3 Helpful Tips on Health Insurance & Annual Open Enrollment

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Tips to Help You Choose a Policy On or Off Marketplace

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Photo by Scott Graham

When it comes to insurance, especially health insurance, many of us are at a loss for the basic information we need to make a wise decision for ourselves and our family. Here are 3 tips that can help:

Tip #1: Open Enrollment runs from November 1st, through December 15th, each year. However, coverage or policy changes will take effect on January 1st, following Open Enrollment. If you do not sign up for health insurance during the annual open enrollment, don’t worry, you may still be able to get coverage throughout the year.

You may qualify for Medicaid or experience a “qualifying event” which would trigger a 60-day special enrollment period [SEP]. A few examples of qualifying events are loss of other coverage, experiencing a birth, an adoption, child support or other court-ordered family events, or even marriage, divorce or a death in the family.

Tip #2: Know what your qualifying options are. See if you qualify for Marketplace assistance. There are two types of Marketplace assistance: premium tax credit assistance or CSR, Cost Share Reduction. Premium tax credit assistance can dramatically offset the cost of health insurance based on your household size and estimated household income for the specific calendar year. However, you may qualify for a better plan designed with richer benefits with Cost Share Reductions. Ask about both and see if you qualify.

If you currently have Marketplace Now, make sure you update your information, especially your income information. Federal poverty levels and income thresholds change yearly. Do not jeopardize losing your premium tax credit/subsidy because you let it rollover from the previous year. Verify your income each year with the qualifying income amounts.

Marketplace requires updating your application with life or income changes as they occur. Check your eligibility notice for outstanding documents, actions or deadline dates as they may not issue your policy until they have received and matched these documents, which is called “data matching.” Examples of requests that can prolong the application process: proof of citizenship, income documents, loss of coverage proof, Medicaid denial letter, etc.

Tip #3: Last, but definitely not least, there are no pre-existing condition limitations during Open Enrollment.

For free advice and assistance with selecting your health plan call Caton-Hosey Insurance today at 386-767-3161 and ask for Wendy or Gloria.

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