When it comes to your health insurance, Open Enrollment is the most important time of the year. This is the time that you’ll be able to change your plan, or enroll in a new one that better suits your needs and saves you money. It’s imperative that you know when the Open Enrollment Period (OEP) starts and how long it lasts so that you don’t miss out! If you do miss the OEP, you may have to wait an entire year in order to make changes, that is unless you qualify for a Special Enrollment Period (SEP). With all that being said, it’s super important to act before the deadline and avoid waiting until the last minute. To help you on this endeavor, we’ve outlined the key OEP dates for every state, to ensure you have ample time to get enrolled!
The 2025 OEP begins November 1st, 2024 in most states, and since changes to the OEP last year, it generally runs through January 15th in most states. Some states, though, have extended their OEP a little longer. Take a look at the following so you know when your state’s OEP begins and when it ends.
States With January 15th Deadlines
Alabama
There are currently 33 states that have a January 15 deadline for the health insurance OEP.
Alaska
Arizona
Arkansas
Delaware
Florida
Georgia
Hawaii
Illinois
Indiana
Iowa
Kansas
Louisiana
Michigan
Mississippi
Missouri
Montana
Nebraska
New Hampshire
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
South Carolina
South Dakota
Tennessee
Texas
Utah
Virginia
West Virginia
Wisconsin
Wyoming
States with Different OEP Dates
Some states with their own ACA exchanges have different date ranges for the 2025 Open Enrollment Period. The chart below shows the State Enrollment Period (SEP) and OEP dates for these states; other states have not yet announced their dates (these are also listed below).
State
State Open Enrollment Period for 2025 Plans
California
November 1, 2024 – January 31, 2025
Colorado
November 1, 2024 – January 15, 2025
Connecticut
November 1, 2024 – January 15, 2025
Idaho
October 15, 2024 – December 15, 2025
Kentucky
November 1, 2024 – January 15, 2025
Maine
November 1, 2024 – January 15, 2025
Maryland
November 1, 2024 – January 15, 2025
Massachusetts
November 1, 2024 – January 23, 2025
Minnesota
November 1, 2024 – January 15, 2025
Nevada
November 1, 2024 – January 15, 2025
New Jersey
November 1, 2024 – January 31, 2025
New Mexico
November 1, 2024 – January 15, 2025
New York
November 16, 2024 – January 31, 2025
Pennsylvania
November 1, 2024 – January 15, 2025
Rhode Island
November 1, 2024 – January 31, 2025
Vermont
November 1, 2024 – January 15, 2025
Washington DC
November 1, 2024 – January 31, 2025
Washington
November 1, 2024 – January 15, 2025
Looking For Affordable Health Insurance?
The health insurance 2025 Open Enrollment Period is open from November 1 until January 15 (depending on your state), so now is the perfect time to reconsider getting a health insurance plan, or looking into your current one and making sure it’s got you covered. And if your plan doesn’t cover everything you need it to, it’s time to find a plan that does, so you can save as much money as possible.
If you’re shopping for a plan, your best bet is to speak to a licensed EZ agent. Our agents work with the top-rated insurance companies in the nation, so we can compare plans in minutes. We will not only find a plan that has all the benefits you’re looking for, but we will also make sure the plan meets your financial needs. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-694-0047. No obligation.
The Health Insurance Open Enrollment Period is coming up: starting November 1st, you’ll have around 6 weeks to find a plan that meets your needs. That means a lot of information about all the different health insurance plans available, and information about any changes to your current plan will soon be coming your way. You’ll have to sort through all of this while trying to figure out how much coverage you need, and what you can afford, which can feel like a lot. And this time is going to come and go quickly! That means it’s important to begin planning now, so you are ready and don’t feel rushed during the process.
Luckily, you won’t have to feel alone during this OEP, because EZ.Insure is here to help! EZ.Insure makes the enrollment process stress-free and simple. Our easy-to-use platform provides free quotes and side-by-side comparisons of all the available health plans in your area. We also have a team of dedicated agents who are always on hand to help guide you through the process or answer any questions, so you can leave feeling confident in your coverage. To help you feel even more prepared, we’ve compiled a brief list of helpful tips so you can tackle this OEP with ease.
EZ’s certified insurance agents are also always up-to-date on the newest healthcare plans.
