Open enrollment is when both individuals and employers can apply for, change, and compare their health insurance options. Open enrollment for 2022 begins from November 1 to December 15, 2020. On the first day of 2022, your chosen health insurance plan starts. You’ll need to apply during open enrollment if you want to get health coverage through, Medicare, your employer’s health insurance, or a private individual plan.
Your health insurance helps cover most or all your medical expenses. This includes medical, vision, dental, prescription drugs, and specialists visits. But how do you decide what plan is right for you? How do you find ways to save money on your health insurance costs while still receiving good coverage?
It’s important to prepare for 2021 open enrollment well before it starts, as you only have a limited timeframe to see and purchase your coverage options. If you miss open enrollment, you’ll need to apply for special enrollment. Here, we’ll share with you a step-by-step guide that’ll help you prepare for 2021’s open enrollment.
Step One: Decide How Much Coverage You Need
Everyone has different needs. Before you start shopping around for health insurance during 2021’s open enrollment, figure out how much coverage you’ll need. There are many different types of plans and coverage options suited for your needs. If you go with a plan that has higher premiums, you’ll have lower out-of-pocket costs. However, this may not be suited for your medical or financial needs.
To decide how much medical coverage you’ll need, ask yourself:
- Who you need to get coverage for and if that’s changed since last year.
- How much you’re currently paying in premiums and out-of-pocket expenses.
- If you or your dependant’s medical, dental, or vision needs have changed.
- Where you got your insurance last year.
- If you’re satisfied with your current plan.
Paying For Health Insurance
Once you’ve asked yourself some of these basic questions, you can decide how you’ll pay for your coverage. With higher premiums comes lower out-of-pocket costs. But this might not be the best option for everyone. When deciding how you’ll pay for your medical coverage, ask yourself if you:
- See a doctor or specialist frequently.
- Need frequent emergency care.
- Regularly take expensive or name-brand medications.
- Plan to or are having a baby.
- Have a planned surgery coming up.
- Are diagnosed with a chronic health condition.
If you agree with most of these statements, you’ll want a plan with higher premiums. However, if you can’t afford higher monthly premiums or you’re in good health without any chronic conditions, you may want to opt for a plan with lower premiums.
Having a plan with lower premiums means you pay higher out-of-pocket costs. If you don’t need to access medical care regularly and just need insurance to cover preventive care and emergencies, lower premium plans will be a better option.
Step Two: Compare Coverage And Plans
The next thing you need to do is decide what kind of coverage and plan you want. There are several different types of basic plans most insurance companies use:
Health Maintenance Organization (HMO)
A HMO plan has lower out-of-pocket costs, but typically doesn’t offer a lot of options outside your network. They do typically cover specialists visits with a referral, but always check with your insurance company before the appointment. HMO plans do allow you to go outside of your network in case of emergencies, seeking care outside your network is expensive and has higher copays.
Also Read: The Difference Between Medicare Supplement Vs. Medicare Advantage
Preferred Provider Organization (PPO)
You can go outside of the network with PPO plans, but the visits are typically much more expensive. You won’t need a referral to see a specialist with a PPO. With this plan, you have more provider options, but will have much higher out-of-pocket costs.
Exclusive Provider Organization (EPO)
An EPO is a higher out-of-pocket plan, and only has limited provider options. You can go outside of your network in emergencies, but as the name suggests, a EPO has a limited network. With this plan, you do not need a referral to see a specialist.
Point Of Service Plan (POS)
With a POS, you can go outside of your network to seek care, but it’s typically more expensive. You will also need a referral to see a specialist. This plan gives you more provider options, and provides you with a primary physician you’ll be working with.
Other things to consider when choosing your right health insurance plan is if you want to add a health savings account (HSA), health reimbursement account (HRA), or a flexible spending account (FSA).
Also Read: Ultimate Guide To Your Health Insurance
Step Three: Review Your Current Plan
At this point, you’ll want to take a look at your current plan if you have one. If you don’t have a plan currently, or have recently lost your health insurance, you should still think of what you can get coverage for. Keep in mind that if you have dependents on your health insurance, your health insurance must fit their needs too. Start by asking yourself if you:
- Take medications and how they’re currently covered.
- Are currently taking prescriptions that aren’t covered.
- Will have procedures in the near future that won’t be covered.
- Are covered for an unexpected illness.
- Have dependents with changing medical needs.
You may find that your current health insurance plan still suits your needs. In that case, you would work with your current carrier to renew your health insurance. There may be some changes in coverage and price. From there, you can either decide to renew your health insurance plan, or look at similar ones.
Also Read: Pros and Cons To Ditching Your Employer’s Health Insurance
If you get your health insurance through your employer, ask if there are any changes that may occur in your group coverage. For example, your employer may recognize that there are more employees with families. In that case, your employer might change your group plan to cater more towards those employees. This can affect your plan if you do not fit into that category. Other common changes also include:
- Wellness programs
- Women’s Health and Cancer Rights Act notices
- Medicaid and CHIP assistance
- Grandfathered Plan notices
Your employer will likely send out a notice regarding any changes. However, you should still be proactive and ask your employer if there are any changes to your group’s plan. You should also look to see if your state had any recent changes in health insurance policies.
Also Read: Where To Get Health Insurance If You’re Self-Employed
Step Four: Check Out New Plans And Get Quotes
At this point, you should know the following:
- How much coverage you’ll need and who you need to cover.
- How you’d prefer to pay for your health insurance.
- What kind of plans are available.
- What’s covered on your current plan and if it still suits your needs.
You may have come to the conclusion that your plan still suits all your needs. In that case, you should look for plans similar to yours and compare costs rather than the coverage. This will let you know if you’re still saving money with your plan.
If you need to change your plan, start by thinking of what kind of things you need covered. For instance, if you need glasses, you should look for a plan with more vision coverage.
Step Five: Compare The New Plans And The Old Plans
Now that you’ve figured out what your health insurance needs to cover and how payments work, you can check out competing plans on Marketplace. You only have a limited time during open enrollment to find the plan that’s perfect for you, so you should prepare this a few weeks before then. From November 1 to December 15, 2021 you can see competing plans, and purchase your health insurance plan for 2022.
To find competing plans, you can go online to the Marketplace, or call Quote Purple. Quote Purple works with premier health insurance partners who can find plans and quotes suited to your needs.
Your health insurance should be catered to you and your needs. It’s essential that everyone has health insurance coverage, but that doesn’t mean you need to settle for subpar coverage. Thankfully, you have hundreds of options to choose from on the Marketplace. It can be overwhelming trying to find the right one. Working with your health insurance company can help you decide which one is right for you.
If you want to switch your health insurance company, or ditch your employer’s insurance for a private plan, you can always call Quote Purple to see competing plans from the best provide