New to open enrollment? Here is everything you need to know about how to navigate open enrollment in 2021!
Dates to watch out for
Open enrollment for your health insurance policy to kick in on January 1, 2021 lasts from November 1 to December 15, 2020. However, some states have longer enrollment periods (with later policy activation dates), so research on your state’s policies for more information on 2021 open enrollment.
What happens if you miss open enrollment? You can no longer purchase an annual health insurance plan through the Marketplace until the next open enrollment period in 2021. You would need a to qualify for a special enrollment period, or lean on a short-term plan, to gain coverage outside of this period.
Part I: Create an account
To easily purchase your health insurance plan through the Marketplace, you will need an account with HealthCare.gov.
1. Select your state
2. Fill out your personal information (name and email address)
3. Fill out your security information (password and security question)
Part II: Preview 2021 health insurance plans and prices
If you are in the Marketplace for the first time, review the plans and prices available. You don’t even need to log into your account to do this.
1. Input your zip code
2. Select a provider from the options in the Marketplace
3. Visit the provider’s site to review their plans and policies
Part III: Pick your tier
Most health insurance plans and policies come with different tiers, based on metals: bronze, silver, gold, or platinum. What makes them different?
To put it in an equation, here you go:
Lower tier = Lower premiums + higher out-of-pocket expenses
Higher tier = Higher premiums + lower out-of-pocket expenses
HealthCare.gov makes it transparent:
- Bronze tier. The insurance company pays 60% of the covered costs, while you pay 40%. The deductibles, or the amount you pay before the insurance company shells anything out, are also higher.
- Silver tier. The insurance company pays 70% of the covered costs, while you pay 30%. Deductibles are lower than those for Bronze. If you qualify for a cost-sharing reduction (CSR), you will need to buy a Silver tier health plan to take advantage of it. The premiums are higher, but you get a discount on out-of-pocket expenses.
- Gold tier. The insurance company pays 80% of the covered costs, while you pay 20%. Deductibles are much lower than Bronze or Silver. It is a good health plan if you prefer to keep your out-of-pocket expenses low, but monthly premiums remain high.
- Platinum tier. The insurance company pays 90% of the covered costs, while you pay 10%. The premiums are the highest among the tiers, but out-of-pocket expenses would be quite low. It works if you can afford and are willing to pay higher premiums every month, knowing that insurance will cover a large amount of your healthcare costs.
Part IV: Choose your health plan
Now that you have a general idea of the premiums and out-of-pocket expenses for each health plan tier, you can narrow down the inclusions to your health plan.
What is usually covered? According to the Affordable Care Act, all federally-funded and private health insurance companies are required to offer the following essential health benefits:
- Outpatient care
- Emergency services
- Inpatient care
- Maternity care
- Mental health treatment
- Prescription drugs
- Rehabilitative care
- Lab tests
- Preventative care
- Pediatric care
Depending on your gender, age, and life stage, you can review which health benefits are the most relevant to you. And then, with your health care provider or insurance agent, you can discuss and decide which benefits and services you want to emphasize. This discussion will lead to the insurance agency’s calculation of your healthcare premium.
Part V: Purchase your health plan on or before December 15, 2020
If you feel like your health plan has a fair premium and the out-of-pocket expenses are acceptable to your budget, you can now purchase your health plan. Remember to do it on or before December 15, 2020 (unless your state has a longer enrollment period), so that your policy kicks in by January 1, 2021.