1. Choose an Unbiased Agent
Who you choose to work with when looking for a health insurance plan is a very important decision, and plays a big part in finding a comprehensive, affordable plan. It’s important to work with a licensed, knowledgeable agent who is not connected to a certain type of health insurance plan or insurance company, so you can get an unbiased look at all available options in your area.
EZ’s agents work with the top-rated health insurance companies in the nation, and we guarantee that we will compare all plans in your area so that you can find the perfect plan. And not only are our agents independent, but they are also always up-to-date on newer healthcare plans, so they can provide you with all the information that you need before you make your decision.
2. Consider ALL of Your Options
After choosing to work with an EZ agent, you can simply ask them to research every option that you have, as well as help you weigh all the pros and cons of each plan. There are many different types of healthcare plans available, including PPO plans, HMO plans, or metal tier plans; if you’re not sure what’s best for you, an EZ agent will go over all of these different plan types, and will not try to limit you to a certain plan. We will lay all of your options on the table and review the coverage and cost of each one.
3. Ask the Right Questions
When it’s time to start searching for plans, think ahead of time about what you want to ask your agent, and what is important to you in a plan. In addition to asking about prices and coverage options, have a list of questions you want to ask, like:
Is mental health care (or anything else you’re interested in having covered) covered?
Is a higher deductible or lower premium plan better for you?
4. Find the Plan That Has the Most Value
People often choose the cheapest plan available, but this cheapest plan might not have the best benefits available for the price. A good health insurance plan will come from a quality carrier, provide comprehensive benefits, allow you to see the doctors you want to see, and have affordable co-pays. And remember, if you go for the cheapest plan available, you might end up paying more out-of-pocket when you use medical services. Our agent will review your medical needs and budget, and search for a plan that will check all the boxes for you.
Need Help? EZ’s Got You Covered
The health insurance Open Enrollment Period will be open from November 1st through January 15 (depending on your state), so now is the perfect time to reconsider getting a health insurance plan, or to look closely at your current one to make sure it will cover all of the above-mentioned costs. And if your plan doesn’t cover everything you need it to, it’s time to find a plan that does, so you can save as much money as possible.
If you’re shopping for a plan, your best bet is to speak to a licensed EZ agent. Our agents work with the top-rated insurance companies in the nation, so we can compare plans in minutes. We will not only find a plan that has all the benefits you’re looking for, but we will also make sure the plan meets your financial needs. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local agent, call 888-350-1890. No obligation.
By now you know that the Open Enrollment is the only time where you can enroll or change your health insurance plan. But what you might not know is why the Open Enrollment Period exists. The short answer is that it prevents adverse selection. Which is when people only buy health insurance when they’re sick or need it. However, there is a lot more that went into the creation of the Open Enrollment.
To fully understand how the open enrollment period began you need to understand how health insurance came to be. This way you can see the series of events that shaped open enrollment’s creation and the reasons it was needed. Health insurance as we know it today has been around since the 1850’s. Back then, people who worked on the railroads and steamboats did their jobs in dirty, often dangerous places where serious injuries and illnesses were common occurrences. Even though these jobs paid well, workers were essentially risking their lives every day to the point that many became unable to work at all. And in turn couldn’t provide for their families. So the concern of the general population was, if the worst happens, how would they pay for their care while maintaining a household which often held a spouse and several children.
That’s where health insurance came to be. In 1850 the Franklin Assurance Company of Massachusetts became the first company to offer workers’ accident insurance. This set the standard for other companies in the years to come. Workers could now protect themselves financially from major injuries by putting money into an accident insurance “pool”. Everyone put money into the pool and when claims arose the money for their care was taken from the pool. This meant that healthy workers were helping to pay for injured worker’s care. While knowing that if they were ever in that situation the other workers would be helping to pay for their care.
History Of Open Enrollment
Let’s hop in the Delorean and time jump to 1949 when President Harry S. Truman finally set up the national health care system. This creation would eventually lead to the idea of open enrollment. During World War II, companies started offering health insurance to their workers as a way to draw in more people in a tight job market. This practice of offering health insurance as an employee perk ran rampant, every company wanted in on the trick. So, people started signing up for health insurance in such large numbers that the program’s financial future was in serious trouble if something didn’t change.
