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Are you ready for the biggest open enrollment ever?

By on August 28th, 2013
Filed: Advice

Fall LeavesHave you heard about the new health care reform open enrollment period for people buying individual and family health insurance?

It’s almost here – and it’s one of the first big changes that many consumers will experience as a result of the implementation of the Affordable Care Act.

But what exactly is open enrollment? What does it mean for you? And when does it happen?

Here are some specially prepared answers to your open enrollment questions:

Question: When is the new open enrollment period?

Answer: The first-ever open enrollment period for individual and family health insurance plans under the Affordable Care Act begins October 1, 2013 and continues through March 31, 2014. Open enrollment periods in succeeding years will be shorter than this one-time six-month period.

Question: What is an open enrollment period?

Answer: The Affordable Care Act’s open enrollment period is when individuals and families can purchase health insurance plans that meet the requirements of the health reform law. Coverage under these new plans will begin no earlier than January 1, 2014. New health plans will provide coverage for essential health benefits defined by the ACA. Consumers who qualify will be able to apply for government subsidies and enroll without fear of being denied for pre-existing medical conditions.

Question: Who needs to apply for coverage during open enrollment?

Answer: The new open enrollment period is for individuals and families who do not have employer-sponsored major medical health insurance meeting the requirements of the Affordable Care Act. If you already have employer-based major medical health benefits, you do not necessarily need to enroll in a new plan during the open enrollment period, but rather through your employer’s own open enrollment period for group coverage. If your share of your employer-sponsored health insurance monthly premium is deemed too costly under the law, you may choose to opt out of that plan and purchase a qualified health plan with subsidy assistance, depending on your income level.

Question: Will I be required to purchase a health insurance plan during this period?

Answer: If you are currently uninsured and wish to enroll in a health reform-compliant plan for 2014, you will need to enroll during this open enrollment period. If you don’t purchase a health reform-compliant plan, you may be subject to a tax penalty and it may be difficult to find and qualify for health insurance later in the year. If you are currently enrolled in an individually purchased health insurance plan, you may be able to retain your current coverage into 2014. Ask your health insurance company for more details.

Question: What happens if I don’t purchase during the open enrollment period?

Answer: Outside of open enrollment, your ability to apply for health insurance may vary from state to state. It may be limited to the occurrence of a qualifying event, such as the loss of a job, a marriage or divorce, a move, or the birth of a child.

Question: What if I miss open enrollment and don’t have a qualifying event?

Answer: You may be able to purchase a health plan that is not in compliance with the health reform law, like a short-term health insurance plan. However, these plans may not meet the standards of the Affordable Care Act and you may be subject to a tax penalty on your 2014 federal tax return.

Question: Where do I shop for health insurance during open enrollment?

Answer:  During the open enrollment period, consumers can enroll in 2014 health plans through private online health insurance marketplaces like eHealth.com or through state health insurance exchanges. Consumers who want to apply for subsidies may do so through the government exchange in their state or through online health insurance marketplaces like eHealth.com, as allowed by their state’s exchange authority.

To learn more about open enrollment and how to prepare for it, visit the eHealth Affordable Care Act Resource Center.

Image by Flickr user Gordon M Robertson


About Carrie McLean

Carrie McLean has been in the health insurance field for 7 years and is licensed in all 50 states. She is often seen in the media discussing health insurance trends and issues from an insider’s perspective and as a consumer advocate, having personally helped thousands of individuals and families search for and find affordable health insurance.

4 Comments Add Your Comment

Brock Deskins on Wednesday, September 11 @ 9:40 pm

Where can I find the particulars regarding changes in my current health insurance?

Sonia on Monday, September 16 @ 3:09 pm

I have insurance through my work (for myself) and by law my income amount they would probaly say I have to have insurance through my work. With all my bills and everything its costly. With this new act my child can not have his own insurance plan, like he has for years.

I want to understand how this works. I either have him (7 years old) under my work insurance or can I find a plan for him and I out side of my work. He can no longer have his own plan correct?

Jo Ann on Sunday, December 29 @ 5:54 pm

How can I find out if my son’s current plan is compliant with the Health Care Reform Act?

Nate Purpura on Tuesday, January 14 @ 9:39 am

In November the President encouraged insurers to extend pre-2014 plans one more year.

You should have gotten a notification from your insurer letting you know if the plan was extended, but to be certain you should call them and check.

Also be aware that you can enroll him in a new plan up until the end of March 2014, without a qualifying event. Here is a video on the topic: http://www.youtube.com/watch?v=O8VYVx3NXsY&list=SPyykTKaGJq8ioxPDaFtAppS3GOfkoHKuA

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