After the heat of summer, everyone is looking forward to cooler temperatures. Fall in near! Fall, that wonderful time of year that brings cool mornings, the Texas State Fair, pumpkin patches, and in the world of healthcare, enrollment periods!
Three enrollment periods take place in the fall: Medicare’s Annual Election Period (AEP), Affordable Care Act (ACA) Open Enrollment (primarily for individuals under 65), and an Open Enrollment for Small Groups. I regularly receive questions about these enrollment periods as selecting coverage can be confusing. In this article, I’d like to address AEP and ACA Open Enrollment. My goal is to help you understand the rules, the coverage you have, and the coverage you need.
Let’s start with Medicare.
Medicare’s AEP runs October 15 through December 7. During this time, you can make changes to your Medicare benefits. Here are the types of changes you can make:
- Switch from Original Medicare or a Medigap plan to a Medicare Advantage Plan
- Switch from a Medicare Advantage plan back to Original Medicare
- Switch from a Medicare Advantage plan to a different Medicare Advantage Plan
- Switch from a Medicare Advantage Plan that does not include prescription drug coverage to one that does, and vice versa
- Enroll in a stand-alone Medicare Part D Prescription Drug Plan
- Switch from a Medicare Part D Prescription Drug Plan to another
- Drop your prescription drug coverage
Every year new Medicare Advantage Plans are released. These plans may have network changes or drug formulary changes, and many come with valued ancillary product features like dental, vision, transportation, and more. It is important to carefully review your plan and new plan options to see if you are in a plan that meets your needs.
ACA Open Enrollment
ACA Open Enrollment is primarily for people under 65 and typically runs November 1st through December 15th. However, the government has made adjustments – for example, last year open enrollment was extended through January 15th of 2022. These plans are known as Marketplace plans and are commonly referred to as Obamacare. For most people, Open Enrollment is the only time they can enroll in a health plan without needing a qualifying event. The plans are guaranteed issue, meaning no health question are asked, and the plans cover pre-existing conditions. Another important factor with ACA plans is individuals and families may qualify for a tax premium credit to help cover the cost of their heath insurance premium. Qualifying for a tax credit helps with the affordability of your benefit coverage!
Understanding benefit options for Medicare and ACA plans for those under 65 can be confusing. This is where I help – my knowledge and expertise help clients select benefits that fit their needs and budget. As a broker, I represent multiple carriers and multiple products. Since there is no “one size fits all” when it comes to healthcare, this allows me to provide my clients options.
When meeting with my clients I ask questions to thoroughly understand their health needs, and I ensure their doctors and medications are covered before making any changes. When presenting plan options, I want my clients to understand the different plan types and benefits provided by each.
“I was referred to Laura and am very pleased with what she brought to the table. Knowledgeable, can-do attitude, and personable. She helped me through the maze of Medicare and supplements. My budget was a factor, and I am pleased she kept me within the parameters. Thank you to Laura!”
“I can’t tell you how much we have appreciated working with IHC! We recommend them to everyone. Especially if you’re unsure about the marketplace, they are great at explaining and helping find coverage. It’s been life changing for our family.”
If you are looking for a someone to help guide you through the process of selecting the right health benefits, let me help! Please contact me at 214-695-3276 or email@example.com. I look forward to helping you!