This is because unhealthy people had more reason to sign up then immediately start making claims. Which would crash the system because more money was coming out of the insurance company than going into it. This is what led to insurance companies starting to only let people enroll during specific times of the year. Doing this gave the insurance companies the ability to:
Manage their risks by limiting the number of enrollees at any given time.
Handle their cost basis by understanding how many people would enroll and what their health status would be.
Simplify the entire health insurance process by only reviewing applications or updating policies at a certain time of year.
Track their coverage levels so they could manage their ability to fulfill their current policy offerings.
During open enrollment insurance companies were also able to improve ties with other insurance companies. They could now take the time to strengthen the insurance contracts they currently had, make new partnerships, and improve healthcare all around. Most importantly, open enrollment helped health insurance grow a sense of shared duty. Companies could now pool their resources, share the best practices and ideas, as well as figure out how to navigate all the rapid new changes to the industry and market.
What Is Adverse Selection
Okay, now that the history lesson is over everyone back to the Delorean- we’re headed home. Well actually, we’re headed back to the beginning of this article where we mentioned open enrollment discouraging adverse selection. This is what health insurance companies nicknamed the trend in people only buying health insurance when they’re sick. When only sick people buy policies the insurance companys’ risk skyrockets. This is because they end up having to pay out more money than they have because there’s more claims than premiums. Health insurance companies only stay in business if they get more money from premiums than they give out in claims. So, it needs more healthy people than sick ones to properly pay out claims as well as pay to keep the company running smoothly.
Here’s what we mean. Let’s say that a health insurance company charges an annual premium of $4,200. Brianna is a member of this plan and she gets sick and her care costs $10,000 for that year. Brianna’s premiums aren’t enough to cover those costs by themselves. So, the health insurance company has to tap into the premiums of healthy policyholders who haven’t needed any healthcare that year to cover the difference for Brianna’s care. If there isn’t enough available money from healthy premiums. Then Brianna’s care comes out of the business’ pocket and their company as a whole goes into the red. This would lead to the health insurance company having to shut down or raise their premiums to supplement their loss. Both hurt everyone across the board.
Consequences of Adverse Selection
At the end of the day, health insurance companies are businesses. And adverse selection is a surefire way to bankrupt said business. In addition to paying out claims, insurance companies also have other expenses. Things such as employee wages, building rent, utilities, taxes etc. are all a part of running a healthy business. Not to mention health insurance is private in the U.S. Meaning these companies also have to make money after paying out claims and bills. Otherwise, the business closes its doors. So, what makes it so harmful to not only the companies, but also the general public as a whole?
Lack of Competition
The more health insurance companies close the more other companies begin to hold a monopoly on the market. When an insurance company has a hold on the market it has no competition so there’s no reason for them to try to improve their policies or create new upgraded ones. They can also charge whatever they want because other companies aren’t around offering cheaper options to pull customers away from them.
Less Accessibility
If health insurance companies start going the way of dinosaurs, there’s a chance that you won’t be able to get health insurance at all. Health insurance companies tend to focus on specific areas like certain states, counties, and even cities. So, if the health insurance companies in your area go out of business, you won’t have access to a plan that you want or need. If you do manage to get a plan from another area that’s extended its coverage a little, you may end up having to travel long distances to reach their in-network providers.
You Leave Yourself Vulnerable
If you wait to get health insurance until you’re sick, your medical bills might end up not even being covered. The point of health insurance is to protect you in case of something happening. It helps pay the costs for the unexpected injuries and illnesses. The thing about health insurance is that coverage doesn’t start right away. It usually begins at the beginning of the month after you enroll or even at the beginning of the next year, whichever comes first. So if you try to get coverage because you need it right then it most likely won’t be covered because your policy will not pay for anything before it’s active.
How Open Enrollment Prevents Adverse Selection
Health insurance companies can’t entirely erase adverse selection, but they can lower the risk of it happening by only accepting applications once a year. Everyone who wants health insurance can sign up or make changes to their plans during the open enrollment. This keeps healthy people from assuming that they can just wait until they’re sick to get insurance because it’s always available. They won’t be able to sign up for health insurance when they’re sick unless they happen to get sick during the open enrollment period. As we noted above, the open enrollment period comes with a waiting period between enrolling and your coverage beginning. This keeps people from signing up for health insurance on their ride over to the hospital in the hopes that their new plan will cover the bill.
