On Friday, November 1st, those wishing to obtain a health plan through Obamacare, the Affordable Care Act (ACA), will be able to enroll in the program. The ACA offers health plans that may be subsidized by the government depending on the applicant’s income. In other words, a way for you to have medical coverage at a slightly more affordable rate.
Below you will find what you need to know about the enrollment period
How long can you enroll in Obamacare?
The open enrollment period to acquire ACA plans runs from November 1, 2024, to January 15, 2025, in most states (some states have different periods). For Medicare plans, the period has been ongoing since October 15, 2024, and will last until December 7, 2024. The open enrollment period for employer-sponsored health plans varies, but typically starts in the fall and lasts a few weeks.
How do I prepare for this open enrollment period?
Before making changes to your plan, be sure to review your existing plan. Consider your current medical needs and assess if there are things you need that your plan is not covering.
Try to think about what medical needs you might have in the coming year. Obviously, there will be situations that you won’t be able to predict, but if you know you will need medical procedures or medications, for example, take that into account.
Who should choose a high-deductible plan?
High-deductible health plans (HDHPs), as the name suggests, have higher annual deductibles than other health plans — this means you will have to pay more out-of-pocket costs before your insurance starts covering medical expenses. That said, many HDHPs fully cover preventive care in-network even before you reach your deductible, so you don’t have to pay out of pocket for these types of services (for example, an annual routine physical exam), but you would have to pay out of pocket for non-preventive care, such as urgent care visits. HDHPs also have lower monthly premiums, which is the amount you pay each month for your health insurance.
In general terms, if you are relatively healthy and do not expect to have many medical needs — for example, if you typically only have routine physicals or preventive care visits — an HDHP may be a good option for you.
Who should not choose a high-deductible plan?
For some, the downside of HDHPs is that you have to pay out of pocket for non-preventive care until you reach your deductible. If you expect to have more non-preventive care needs — for example, if you are planning to have a baby soon or have a chronic condition for which you are receiving treatment — an HDHP may not be the best option for you.
When can I enroll in Medicare?
Most people enroll in Medicare — Part A, which is hospital insurance, and Part B, which is medical insurance — when they become eligible for it, which is usually at age 65. This is called the Initial Enrollment Period. The Initial Enrollment Period lasts seven months, typically starting about three months before you turn 65 and ending about three months after your 65th birthday.
If you miss your Initial Enrollment Period, you can also enroll in Medicare, without paying a penalty, during a Special Enrollment Period, in certain qualifying situations — for example, if you have or had health insurance coverage from your job.
If you miss both periods, you can enroll in Medicare during the General Enrollment Period, from January 1 to March 31 each year, although this may incur some type of monetary penalty.
What are the requirements for Medicare?
To be eligible for Medicare, you need to: be 65 years or older, have a disability, have end-stage renal disease, or have ALS (also known as Lou Gehrig’s disease). Medicare also has residency requirements, but people who are not U.S. citizens may still qualify if they meet certain criteria.
Source: Time