Open Enrollment 2019: Here's What You Need To Know

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Every year, you mark your calendar for birthdays, holidays, special events and more. However, you might be missing two very important dates: November 1 and December 15, AKA the start and end of the annual open enrollment period for health insurance coverage.

This period of time is when you can select a new health insurance plan, including dental and vision, for the following calendar year. Unless you have a qualifying life event at another point during the year (more on that in a bit), you can only sign up during this time.

Since health insurance can be extremely confusing, we’re here to break down the basics of open enrollment so you can find the benefits that work best for you and your lifestyle.

Open Enrollment And Health Insurance Basics

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When it comes to health insurance, there are few things to consider. For instance, if you’re under the age of 26, you may still be covered by your parents’ health insurance and not need to do anything during open enrollment.

If you’re 26 or older and don’t have access to an employer-sponsored health insurance plan, you can explore your options via the Health Insurance Marketplace at healthcare.gov.

If you do have access to an employer-sponsored health insurance plan, you should receive information from HR regarding your plan options prior to November 1. Employer-sponsored health insurance plans are great because your company may cover a portion of the plan’s cost, which reduces what you pay out of pocket every month. Another perk of your employer-sponsored insurance plan is that you may be able to pay your monthly premium with pre-tax dollars, meaning the money is taken from your paychecks prior to taxes.

Regardless of whether you’re purchasing your own health insurance or getting it through an employer, coverage options vary across individual insurance companies. Compare your different plan options based on:

In- and out-of-network coverage
Deductibles
Premiums (what you pay for the insurance each month)
Co-pays
Co-insurance
Prescriptions
Whether the plan comes with a Health Savings Account (HSA) or not

An HSA is an account where you can put pre-tax dollars aside specifically to use for medical expenses like hospital services or even contact lenses. Check out HSACenter.com for a full list what may be covered by your HSA funds.

Qualifying Life Events

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You have to sign up for health coverage by December 15; otherwise, you won’t be able to do so for another year unless you have a qualifying life event. A qualifying life event is anything that causes you to lose your health insurance or any type of change in your household or residence. These include:

Turning 26 and losing coverage through a parent’s plan
Moving to a new zip code, including students who are moving for college
Becoming a U.S. citizen
Changes in your income or being laid off/fired from work
Losing eligibility for Medicaid
Getting married or divorced
Having or adopting a baby
Leaving incarceration
Someone on your health plan passing away
Joining or leaving the AmeriCorps

If you’re experiencing a qualifying life event, you have up to 60 days following the event to enroll in a new plan. This time period is known as your special enrollment period.

If you don’t sign up and don’t have a qualifying life event, you won’t be covered for the next calendar year. Anyone without health insurance for three or more months in 2018 will need to pay a tax penalty fee of $695 per adult and $347.50 per child, up to a maximum of $2,085 per family or 2.5 percent of household income — whichever is greater. This fee is due by the same time you’re required to file your taxes in April 2019. If you’re without health coverage for less than three months in 2018, this fee is waived. Starting January 1, 2019, health insurance is no longer required by the federal government and IRS, so you won’t be charged a fee for not being covered in 2019.

Pro Tip: Even though you don’t technically need health insurance in 2019, it’s a good idea to get it anyway. You never know what could happen. Plus, Americans who purchase a health plan through the Health Insurance Marketplace may be eligible for a premium tax credit, which is a refundable tax credit that helps them pay less during income tax season.

Enrolling In A New Plan

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You’ll need a few details squared away before you enroll in a new plan. Have your social security number handy and know your total household income, as well as your primary care physician’s name, address and phone number. You’ll also want to ensure that all of your doctors are covered by your new plan. Healthcare.gov has a full checklist to help you get ready for open enrollment.

Your new plan goes into effect on January 1, 2019, but don’t worry — your current coverage will still be active through December 31.

Annual Open Enrollment

Every year, open enrollment starts on or around November 1 and ends on or around December 15, so mark your calendars now. Even if you have health insurance through an employer or the Health Insurance Marketplace and don’t plan to make any changes for the next year, it’s smart to review your plans to see if they’re still the best fits for you.

If you’re healthy, you may be paying too much for insurance and can opt into a new, more affordable plan. If you received a promotion and went up in salary, it might be smart to consider whether you’re able to afford more coverage now.

Meredith Ryan-Reid, senior vice president, Group Benefits, MetLife, told Swirled that it’s important to take a closer look at your health plan and other benefits during open enrollment.

“If there is a high deductible, your out-of-pocket expense exposure might be more than you can handle,” she said. “There may be benefits you’re not familiar with, but ones can that can prevent a lot of headaches. For example, a legal plan can give you access to a network of fully vetted attorneys to help with legal needs such as a dealing with a landlord dispute or a speeding ticket.”

Plus, many employers offer group discounts when you enroll in health, auto and life insurance. “You have to purchase these anyway, why not save money?” You can sign up for all of this during open enrollment, so add it to your to-do list now.

Regardless, health insurance (and insurance in general) is a big part of becoming an adult. Be smart about your insurance by marking your calendar for the annual open enrollment period so you can ensure that you’re covered — just in case. You can’t thrive in your career and life if you don’t take care of your health, so make it a priority.

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