Open Enrollment Period Archives

4 Things You Should Do to Plan for the Open Enrollment Period

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.

woman smiling with a headpiece on — *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 advanced primary care included in the plan?
Can you keep your current doctor?
Do you qualify for subsidies for any of the plans?
Can you see doctors outside of your network?
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.

Questions To Ask When Requesting Health Insurance Quotes

The Open Enrollment Period is coming to an end soon, and if you still haven’t looked into your health insurance options for the new year, now is the time to do so. But we get that picking a plan can be overwhelming because of all the options out there, so we want to give you the inside scoop on finding the best plan for you: your best bet is to work with an insurance agent. They know the ins and outs of health insurance and work with every insurance company, so they can get you the best possible plan. The best part? If you work with an EZ agent, we will compare plans for you for free! So if you’re ready to get started, we’ve got the most important questions to ask when requesting health insurance quotes from your EZ agent.

What Types Of Plans Are Available?

There are a lot of plans – and we mean A LOT – of different plans out there to choose from. There are metal tier plans, HMOs, PPOs, POSs, EPOs, and more. Each plan offers different levels of flexibility, coverage options, and rates; your available options also depend on where you live, so be sure to ask your EZ agent which plans are available in your region. We will gladly go over every single option and discuss the difference between each plan, so we can help you determine which one is right for you and your family.

What Are The Metal Tiers?

Health plans available on the ACA Exchange are separated into four metal tiers. These tiers do not indicate the level of care you will receive; rather, the tiers let you know how much you will pay for care and how much your insurer will pay. The tiers are:

Bronze– Lower monthly premiums, but a higher deductible and copays. You will usually pay an average of 40% of costs of care, and your insurer will pay 60%.
Silver– Moderate monthly premiums and moderate medical costs. You will pay 30%, and your insurer will pay 70%.
Gold– Higher monthly premiums with lower out-of-pocket costs. You will pay 20% and your insurer will pay 80%.
Platinum– Highest monthly premiums and lowest out-of-pocket costs. You will pay 10% and your insurer will pay 90%.

We will be able to go over this in more detail, including what each type of plan will cover and how much you will pay, so you can have a better understanding of how these plans work.

Can I Add Supplemental Insurance?

Dental and vision are considered supplemental insurance plans; some health insurance plans do not offer these, so you will have to ask if they are part of the plan you are looking into. If they are not, we can help you find affordable dental and vision plans.

What is A HDHP & Will It Work For Me?

High deductible health plans are exactly what they sound like: these plans have high deductibles, but in exchange, you will have low affordable monthly premiums. These plans are generally for healthy people who only see the doctor for annual physical exams and do not have any chronic conditions that require constant medical attention, and who will most likely not have to pay their whole deductible. For 2022, the Internal Revenue Service has defined a HDHP as any plan with a deductible of at least $1,400 for an individual, or $2,800 for a family.

How Are Medications Covered?

money made out of medication pills — *Medications are covered differently on plan’s drug formulary, which determines how much your medications cost.*

Figuring out the cost of your prescriptions can be a little complicated since different insurance companies can charge differently for the same drug – some drugs might even be covered differently by the same insurer depending on the plan you choose. Basically, insurers put medications into a drug formulary, which is divided into four tiers:

Tier 1– Inexpensive generic drugs
Tier 2- Brand name drugs and more expensive generic drugs
Tier 3– Non-formulary drugs, generic or brand name
Tier 4- Specialty drugs

To find out which plans cover your medications and how much you will be charged based on their placement in the insurer’s drug formulary, you need to speak with an EZ agent. We will review each plan available in your area and their drug formularies to make sure that your medications are covered, and that they will not cost you an arm and a leg.

What About Out-of-Network Coverage?

Some plans, like HMOs, will not cover out-of-network coverage, but PPO and POS plans do cover out-of-network coverage in case of an emergency. If you travel or visit family in other parts of the country often, you’ll definitely want to consider a plan that covers out-of-network emergencies; otherwise, if you have an accident while away from home, you could be stuck with a bill that you have to pay out-of-pocket.

Do I Need Referrals?