The Affordable Care Act did originally have a plan to stop adverse selection. There was an annual fine for anyone who had access to affordable health insurance and didn’t enroll. The federal fine was removed in 2018 though. However, California, Massachusetts, New Jersey, and Rhode Island all have their own health insurance laws that penalize people that don’t have health insurance. They only get fined if they don’t qualify for an exemption on their state or district tax returns. These states keep this fine in place not to be harsh, but because they believe it’s a useful tool in preventing adverse selection in the health insurance market. In turn it keeps these state’s insurance premiums lower for their population.
Find Health Insurance With EZ
Because there are so many factors to take into account when organizing your own health insurance, it can be frustrating. No one enjoys reading hours of different plan benefits and premiums, so why not let a professional do all of the hard work for you- for free! There is a way to get affordable health insurance without all the hassle. A licensed EZ insurance agent can outline the benefits and drawbacks of each plan and assist in creating the plan that will work best for you.
Working with an agent saves you time and stress, no more trying to decode legal jargon or reading fine print. Agents do all the heavy lifting while you rest easy knowing that your coverage will be the best fit for your financial and medical needs.
Not to mention EZ agents can save you hundreds of dollars every year on health insurance premiums. We do this by having the ability to search both on and off the market for the most affordable plans. We’re also able to find and apply any discounts you may qualify for. Furthermore, we don’t stop at just finding you a plan, we help maintain your plan after the fact too! We can help you file claims with your provider and even help renew your policy when the time comes. To get started, simply put your zip code into the box below or give one of our licensed agents a call at 877-670-3557.
The health insurance Open Enrollment Period (OEP) is coming, and you might feel a little lost. It can be hard to sort through all of the different health insurance options in your area, but you know that you and your family need health insurance to stay healthy. Don’t worry though. You can always work with a licensed EZ agent, who will help you find a plan that fits your budget and your needs. Before you do that, let’s look at everything you need to know about the OEP.
What Is The OEP?
The Open Enrollment Period (OEP) is the only time of the year when you can change, cancel, or buy a new health insurance plan. Depending on which state you live in, it starts on November 1st and goes until mid-to late-January. Now is a good time to look at your current health insurance plan, see if it will change in the new year, and decide if it will meet your needs in the future or if you need a new plan.
When Is The OEP?
The open enrollment period for Obamacare plans is from November 1, 2023 to January 15, 2024. Any plan you buy by December 15 will cover you starting on January 1, 2024. If you buy a plan during open enrollment, which is between Dec. 15 and Jan. 1, it should take effect by Jan. 15, 2024, as long as you pay your first premium on time. Also, if you buy a plan between Jan. 1 and Jan. 15, your plan should start on Feb. 1, 2024. Some states’ open enrollment periods are longer than others, but this can change. At the moment, these states have longer periods for signing up:
California – November 1st, 2023, to January 31st, 2024
Idaho – October 15th, 2023, to December 15th, 2023
Maryland – November 1st, 2023, to December 15th, 2023
Massachusetts – November 1st, 2023, to January 23rd, 2024
New Jersey – November 1st, 2023, to January 31st, 2024
New York – November 16th, 2023, to January 31st, 2024
Rhode Island – November 1st, 2023, to December 31st, 2023
If you get your health insurance through your job, your employer can choose when your open enrollment period is.
Marketplace Plan Tiers
Since the Affordable Care Act (ACA) went into effect in 2010, most people buy traditional health insurance plans on the insurance marketplace during the OEP. When you buy plans this way, they come in four levels called “metal tiers.” Bronze, Silver, Gold, and Platinum are the tiers. The plans in these tiers are different in terms of price and how much you’ll have to pay out of pocket, not in terms of the quality of care you’ll get.
Bronze
The monthly premiums for bronze plans are the cheapest, but you have to pay the most out of pocket. With these plans, your insurance company will pay 60% of each of your medical bills. The other 40% will be your responsibility. Also, the deductibles for these plans, which are the amount you have to pay out of pocket for medical costs before your insurance plan starts to pay for them, can be in the thousands of dollars each year. Bronze plans are a good choice if you don’t use medical services very often but need a low-cost plan to protect yourself against the worst-case medical scenarios, like getting sick or hurt badly. Your monthly premium will be low, but since the deductible and cost-sharing percentage are both so high, you will have to pay for most of your routine care.
