Working with Health Insurance Open Enrollment Deadlines

When you’re dealing with health insurance enrollment, you must pay attention to the open enrollment deadlines. 

First, what are these deadlines? There are three different types of health insurance policies we work with. Each one has its own deadlines for enrollment that you have to be very aware of. I will cover each one.

1. Affordable Care Act (also known as Obamacare). Their enrollment window is from November 1st through December 15th. It’s a 45-day window during which I can write policies for anybody, any time, anyplace, anywhere, no questions asked. Outside of that window, you have to have a special qualification to enroll in a health insurance plan. Therefore, it’s very important for me to enroll people during that limited timeframe. 

2. Group policies. Enrollment activities related to a group policy typically occur 30 days before the effective date and 30 days after it. So I work very closely with owners and HR managers to disseminate information to the employees so they can add on spouses, children or maybe even change from plan to plan if it’s offered at the company. So it’s very important to take advantage of that window of opportunity. 

3. Medicare. Their annual election period is October 15th through December 7th. Anybody that has a Medicare product, that’s the timeframe in which to change it or make any adjustment to it. If you want to move to a different plan, that’s your window for doing so. You want to be particularly diligent when it comes to the Medicare plans.

The Importance of Adhering to Health Insurance Enrollment Windows

Remember this: If you don’t take action during the correct open enrollment period, you just can’t get health insurance until that window comes around again. If you miss enrolling in an Affordable Care Act plan between that November 1st and December 15th window, you don’t get another chance again until November 1st the following calendar year. 

It’s the same with a group plan. If an employee doesn’t make that election during that open enrollment, they must wait until the next open enrollment with the group. It’s similar with Medicare—you miss those opportunities and you have to wait.

Exceptions to Health Insurance Enrollment Periods

There are ways around these restrictions. Those are special enrollment periods. It’s very important to know what these exceptions are. Here are some of them.

  • Couples getting married
  • Couples getting divorced
  • A move from state to state
  • Having a wonderful new baby added to the family

In these situations, an individual is not held to those open enrollment deadlines. When these situations occur, you typically have 60 days to get coverage. So you still have a window there in which we can help you outside the normal timeframes listed above. It’s just really important to take advantage of those timeframes and not miss any of these deadlines. 

If you need help taking advantage of one of these special enrollment periods or choosing your best health insurance plan in one of the open enrollment periods, talk with us at MBhealth. Call us at (314) 544-5400 or fill out the form on our contact page to get in touch. 

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