With some plans, you’ll need a referral from your primary care physician (PCP) to see a specialist, like a gastroenterologist or an orthopedic doctor. If you want to skip this step and see a specialist whenever you feel necessary, we can help you find a plan that does not require a referral. You’ll have more flexibility with a plan that doesn’t require referrals, and you won’t have to pay a PCP copay just to get a referral to see a specialist.

There are so many things to think about when looking for a health insurance plan for you and your family. Do you want more flexibility? Supplemental insurance? Cheaper prescriptions? The easiest way to find the right plan for you and get the answers to these questions is to work with an EZ agent. We will compare plans, go over every option, discuss your needs, and help you sign up for the plan you need, all at no cost to you. Our services are completely free, with no hassle and no obligation. Speak to an EZ agent now, before the OEP ends! Get free health insurance quotes by entering your zip code in the bar above, or to speak with a local agent, call 888-350-1890.

Which States Run Their Own Health Insurance Exchanges?

The Open Enrollment Period is almost over: you only have until January 15 to purchase or change your plan! With that being said, though, some states have chosen to extend their deadline; they can do this because, under the Affordable Care Act (ACA), each state can run its own health insurance exchange, or Marketplace, in which people can shop for health insurance.

This state-based Marketplace is a government agency that is created and maintained by the state, and that offers subsidized ACA plans for residents of that state. You can buy a plan from your state’s Marketplace, or you have the option of buying off-exchange coverage from an insurance company; if you do this, you will not get premium subsidies and cost-sharing reductions– those are only available through the exchange. So which states run their own Marketplaces and what does that mean for you?

State-Run Vs. Federally Run Exchanges

When the ACA was passed in 2010, it provided funding and laid out rules for states to be able to establish their own exchanges; if states chose not to have their own exchange, the federal government would then step in and offer insurance for that state’s residents. So, many states chose to do it themselves so they could have more control of their Marketplace, and make it more profitable and sustainable. The federally run exchange, accessible through Healthcare.gov, is used in 36 states. The other 14 states (and Washington D.C.) have their own exchanges.

States With Their Own Exchanges:

California (Covered California)
- Deadline is January 31
Colorado (Connect for Health Colorado)
Connecticut (Access Health CT)
District of Columbia (DC Health Link)
Idaho (Your Health Idaho)
Maryland (Maryland Health Connection)
Massachusetts (Massachusetts Health Connector)
- Deadline is January 23
Minnesota (MNsure)
Nevada (Nevada Health Link)
New Jersey (Get Covered NJ)
- Deadline is January 31
New York (New York State of Health)
Pennsylvania (Pennie)
Rhode Island (HealthSource RI)
- Deadline is January 31
Vermont (Vermont Health Connect)
Washington (Washington Healthplanfinder)

If you live in a state that has its own exchange, your health insurance plan options and prices might be a little different than if you only have the option of using Healthcare.gov or going off-exchange. In addition, depending on where you live, your OEP might be extended! But just because your state is in control of the Marketplace, that doesn’t mean you can’t find a great affordable ACA-compliant health insurance plan that is right for you by working with an EZ agent.

Looking For Insurance?

The best way to get the right plan for you and your needs is by working with a licensed health insurance agent. At EZ, our agents are highly trained and work with the top-rated insurance companies in the nation, in every state! We will connect you with a local agent who will go over your medical needs and budget, and sift through all the available plans in minutes. We’ll quickly find you a plan that will save you money – especially now, with the premium subsidies President Biden has extended to all Americans. You could save hundreds of dollars a year! No hassle and no obligation. 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.

Can You Be Denied Coverage During the Open Enrollment Period?

The ACA Open Enrollment Period is the only time of the year when everyone can enroll in a health insurance plan. But can literally anyone enroll, or is there any reason you can be denied coverage during this time? The short answer to this question is no: the whole idea behind the creation of the Affordable Care Act (ACA) was to make sure everyone could get insurance. But being allowed to get insurance is different from insurance being accessible to all – so how does the ACA remove all the barriers to getting insurance and make everyone truly able to get the plan they need?