Silver
The monthly premiums and out-of-pocket costs for silver-tier plans aren’t too high or too low. These plans cover 70% of the cost of your medical care. You pay the other 30%. The deductibles for this tier are often lower than those for Bronze plans, so if you’re willing to spend a little more to have more of your routine care covered, these plans are a great choice. When you qualify for cost-sharing discounts, you have to choose a Silver plan to get the extra savings. If you are on the Silver plan and stop getting cost-sharing reductions, you will have a Special Enrollment Period. If you want to switch plans, you can sign up for the Bronze, Silver, or Gold plan that fits your needs and budget the best.
Gold
Even though the premiums for Gold plans are high, the out-of-pocket costs of care are lower than for the plans above it. These plans have low deductibles, and your plan will pay for 80% of your care while you only pay 20%. If you need a lot of medical care, a Gold plan might be a good choice for you because it will cover more of your care.
Platinum
Platinum has the highest monthly premiums of all the tiers. While the premiums will be high, your out-of-pocket costs will be the lowest of any type of plan, and since the deductibles are so low, your insurance company will pay more of your costs throughout the year. Since these plans cover 90% of all your medical costs, they can be a good deal for people who need a lot of medical services.
In addition to the different types of metal tiers, there are also different types of plans to choose from during the OEP. Some plans only let you choose from a small number of doctors, hospitals, pharmacies, and other health care providers, or they force you to use only those in their network. On the other hand, some plans will pay a bigger share of the bill for healthcare providers outside of the plan’s network. Depending on where you live, you might find plans in any or all of these categories at each metal tier level:
Health Maintenance Organization (HMO) – A type of health insurance plan that usually only pays for medical services from doctors who work for the plan or have contracts with it. Most of the time, out-of-network care is not covered, unless it is an emergency.
Preferred Provider Organization (PPO) – A type of health plan that has a network of providers but doesn’t force you to only see those providers. But your out-of-pocket costs will be lower if you use providers in the network. You can use medical professionals, facilities, and suppliers outside the network if you pay extra and don’t have a referral.
Exclusive Provider Organization (EPO) – A managed care plan is one in which treatments are only covered if you go to doctors, hospitals, or other healthcare providers in the network, unless it’s an emergency.
Point of Service (POS) – A type of plan where you pay less if you go to hospitals, doctors, and other healthcare providers in the plan’s network. To see a specialist, you need to get a referral from your primary care doctor.
How To Buy Health Insurance During The OEP
If your employer gives you health insurance, they should tell you when and how to choose coverage for the next year. If you don’t get health insurance through your job, you can use the marketplace to look for and buy a plan. Another way to buy health insurance during this time is to work with an EZ agent who can help you shop through all of the plans available and help you enroll. Most states use the federal marketplace, healthcare.gov, but 17 states and Washington, D.C., have their own state-based marketplaces where people can buy coverage. States that run their own health insurance exchanges may also offer longer sign-up periods. These are the states that have their own insurance markets where people can buy plans for 2024:
Residents of all other states should shop for and sign up for their next health insurance plan on the federal exchange.
Things To Consider During The OEP
As Open Enrollment for Individual and Family Health Insurance in 2024 gets closer, there are a few important steps to take when choosing your plan.
Review Your Current Plan
If you already have health insurance, look it over to see if it still meets your needs. Think about any changes in your health, finances, or lifestyle recently that might mean you need a different health insurance.
Explore Options
During Open Enrollment, it’s important to look at different plan options to find one that fits your healthcare needs and budget. Look for plans that have a network of doctors and hospitals that fit your needs and preferences.
Consider Subsidies
As you look at and compare insurance plans on the Marketplace, make sure to update your personal information, especially your financial information. If you make less than a certain amount of money, you may be able to get health insurance subsidies that can lower your monthly premium by a lot. Also, Silver Marketplace plans offer cost-sharing reductions, which can lower your out-of-pocket costs by lowering your deductible, copays, and coinsurance.
Consider Additional Coverages
Even though Marketplace health insurance plans cover a wide range of medical services and include prescription drug coverage, you may want to think about getting more coverage, like dental and vision plans, to make sure your health is well-rounded.
What If I Miss The OEP?
