Special Enrollment Period Archives - Healthedly Insurance Services

Are You Enrolling in the Right Health Plan?

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How to know for sure that you are enrolled in the right health plan

There are a few key factors to consider when deciding whether to enroll in an ACA (Affordable Care Act) plan or a short-term health plan.

First and foremost, it’s important to understand the differences between the two types of plans. ACA plans, also known as “Obamacare” plans, provide comprehensive coverage for a wide range of medical services. This includes preventative care, hospitalization, and prescription drugs. These plans must meet certain requirements set by the federal government, such as covering pre-existing conditions. They also offer a minimum level of coverage.

On the other hand, short-term medical plans provide temporary coverage for unexpected medical expenses. These plans typically have lower premiums and offer more flexibility than ACA plans. However, they provide much less comprehensive coverage. Short-term plans typically exclude coverage for pre-existing conditions. They may not cover certain types of care, such as maternity or mental health services.

What are your health and medical needs?

One major factor to consider when deciding between an ACA plan and a short-term medical plan? Your current health and medical needs. For example, you have a chronic condition or expect to need a lot of medical care in the near future. An ACA plan is likely to be a better choice because of its comprehensive coverage. On the other hand, if you’re healthy and just want some protection against unexpected medical expenses, a short-term plan may be a good option.

Another important factor to consider is your budget. ACA plans can be more expensive than short-term plans, if you don’t qualify for subsidies to help lower your premiums. If you’re on a tight budget and need to save money on your health insurance, a short-term plan is a good option. However, keep in mind that you’ll likely end up paying more out of pocket for medical care if you have a short-term plan. These plans provide less comprehensive coverage.

Think long-term vs short-term when it comes to your health plan

It’s also important to think about the long-term implications of your decision. ACA plans seem more stable and predictable than short-term plans. They provide continuous coverage and can’t be canceled for reasons like getting sick or making a claim. If you’re looking for a long-term solution for your health insurance needs, an ACA plan may be a better choice.

Whether you choose an ACA plan or a short-term medical plan will depend on your individual circumstances and needs. ACA plans provide comprehensive coverage, but can be more expensive. Short-term plans are less expensive, but provide less comprehensive coverage.

Ultimately, the right choice for you will depend on your health, budget, and long-term needs. Healthedly offers a variety of plans, from

Look no further than Healthedly for all your answers about health insurance and coverage. Start getting enrolled today, grab a free quote, and chat with a Healthedly agent. We are here to help you get the right healthcare coverage.

December 22, 2022

Open Enrollment vs. Annual Enrollment

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While you might be happy with your existing health insurance plan, it’s never a bad idea to explore your options and consider whether you might benefit from changing your coverage.

If you’re looking to update your health plan, you can make changes during certain months of the year known as “enrollment periods”. But how do the enrollment periods work, and when can you amend your existing coverage? At Healthedly, we understand the terminology can seem daunting, so here’s a breakdown of the difference between open and annual enrollment periods so you can see how they might apply in your situation.

Open Enrollment Period

The open enrollment period (OEP) is a time when you can change your health insurance. When is the open enrollment period? Well, the exact time frame depends on your provider, but it usually falls around October, November or December. Open enrollment for the ACA in 2022 runs from November 1st, 2022 to January 15th, 2023.

During the OEP, you can:

open a new policy
switch plans
amend your level of coverage

Who can use the OEP? Typically it applies to individuals who don’t have an employee-sponsored healthcare plan; for example, the self-employed. So, if you don’t have employee-sponsored health insurance and you want to change your plan to suit your evolving health needs, then this is your window of opportunity.

Medicare’s Annual Open Enrollment Period

Medicare has its own annual open enrollment periods. Here’s everything you need to know about it!

Medicare open enrollment period: If you have a Medicare policy, you can switch, change, or cancel your plan between October 15 and December 7.

Medicare Advantage open enrollment period: Individuals with Medicare Advantage plans can change, cancel, or switch their coverage between January 1 and March 31.

You could switch from Medicare Advantage to Original Medicare during this special enrollment period for Medicare customers.
Switch from a Medicare Advantage plan without prescription coverage to a Medicare Advantage with a Prescription Drug plan (or vice versa).
Switch to a new plan with a different provider

Healthy multigenerational family walking together through a field

Annual Open Enrollment Period

The annual enrollment period (AEP) applies to individuals with employer-sponsored health insurance. During this window – which, again, usually falls between November and December – you can change your policy, join a new plan, amend your coverage, or cancel your insurance.

Check with your employer if you’re unsure when your annual enrollment period is.
Your employer may require you to take some affirmative action to renew your coverage each year, so double-check your policy to see if there’s anything you should do before the window ends.