What The ACA Has Done for Millions

Before the ACA was passed in 2010, you could have been denied a health insurance plan simply because you had a pre-existing condition. That meant a huge amount of Americans were unable to find affordable health insurance: approximately 43% of U.S. households report having pre-existing conditions. And indeed, health insurance was out of reach for many before 2010: when the ACA went into effect approximately 46.5 million people, or 17.8% of the total nonelderly population, were uninsured.

But the ACA, with its Patients’ Bill of Rights that prohibits insurers from discriminating based on pre-existing conditions or revoking your coverage because of an unintentional mistake on an application, changed everything. 31 million people have enrolled in health insurance plans through the Affordable Care Act since it was enacted, and that is a huge accomplishment! But there has been criticism over the years that health insurance, while available to everyone, was still not accessible to everyone – but that has all changed.

President Biden’s American Rescue Plan

illustration of a cell phone with a money sign on it and dollar bills behind it — *The American Rescue Plan Act has offered more people the ability to save more money on their health insurance premiums.*

save afcad

Earlier this year, President Biden passed the American Rescue Plan (ARP), which has made health insurance far more affordable for far more people. It extended premium tax credits to more Americans by allowing people who earn over 400% of the federal poverty level to receive subsidies to purchase health insurance through the ACA Marketplace; it also requires that Americans pay no more than 8.5% of their income on health insurance premiums, and provides a larger tax credit to people who already receive financial assistance.

What all of this means is cheaper premiums! For most people, premiums will be at least $50 per month cheaper, while some people might pay $0 in premiums. With the new law:

An individual making $19,000 or less per year will not have to pay a monthly premium for health insurance.
Couples who earn less than $70,000 together will save $1,000 per month on their health insurance monthly premiums.
A family of 4 with an income of $90,000 will pay about $200 less in health insurance premiums.

The bottom line is you can never be denied health insurance coverage during the Open Enrollment Period; not only that, but insurance is now affordable for everyone, so there is no reason you can’t get a plan that is right for you. It is important to note, though, that the Open Enrollment Period is the only time you will be able to get coverage: if you miss the OEP, you will have to wait until next year’s OEP, unless you qualify for a Special Enrollment Period. Don’t let this period pass you by – it’s the perfect (and only) time to get a great affordable health insurance plan!

Need Help?

If you have any further questions, or need help finding a plan during the Open Enrollment Period, an EZ agent can help you. We will provide you with a local licensed agent who will search all available plans in your area and find the best one for your medical and financial needs. We will also double check to see if you qualify for any subsidies to save you even more money. All of our services are done in minutes and at no cost to you. To get free instant quotes, simply enter your zip code in the bar above, or to speak to a local licensed agent call 888-350-1890.

What Happens If I Don’t Do Anything During The Open Enrollment Period?

The ACA Open Enrollment Period only comes around once a year, usually lasting from November 1- December 15, although this year the deadline has been extended to January 15. During this period, you can enroll in a new health insurance plan, or make changes to your current plan. If you’re happy with your current plan, though, you might opt to not do anything at all during the Open Enrollment Period – but not doing anything can have certain consequences, depending on your situation.

You Could Get Stuck With Your Current Plan

This might not necessarily be a bad thing if you are happy with your current plan, but if your plan isn’t quite right for you, you will unfortunately be stuck with it until the next Open Enrollment Period opens up again.

You’ll Miss The Opportunity To Change Your Plan

If you don’t take the opportunity to review your current plan and do nothing during the Open Enrollment Period, you won’t be able to change your plan. What this really means is that your health insurance might:

Not provide enough coverage for the following year, which will cost you money.
Have too much coverage that you don’t need, essentially leaving you to pay for insurance that you don’t need.
Be too expensive. If you don’t change your plan during the OEP, you’ll be stuck with the rise in rates and costs for the following year.

Options Are Limited Afterwards

If you don’t have health insurance and are looking to enroll in a plan, but you do nothing during the Open Enrollment Period, you won’t be able to get a Marketplace or exchange health insurance plan – in other words, you won’t be able to get an ACA-compliant health plan. With that being said, you do have other options even if you miss the OEP, but you should be aware that they are very limited. For example, you can opt to get a short-term health insurance plan that covers the essentials and nothing more; this type of insurance is temporary and not ideal for those who require more comprehensive coverage, or have health conditions. Short term plans are not guaranteed issue, meaning they do not cover pre-existing conditions.

