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Preparing for Open Enrollment 2021

Choosing a health insurance plan can be confusing and stressful even if you've done it many times before. Be ready to make the best choice for yourself and your family.

The Special enrollment period for health care coverage for 2021 is six weeks in November and December. During that time, people in most states must make health care elections for next year.

Not sure how to navigate the health care marketplace? We're here to give you the answers you need about open enrollment.

Learn more about open enrollment
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Employees discuss health insurance options with HR

When is Open Enrollment 2021?

The 2021 open enrollment period starts Sunday, November 1, 2020, and closes Tuesday, December 15, 2020. If you don’t purchase health insurance by the December 15 deadline, you can’t get 2021 coverage unless you qualify for a special enrollment period. Insurance plans purchased during open enrollment take effect on January 1, 2021.

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How Do You Qualify for a Special Enrollment Period?

In most of the United States, you can’t buy health insurance just anytime. The only way to get health insurance if you have missed open enrollment is to experience a qualifying life event. Such events include getting married, having a baby, moving to another state, or losing other health coverage.

A Special Enrollment Period (SEP) usually lasts 60 days from the date of the qualifying event. If you miss the open enrollment deadline and do not qualify for a special enrollment period, you might consider a supplemental health insurance plan such as hospital or critical illness.

Whether you qualify for a SEP or not, you can also enroll in Medicaid and the Children’s Health Insurance Plan (CHIP) at any time during the year.

Professionals work on finding the right health insurance plan in the workplace

How Current Legislation Impacts Your Health Insurance?

The comprehensive health care reform law enacted in March 2010, known as the Affordable Care Act (ACA), made affordable health insurance available to more people in the United States. The American Health Care Act of 2017 was passed by the United States House of Representatives but not by the United States Senate. It did not, therefore, repeal or replace the ACA.

Nevertheless, there have been some healthcare policy changes since the inception of the ACA. Congress repealed the individual mandate at the end of 2018, which means that you do not have to purchase health coverage for 2021 and will not have to pay a tax penalty if you don’t. However, going without coverage could leave you at risk for high unexpected medical bills.

Subsidies for insurance purchased through the health insurance marketplace are still in place, and they may be higher or lower than 2019, depending on several factors. Even if you’ve checked your eligibility for subsidies before, be sure you do so again for 2021. Things may have changed in your state.

Coverage for preexisting conditions also remains. So, if you do decide to purchase health insurance, no plan can deny you coverage or charge you more for essential benefits for a condition you had in the past or currently have. Nevertheless, insurance costs do typically rise from year to year. For 2019, average insurance premiums increased around 5% to 8%1, though some plans did get less expensive. Projections put 2021 increases at about the same2.

Insurance companies can’t set a dollar limit on what they deem essential health benefits while you’re enrolled in a plan. They can, however, put yearly or lifetime dollar limits on spending for health care services they consider nonessential benefits, which can include emergency room visits and prescription drugs. That’s where a supplemental insurance plan can make all the difference because they pay you cash directly (unless assigned otherwise).

Make sure you’re fully covered. Learn about supplemental insurance and get a complimentary quote.

Your Step-by-Step Guide to Open Enrollment

Even a daunting task is manageable if you take it one step at a time. Here’s what you need to do and the questions you need to ask before you sign up for health care insurance for 2021.

5 things to keep handy during Open Enrollment.

OPEN ENROLLMENT 2021 CHECKLIST
  • Social Security numbers for you and your family members
  • Your current health care plan
  • Your employer’s available plans for 2021 (unless you plan to buy health insurance on your own through the health insurance marketplace)
  • Tax filing information
  • A positive attitude!

Ask yourself these questions about your health and your family.

In addition to getting answers from your employer, consider what’s on the horizon for you and your family.

What are your current and future medical, dental, and vision needs?

A medical emergency cannot be predicted but some treatments and surgeries can. In the year ahead, are you planning an elective surgery? Will you have a teen who needs wisdom tooth removal or braces? Is your spouse thinking about LASIK eye surgery? Do you have a chronic illness that requires ongoing care?

What big life changes are you anticipating for your family?

Life events can impact health coverage. A wedding can mean adding a spouse or children to a health insurance policy. A divorce could mean you lose coverage. The birth of a child could result in the need for short-term disability insurance to help with the loss of income.

Get answers from your employer.

Find out about how your employer’s plan options will change. Take this list of questions to your open enrollment meeting.

  • Will I need to pay more for health coverage for my working spouse or children?

  • Has prescription drug coverage changed?

  • Are my preferred doctors and other medical service providers still covered?

  • Have you done anything that would make health care costs more affordable for me?

  • Have you changed administrators for medical benefits?

  • Are you offering new or expanded options for receiving care?

  • Have you added new voluntary benefits?

  • Does your wellness plan have new features that can help me manage my health or save money?

  • Have you added or expanded coverage for complementary or alternative medical services?

  • Have insurers added or expanded the use of technology for managing my benefits or delivering care?

How do You Decide between an HDHP and a PPO?

A high-deductible health policy (HDHP) has lower premiums than a preferred provider organization (PPO). It also has a higher deductible and higher annual out-of-pocket maximum. An HDHP protects you from big medical bills resulting from catastrophic illness or prolonged hospitalization.

If you’re healthy and could cover a higher deductible and maximum for a terrible illness or accident, then you could consider a high-deductible plan. You might want to put the money you save on premiums into a health savings account (HSA), which would save you money when you file your income tax return.

However, if you and your family members deal with chronic conditions and would be unable to cover unexpected medical expenses, the lower deductible and lower annual out-of-pocket maximum of a PPO may be a better choice for you.

What will your out-of-pocket costs be?

Deductibles, copays, and nonmedical costs such as transportation to appointments and missed work due to sick leave add up. In fact, when it’s all said and done, most insurance plans cover only 60% of medical expenses.3

WHAT IT COULD COST YOU

The average cost of a broken leg is

$7,1524

After major medical coverage, you could still owe

$2,8615

in out-of-pocket medical expenses not covered by your insurance.

You’ve Got This

Peace of mind doesn’t have to break the bank. Aflac gives you cash to help with expenses that health insurance doesn’t. Choose an option to get started during open enrollment.

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