It is that time of year again where open enrollment for health insurance and Medicare are all around us. It can be complex and confusing. The best advice is to find a knowledgeable agent to help.
ACA marketplace (Your Health Idaho) plans
Health insurance plans under the Affordable Care Act (ACA) are designed for people under 65. Idaho runs its own state marketplace called Your Health Idaho. These health insurance marketplaces are also called exchanges.
Open enrollment period
The open enrollment period typically runs from Oct. 15 through Dec. 16. Plans selected during this period will take effect Jan. 1 of the coming year. Idaho’s schedule is an exception to the federal Nov. 1 through Jan. 15 standard window.
Through the marketplace, you can compare plans and see premiums, deductibles, provider networks and if you qualify for premium tax credits.
If you have a plan through the exchange, always review your current coverage and compare all your options, especially drug coverage and provider networks. Don’t assume auto-renewal is always best. Idaho offers certified brokers who can assist you in comparing options. If you have a life change such as a change in income, adding a dependent or a death, you should report it to the marketplace. The time frame to report a change is 60 days.
Medicare key enrollment periods
Medicare is health insurance designed for people 65 and older. There are several different enrollment periods to consider.
Initial enrollment period
For most people, you can initially enroll during the seven-month window that begins three months before you turn 65, includes the month you turn 65 and extends three months afterward. During this window, you can sign up for various plans, including original Medicare (Part A and Part B), Advantage (Part C), drug coverage (Part D) or Medigap.
Annual enrollment period
If you already have Medicare, Oct. 15 through Dec. 7 each year is the main window in which you can make changes to your coverage. You may switch from one plan to another or drop the Advantage plan and return to original Medicare, as well as enrolling in or switching your Part D drug plan. Any changes you make during this time will take effect Jan. 1 of the next year.
Open enrollment period
From Jan. 1 to March 31, if you are already enrolled in a Medicare Advantage plan, you can switch to a different plan or drop it and revert back to original Medicare and enroll in a stand-alone Part D plan.
General enrollment period
If you missed your initial enrollment period and don’t have a special enrollment period, you can enroll in Part A and Part B from Jan. 1 to March 31.
Special enrollment period
Special enrollment periods allow you to enroll outside of the regular windows under certain qualifying life events, such as losing employer coverage, moving outside of a plan's area or other changes. There are time limits (often two months from the event) to make changes and enroll.
Always review plan coverage to make sure you have the best plan to fit your needs, and always read your mail and emails regarding your insurance coverage. Do not assume everything will stay the same.