You Will Need To Qualify For an SEP

The only way to get an affordable health insurance plan that is ACA-compliant outside of the OEP is to qualify for a Special Enrollment Period, or SEP. A Special Enrollment Period is only available to those who have a qualifying life event, including: movers with boxes and a truck and houses in the background

Change in residence (moving to a different zip code or county)
Change in household size (having a baby or adopting a child, getting married, or getting divorced)
Loss of health insurance (losing employment, turning 26 and getting kicked off of a parent’s plan, or a death in the family)
Changes in income

Don’t Do Nothing…

Compare plans! There’s no harm in comparing plans and seeing your options before the Open Enrollment Period ends. But we get that it can be a headache to try and research all the different plans around, so we’re here to help! Our highly trained agents will take the time to talk with you and thoroughly explain all of your options. Once you are ready to enroll, they will search through all the plans in your area and find the right plan for you, making sure the plan fits your needs and budget. EZ always provides you with your own personal agent, so there’s never any need to worry about bouncing around from agent to agent or getting hassled by endless sales calls. To get started, enter your zip code in the bar above, or to speak to an agent directly, call 888-350-1890.

Can You Get Health Insurance at Any Time?

If you are unhappy with your current health insurance policy, then it might be time to shop for a different plan. But can you purchase a new plan at any time? Yes, and no. For marketplace plans, once the open enrollment period (November 10 to December 15) is over, you generally cannot get a new plan. The open enrollment period for employer-based insurance might be at a different time of year, but you will still only be able to change your plan during that enrollment period. In most cases, if you want to get health insurance or change your plan outside of the open enrollment period, you will need to qualify for a Special Enrollment Period (SEP). SEPs open up when you experience what is known as a qualifying life event.

Qualifying Life Events

caucasian couple hlding a baby girl in the middle while both are kissing each cheek — *You can get health insurance outside of open enrollment if you qualify for SEP such as getting married or having a baby.*

You have 60 days to change your plan if you:

Got married
Had a baby, adopted a child, or took in a foster child
Got divorced or legally separated. However, if you do not lose coverage due to divorce or legal separation, then you do not qualify for a Special Enrollment Period.
Had someone on your marketplace plan die
Changed residence. If you move to a new home in a new ZIP code or county, move to attend school, are a seasonal worker and move between job and home, or move from a shelter or other transitional housing to a permanent residence, you will qualify for an SEP.
Lost your health insurance. This includes losing job-based coverage, losing a plan you bought yourself, losing eligibility for Medicaid or Medicare, and losing coverage through a family member.
Gained membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
Became newly eligible for Marketplace coverage because you became a U.S. citizen
Left incarceration
Started or ended service as an AmeriCorps State and National, VISTA, or NCCC member

Short-Term Medical Plans

If you do not qualify for any of the life events listed above, all hope is not lost. You can enroll in a short-term medical plan. Short-term health insurance provides fast, flexible insurance with many benefits. These plans can be extended up to 3 years, and you can pick your deductible amount from many options. You are also able to drop coverage without a penalty if you want to change to a long term insurance option. Premiums are lower than ACA health insurance plans, and you get coverage as soon as a day after applying.

It is important to understand that short-term insurance is temporary and not ideal for those who require more comprehensive coverage or have health conditions. Short term plans are not guaranteed-issue, meaning they do not cover pre-existing conditions. They only cover the basics.

Do you qualify for a special enrollment period? If not, are you considering a short-term health insurance plan to hold you over until open enrollment begins? EZ.Insure can help. We offer accurate health insurance quotes based on your specific region, free of charge. That’s right. We will provide you with an agent who will compare all available plans for you, and help you choose a health insurance plan that is based on your health needs and budget, for free. To get your free quotes, simply enter your zip code in the bar above, or to speak to an agent, call 888-350-1890.

Tag: Open Enrollment Period