Open Enrollment vs. Annual Enrollment

While you might sometimes see OEP and AEP used interchangeably, they are slightly different.

Anyone with an employer-sponsored health insurance plan can change their coverage during the annual enrollment period.

If you don’t have an employer-sponsored healthcare plan, you can change your coverage during the open enrollment period.

Finally, if you have a Medicare plan, you can change it during the annual enrollment period which typically runs from October to December. And if you have a Medicare Advantage plan, you can make a one-time policy change between January and March.

Open Enrollment or Annual Enrollment: Which Is Right for You?

Ultimately, this comes down to your personal circumstances. Whether you use an open enrollment or annual enrollment period depends on:

what health insurance coverage you already have;
whether your employer covers your health insurance; and
what changes may be required to ensure your health insurance covers your needs.

At Healthedly, we know how confusing the health insurance market can be, and we’re committed to helping our clients choose the right coverage at the right time. Our friendly, experienced team can walk you through a range of health plans to suit your budget and your long-term care needs – and we can offer you free enrollment support when you need it most.

Still looking for the right health insurance plan? Call 855-522-2201 to receive a quote today!

October 11, 2022

Important Information About Special Enrollment Periods (SEPs)

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Special Enrollment Periods (SEPs) are a specific time frame during which individuals and families can enroll in a health insurance plan outside of the standard open enrollment period. SEPs are typically triggered by certain life events, such as getting married, having a baby, or losing employer-sponsored coverage.

It’s important to understand that SEPs have strict eligibility requirements and time frames, and failing to enroll during an SEP can result in a gap in coverage or a tax penalty. Here’s what you need to know about SEPs:

Eligibility Requirements

SEPs are only available to individuals and families who experience a qualifying life event, such as:

Marriage
Divorce
Birth or adoption of a child
Loss of employer-sponsored coverage
Moving to a new area with different health plan options
Gaining citizenship or legal resident status
Leaving incarceration

It’s important to note that SEPs are not available to individuals who simply decide they want to change health plans outside of the open enrollment period. You must have a qualifying life event in order to be eligible for an SEP.

Time Frames

SEPs have strict time frames during which you must enroll in a health plan. The time frame begins on the date of the qualifying life event and typically lasts for 60 days. However, the exact time frame can vary depending on the specific life event and the state in which you live.

For example, if you get married, the SEP begins on the date of your marriage and lasts for 60 days. If you have a baby, the SEP begins on the date of your child’s birth and lasts for 60 days. It’s important to enroll within this time frame, as failing to do so may result in a gap in coverage or a tax penalty.

Coverage

SEPs allow you to enroll in a health insurance plan outside of the standard open enrollment period. This means that if you experience a qualifying life event, you can enroll in a health plan even if the open enrollment period has already ended.

It’s important to note that SEPs do not guarantee coverage. If you enroll in a health plan during an SEP, the plan may still have a waiting period before coverage begins. This means that you may have a gap in coverage between the date of your qualifying life event and the date that your coverage begins.

Plan Options

During an SEP, you have the option to enroll in any plan that is available through the marketplace. This includes both individual and family plans. It’s important to compare different plan options and consider factors such as premiums, deductibles, and out-of-pocket costs before making a decision.

It’s also important to note that SEPs do not guarantee that you will be eligible for subsidies, such as premium tax credits or cost-sharing reductions. If you are eligible for subsidies, you must enroll during the open enrollment period in order to receive them.

Enrolling in a Plan

To enroll in a health plan during an SEP, you must complete an application through the marketplace. The application will ask for information about your qualifying life event, as well as your personal and financial information.

You will also need to provide proof of your qualifying life event, such as a marriage certificate or a birth certificate. It’s important to provide all required documentation in order to ensure that your application is processed smoothly.

If you are approved for coverage, you will receive a notice of eligibility. This notice will include information about your premium, deductible, and out-of-pocket costs. You will then have the opportunity to select a plan and enroll in coverage.

If you have any questions about SEPs or the enrollment process, you can contact the marketplace or a licensed insurance agent for assistance. It’s important to get the help you need to make an informed decision about your health coverage.

In summary, SEPs are a specific time frame during which individuals and families can enroll in a health insurance plan. This period is outside of the standard open enrollment period. SEPs are triggered by certain life events, such as getting married or having a baby. These events have strict eligibility requirements and time frames. It’s important to understand SEPs and to enroll within the designated time frame to avoid gaps in coverage or tax penalties.

If you have any questions about SEPs or the enrollment process, be sure to seek the help of our licensed agents here at Healthedly! Give us a call at 855-522-2201!

March 24, 2022