry about the Obamacare open enrollment period, though the company you work for may have an enrollment period of its own. Open enrollment for employer-based coverage usually happens around the fall of each year, though dates vary.
It’s a good idea to review your coverage options each open enrollment period. Some plans are cancelled or may raise their rates in the new year, and new plans may become available. The health insurance plan you had last year may no longer be the best match for your needs or budget. Additionally, your medical needs may have changed in the past year, which could make a new plan with different benefits offerings more appropriate.
The Obamacare law makes government-funded subsidies available to qualifying individuals and families with taxable income of no more than 400% of the federal poverty level (according to the U.S. department of health and human services, 400% of the FPL about $12,490 for a single person or $103,000 for a family of four in 2019 in the contiguous US). These subsidies effectively reduce the amount that you need to pay from your own pocket toward your monthly health insurance premiums.
In addition to enrolling in coverage, you’re also able to apply for government subsidies during open enrollment. If you already have subsidies, it may be a good idea to reapply in case your income or other factors have changed. If you receive too little in subsidies, you may have to pay more upfront for your insurance premiums.
If you receive too much in subsidies, you may have to pay back the extra amount when you file your tax return. Depending on the preferences you selected when your last applied for subsidies, your subsidies may not automatically continue into the new year.
If you miss the open enrollment period you may run the risk of going without coverage throughout 2020.
Outside open enrollment, you may only be able to apply for individual and family health insurance coverage when you experience a qualifying life event. Under the Obamacare law, qualifying life events include things like marriage or divorce, the birth or adoption of a child, moving to a new coverage area, or major changes to your income that make you eligible for subsidies.
When you experience a qualifying life event, you generally trigger a 60-day special enrollment period and need to provide certain documentation and meet other criteria related to that qualifying life event.
While there is no federal tax penalty for going without coverage starting in 2019, you may be hit hard financially by expensive or unexpected healthcare costs if you go uninsured.
If you’re looking for personal help and advice in picking out a new health insurance plan for 2020, consider working with a licensed health insurance agent, like those at eHealth.com.
Unlike the “navigators” who staff government-run health insurance exchanges, licensed agents are legally able to make personalized plan recommendations based on your budget and medical needs.
Should disputes arise about billing or benefits under your plan, licensed agents can serve as your advocate to the insurance company.
Also, keep in mind that enrolling in a health insurance plan through an agent does not make the plan any more expensive to you because all insurance plan prices are set by law.