If you miss the Marketplace’s Open Enrollment Period, you might not be able to sign up for an ACA health insurance plan unless you qualify for a Special Enrollment Period. With a Special Enrollment Period, you can sign up for a plan outside of the Open Enrollment if you have a qualifying life event. This is an event that affects your current coverage, like losing your job or getting divorced. You might also be able to sign up for a health plan through your employer. Some plans offered by employers have their own enrollment periods that may differ from the Marketplace. Also, if you change jobs, you may be able to sign up for your new job’s health plan outside of the normal enrollment period.
Need Help?
The best way to find a cheap plan with the right level of coverage for you is to compare plans. Come to EZ first before you start comparing things on your own. We’ll make the process faster and easier by letting you compare plans in your area in just a few minutes. Our licensed insurance agents work with all of the best insurance companies in the country. They can talk to you about your budget, needs, and help you choose the best plan for you and your family. We compare plans and give you advice for free. Enter your zip code in the bar above to get free quotes or call 877-670-3557 to talk to a real person.
So, you’ve decided it’s time to cut ties with your health insurance plan, but can you cancel your policy? The answer is both yes and no. You can cancel your health insurance, but if you do it at the wrong time or without a backup plan ready to go you could face fines or massive coverage gaps.
When To Cancel Your Health Plan
It’s best to cancel your health insurance policy once you have a replacement ready to take its place. If you don’t, you will have coverage gaps, leaving you vulnerable in the event of a health emergency. If you are looking to make the switch,Open Enrollment Period (OEP) is the best time to look into a different health insurance plan. The only time you can switch to a new health insurance plan outside of the OEP is if you qualify for a Special Enrollment Period (SEP). You qualify for an SEP if:
You just got married
Filed for divorce
Just had a baby
You or your spouse got a new job, losing your group health insurance coverage
You’re moving outside of your coverage area
Your current plan is no longer offering coverage in your area
Your current health insurance company is out of business
The Right Way To Cancel Your Private Health Plan
It’s important to cancel your health insurance plan properly so that there is no confusion or loose ends. Below are the steps you can take to cancel your plan the right way.
Call your health insurance company
If you have health insurance through the Marketplace, you can login to your account and terminate the plan’s coverage. If you need help canceling your plan online, you call their customer service line. When you’re canceling a private health insurance plan, you can contact your insurance company directly. Your health insurance company’s phone number is printed right on your policy, health insurance card, and premium bills. Your health insurance provider may let you cancel over the phone. Occasionally, they may request that you fax or mail them additional documentation such as a confirmation letter.
Follow Your Plan’s Cancellation Process
Every health insurance provider has a cancellation procedure you must adhere to, such as ensuring your policy end dates are accurate to avoid a lapse in coverage. During your online or phone cancellation, an insurance agent will confirm the steps you have to take to successfully cancel your health insurance plan. Note the name of the representative and any cancellation confirmation numbers. This is important in the event that there are any procedure errors during the cancellation you’ll be able to quickly prove when the policy was ended.
Ask About Premium Refunds and Check Your Bank
If you paid your plan in full for the year and want to cancel it before it expires, ask your health insurance company if it will reimburse you for the months you’ve already paid for but have not used yet. Many insurers will issue a refund for the remaining time on your policy. Check your bank statements after your new health insurance coverage begins to ensure that the canceled plan is no longer in effect and charging your account. You’ll also want to make sure that the new policy is active and has taken the first payment if you have one.
Check Your Active Health Coverage
Don’t cancel your old policy until you’ve gotten a new one and reviewed the coverage start date. Make sure the active coverage periods don’t overlap, as it’s illegal to submit claims to two separate major medical policies. You’ll also want to check your monthly health allowance if your employer reimburses you for your insurance premium or other out-of-pocket medical expenses through a health reimbursement arrangement (HRA) or health insurance stipend. This amount may affect your desired premium payment and the types of medical expenses you may get. Additionally, check the type of HRA your company offers. Integrated HRAs supplement employer-sponsored health insurance plans by helping to pay for deductibles, copayments, medical services, and other out-of-pocket costs, but cannot reimburse health insurance premiums.
