Understanding Health Insurance Open Enrollment For 2019

September 14, 2019



It’s time to call a spade, a spade. Health insurance is tricky – and trying to pick the best policy for you and your family can be an awful process. Here are some tips to help navigate the changes for the 2019 Open Enrollment Period.

Open enrollment starts Nov. 1, 2018, and continues through Dec. 15, 2018 in most states. Your coverage would start on Jan. 1, 2019. People who qualify for Medicaid or the Children's Health Insurance Program (CHIP) can enroll at any time of the year.

While the ACA required nearly all Americans to have health insurance in 2017, Congress decided to eliminate the individual mandate penalty. You won't get whacked at tax time if you don't have health insurance. The time to make the change to a better play is now. During open enrollment, you can renew your health plan as well as choose a new plan if you desire to do that. If you miss open enrollment, you may have to wait for a year to sign up unless you qualify for a special enrollment period.

If you are currently enrolled in a marketplace health insurance plan, it will automatically renew. However, the plan may make changes to its provider network, copays, co-insurance and drug coverage.

If you qualify for employer-sponsored health insurance, you will likely want to buy health insurance through your employer. Individual insurance usually costs more than employer-sponsored plans. Here's what might trigger a special enrollment period: divorce, marriage, birth or adoption of a child, death of a spouse or partner that leaves you without health insurance, your spouse or partner who has you covered loses his/her job and health insurance, you lose your job and with it your health insurance, your hours are cut making you ineligible for your employer's health insurance plan, or you are in an HMO and move outside its coverage area.

Which plan is right for you depends on how much you'll need healthcare in 2019. If you go to doctors frequently to help manage a chronic condition, you likely want a plan with lower copays and deductibles. If you're pretty healthy, you may be better off signing up for a plan with lower premiums but higher costs when you use your insurance.

All health plans must cover 10 essential benefits:

  • Outpatient care including chronic disease management
  • Emergency care
  • Hospitalization
  • Pregnancy and newborn care
  • Mental health and substance abuse services
  • Prescription drugs
  • Rehabilitation services and devices
  • Lab tests
  • Preventive and wellness services
  • Dental and vision care for children