Open Enrollment for Health Insurance

Open enrollment season is here! What is open enrollment and why should you care? Read on to learn more about why open enrollment is a good time to review and reconsider your health insurance options.

What Is Open Enrollment?

Open enrollment refers to a specific period every fall when you can enroll in a new insurance plan for the upcoming calendar year. If you’re fairly happy with your current insurance policy, you can still use the open enrollment opportunity to renew your current plan or make changes to it.

Most states have an open enrollment period for their health insurance marketplace from November 1^st through January 15^th. Check online to find more details about when open enrollment happens in your state. In Massachusetts, the open enrollment period lasts from November 1^st to January 23^rd.

While open enrollment is the most common time to change or adjust an insurance policy, it’s also possible to purchase insurance plans outside of the open enrollment period if you have a qualifying life event: including marriage, moving states, income changes, and so on. Head to healthcare.gov to learn more about what qualifies you for a Special Enrollment Period.

Here’s some things to consider during the open enrollment period.

If You Have Employer-sponsored Insurance…

Some employers follow their state’s open enrollment period, while others designate a different open enrollment period at some point during the year. If you’re not sure which model your workplace follows, check in with your employer. You also can ask for more information about what plans are available for employees to choose from, keeping in mind that not all workplaces offer a choice of health insurance plans.

If you’re not happy with the coverage offered by your employer, consider using the open enrollment period as an opportunity to shop around for additional or alternative coverage on your state’s health insurance marketplace. Head to healthcare.gov to get started.

If You Have Individual Insurance…

Individuals without employer-sponsored insurance can use their state’s open enrollment period to purchase a new individual or family insurance plan, or adjust their current one. You can browse various health insurance options on your state’s insurance exchange. (Located at mahealthconnector.org for Massachusetts residents).

Before you start shopping, it’s a good idea to review some health insurance terminology to help you choose the right plan. A ‘deducible’ refers to the amount you’ll pay for a given expense before insurance kicks in, while a ‘premium’ refers to the monthly or yearly cost of insurance. Often, people who are in fairly good health opt for a plan with a higher deducible and lower premiums, while people with chronic health conditions may prefer a lower deductible with higher premiums. There are also out-of-pocket costs to consider, especially if you’re expecting to need prescription drugs. Every person and healthcare situation is different—so consider your needs and do your research.

If you’re unsure about whether or not you want a new insurance plan, take advantage of the open enrollment period to consider how your health or life circumstances have changed in the past year. Having a baby, experiencing an injury or illness, or losing a job can all make a significant impact on your healthcare needs and budget.

If You Are Uninsured…

If you don’t hold insurance due to financial limitations, you may qualify for Medicaid. A federal and state program that offers healthcare coverage to low- and medium-income Americans, Medicaid helps people access medical services who would otherwise not be able to afford them. In Massachusetts, Medicaid is offered through MassHealth. Check it out to learn more about who qualifies and what coverage beneficiaries receive.

People who receive Medicaid often have a choice of health insurance plans. After you apply and are accepted into the program, you’ll receive materials detailing what plans are available to help you make a choice. Consider aspects such as what providers are available through the plan, if prescription medications are covered, and if you’ll be responsible for any out-of-pocket expenses.

If You Want a Tax-efficient Option…

Some health insurance plans offer the ability to enroll in a health savings account (HSA) or flexible spending account (FSA), which enables you to save pre-tax money for medical needs. Some employers will even match employee contributions into an account, which can be a good way to boost your medical savings without additional spend. Keep in mind that while HSAs offer the ability to roll over your savings from employer to employer and year to year, FSAs are usually pinned to a single job and must be used within the year.