Know Your Rights
Every state has consumer protection laws and insurance regulators who can help you with questions or complaints regarding your individual coverage. Your state laws may address health coverage requirements, prompt payment of claims, access to specific specialists, and certain treatment coverage. These protection laws apply to all plans, whether individual coverage or employer-provided health insurance, in order to safeguard your access to health services. If you submit false information on your health insurance application, your policy could be canceled. However, they cannot terminate your coverage if you made an honest error on your application. If you have unpaid premiums, your provider can terminate your coverage. In the majority of instances, your health insurance provider must give you at least 30 days notice before canceling your coverage due to missed monthly payments. This notice affords you the opportunity to appeal the decision or find a more cost-effective alternative.
How To Cancel Your Group Health Plan
You may need to cancel your employer-sponsored health insurance plan, even if you remain employed with the company. For example, your spouse or domestic partner’s employer may offer a more affordable plan option. Canceling an employer-sponsored plan is fairly easy if you follow these steps:
Contact HR – Your company’s human resources department will be able to answer your questions and will be your primary contact through the entire cancellation process
Ask about dates – Make sure you know the cancellation date, and make sure your new coverage will begin on or right after that date. You don’t want your plans to overlap.
Complete the paperwork – If you’re opting out of your group plan early, there will likely be a bunch of paperwork that comes with it. Make sure you complete, sign, and submit these forms on time
Cancellation Penalties
In most instances, there is no fee for canceling a health insurance policy. However, some insurance providers do charge a cancellation fee. This would be specified in your plan’s terms and conditions, so you are aware of this policy before you buy it. While the federal government no longer imposes a tax penalty for not having health insurance, some states do. The District of Columbia, California, Massachusetts, New Jersey, and Rhode Island have penalties for not having health insurance. Each state has its own system of fees. Check your state’s regulations before you cancel your health insurance, as you may qualify for an exemption from the tax penalties.
When Can’t I Cancel My Health Plan?
There are very few circumstances where you’re not able to cancel a health plan early. Some employer group health plans are paid for out of your paycheck prior to taxes being taken out. These plans are called Section 125 plans. They can be an excellent way to save money on insurance and taxes. If you have one of these plans, however, you can only change or cancel it during the Open Enrollment Period, or if you have a qualifying life event. Your HR department will be able to let you know if that’s the case with your group plan.
Additionally, if you are under 30 and have a short-term or catastrophic insurance plan, you may not be able to cancel your coverage early. Many of these plans are bought for a specific period of time and can’t be canceled early. Make sure you understand the terms and conditions of these plans before enrolling.
Why You Need Health Insurance
So far we’ve talked about how to switch health insurance plans, but we haven’t mentioned people canceling health insurance with no plans to get another plan. We know that sometimes when money is tight you start cutting expenses and health insurance is one of the first things to go. Especially if you’re healthy you think “well, I don’t use it, I don’t need to pay for it”, but that way of thinking can be detrimental. While being healthy is great, the objective here is to maintain that health throughout one’s life. Unfortunately, neither disease nor accidents can be predicted. Without health insurance, you are responsible for all of your medical expenses. Which poses a substantial threat to your financial and medical stability.
Health Benefits Of Health Insurance
The greatest benefit of health insurance is access to necessary medical care. Health insurance provides access to a comprehensive network of physicians, specialists, hospitals, and laboratories. This network collaborates with you and each other to help you prioritize wellness and prevention. In fact, the majority of healthcare plans include free preventative services, such as immunizations and screenings, to help you stay healthy and avoid illness and its consequences.
Additionally, the Affordable Care Act requires Marketplace plans to cover pre-existing conditions. This means that even if you already have a chronic illness, you will not be denied coverage or charged more for your pre-existing condition. Since you’ll have regular access to the necessary doctors and specialists, your healthcare plan will also assist you in managing the care for any chronic illnesses you may be living with.
Your health insurance provides you with the most effective means of maintaining your health. Having access to this type of continuous care can ultimately result in a longer and healthier life. In fact the mortality rate of adults between 17-64 without health insurance is 40% higher than those without insurance, according to the National Library of Medicine.
Financial Benefits of Health Insurance
Health insurance protects not only your health but also your finances. With an insurance plan, you will have less out-of-pocket healthcare costs, as your insurance will cover your medical services for a monthly premium. You will also be healthier, which will lower your out-of-pocket costs. Consider how much you would pay out of pocket for an unexpected medical emergency Which could easily cost you thousands of dollars.
Working With An EZ Agent
It can be frustrating to organize your own health insurance because there are so many variables to take into account. Why not let a professional do all the hard work for you, for free? A licensed EZ insurance agent can describe the advantages and disadvantages of each plan, and help you choose the best plan for your needs. EZ agents can save you hundreds annually on health insurance premiums. This is accomplished by our ability to search both on and off market for the most cost-effective plans. We can also locate and apply any discounts you may be eligible for. And we don’t stop at finding you a plan; we also assist with plan maintenance after the fact! We can assist you in filing claims with your insurance company and renewing your policy when the time comes. To begin, enter your zip code in the box below or call one of our licensed agents at 877-670-3575.
The health insurance Open Enrollment Period (OEP) is here, and you might be feeling a little overwhelmed. Sifting through all the different health insurance options available to you in your region can be tricky, but you know you and your family need to have health insurance to be protected. Don’t worry, though, if you work with a knowledgeable EZ agent, you’ll be able to find an affordable plan that will give you exactly what you’re looking for. Before you do that, we’re going to give you some guidance on how to start looking for the right plan for you.
What Is Open Enrollment?
The Open Enrollment Period (OEP) is the one time during the year when you can change, cancel, or purchase a new health insurance plan. Depending on what state you live in, it begins on November 1st and lasts until mid-to-late January. It is the perfect time to assess your current health insurance plan, check if it’s going to change in the new year, and decide if it will fit your future needs or if it’s time to get a new plan.
Terms You Need to Know
If you’re looking at plans, you will come across some terms that might be unfamiliar to you, or that maybe you’ve never fully understood. To get a full understanding of your options, you should feel comfortable with the following terms::
Premium– The amount you need to pay per month to keep your health insurance plan active.
Deductible– The amount you will need to pay for healthcare services before your health insurance kicks in and pays the rest of your bills. For example, if you have a $2,000 deductible, you will have to pay that amount in medical bills before your plan covers your healthcare expenses.
Network- A group of hospitals, doctors, and other healthcare professionals that are covered by your plan.
Copay– A set amount you will pay when you see a healthcare professional. For example, you might have to pay $20 every time you see your primary care doctor and $30 when you see a specialist.
Coinsurance– The percentage you’ll pay for healthcare services after you meet your deductible. For example, you might have to pay 20% of a covered service, so if a procedure costs $200, you’ll pay $40.
Out-of-pocket maximum- The most you will pay out-of-pocket per year for your healthcare. Typically this will include your copays, coinsurance, and deductible.
High-deductible health plan (HDHP)- A type of plan that has a high deductible and lower premium. You can also get a health savings account (HSA) alongside a HDHP that allows you to set aside pre-tax dollars towards qualified medical expenses. These types of plans are typically best for people who are healthy and do not see the doctor often.
Exclusion- What your plan will not cover – for example, cosmetic surgery.
When trying to select the right health insurance plan for you and your family, you will come across many different choices. The right one for you will depend on your lifestyle, the doctors you want to see, and any medical equipment you need or medications that you take regularly. You should also take into consideration if you have children, especially if they play sports and might need to go to the emergency room.
You will also need to think about any possible changes in your life in the upcoming year. For example, will you be starting a family, getting married, going through a divorce, or any other life-changing event that will affect how much health insurance you need? Any of these events will mean you’ll need to reconsider your coverage.
In addition, you should look carefully at the different types of plans available, including HMOs and PPOs. With an HMO, you will get lower premiums, but you will be limited to a restricted network. PPOs, or preferred provider organizations, on the other hand, have a larger network. You will also have different metal tears to choose from which offer a range of coverage options and price points. Generally, the difference between the tiers lies in what percentage of your expenses the plan covers.
Last but not least, you should look into subsidies that you might qualify for, especially now that they have been extended through the American Rescue Plan Act. You may now qualify for subsidies that you might not have qualified for a year or two ago. This is why it’s very important to work with a knowledgeable agent who can go over all of your needs to make sure you find the perfect plan for you and your family.
Comparing plans is the best way to find an affordable plan that provides the right level of coverage for you. Before you start doing the work of comparing on your own, come to EZ. We will make the process quicker and easier by comparing available plans in your area in minutes. Our licensed agents work with all the top-rated insurance companies in the nation and can go over your budget and needs, and find the best plan for you and your family. We compare plans and offer guidance at no cost to you. To get free quotes, simply enter your zip code in the bar above, or to speak directly with an agent, call 888-350-1890.
