With a Special Enrollment Period Through May 15, You Can Change or Add Healthcare Coverage Options
By Space Coast Daily // March 29, 2021
With a Special Enrollment Period now underway, you can change or add insurance, no matter your situation
BREVARD COUNTY, FLORIDA – Are you in health insurance limbo or wondering if there might be better coverage options out there? Well, now could be your chance to do something about it.
Under an executive order by President Biden, the Centers for Medicare & Medicaid Services (CMS) determined that the COVID-19 pandemic has presented exceptional circumstances for consumers seeking access to healthcare.
A Special Enrollment Period is now underway (February 15 through May 15), allowing individuals and families to apply for and enroll in the healthcare coverage they need – now.
“It’s a unique opportunity for millions of individuals across the country who are uninsured today to find really affordable and great coverage in their local markets,” explained Jason Alford, Vice President of Sales and Business Development, Health First Health Plans.
This Special Enrollment Period (SEP) isn’t like others, which require a life-changing event (a birth, death, move or job loss, for example) to enroll in or adjust a plan.
“It’s really for anyone,” Alford said, noting both the uninsured and those who currently have a plan, can take advantage of the SEP. “It does allow for those who want to switch plans to make sure they have the right coverage.”
This three-month SEP stretches longer than the yearly Open Enrollment Period (OEP), which is held annually from November 1 to December 15 for the following calendar year’s coverage.
The pandemic has left many people unemployed and suddenly needing health coverage, as well as some employers making tough decisions on whether they can continue to offer this benefit.
And people are finding themselves suddenly with no coverage – or hefty COBRA premiums to protect their families. (The Consolidated Omnibus Budget Reconciliation Act provides employees and their families who lose their health benefits through an employer the option to continue the group health benefits they had for a limited period of time.
“It may be more expensive, though, since the employee now has to pay their premium and the part of premium the employer previously paid.)
“Lots of folks are in a position of needing to find coverage, and this extra time period allows people to do that,” Alford said.
Historically, the individual market has appealed to early retirees who haven’t qualified for Medicare yet, part-time workers and contractors not offered coverage through their employer and recent graduates.
But this SEP “really expands the opportunity to a wider audience today,” Alford said.
Highly Trained Agents
People debating their options can visit healthcare.gov to compare options, factoring in the different types of coverage available and what a plan would cost, based on their income. Alford said those with questions or concerns shouldn’t hesitate to find help.
“The premiums for health insurance are the same whether you go it alone and shop for coverage by yourself or reach out to an independent insurance agent or reach out to a health insurance company,” Alford said.
Highly trained agents can walk people through complex decisions about their health insurance – what subsidies might be available, the different dynamics that affect premium rates, and how to find a plan that’s best tailored to your specific health needs.
Knowing your network design and understanding your benefits (such as pharmacy coverage) can thwart big surprises later on.
“Take a look and be sure you feel comfortable with your coverage level and the affordability level,” Alford said.
For example, do you have a specific doctor you want to continue your care? Check to see if they’re in the network you’re considering. The same goes for prescriptions you might be taking – compare options to see if a certain drug is on a plan’s formulary (list of covered medications), and what the copay or cost-share is.
Also, what’s most important to you – the lowest monthly premium possible or the lowest deductible (if you, let’s say, anticipate having to go to the doctor regularly)? Were you recently let go from a job where you had a Health Savings Account (HSA)? Then, perhaps in that situation, a High Deductible Health Plan might work in your favor.
Clearly, there are a lot of variables.
That’s why it can be extremely beneficial to talk to an insurance agent. He or she can help you with your unique situation – whether they’re an independent agent or an employee with a specific insurer, “so there aren’t any surprises down the road,” Alford said.
“I absolutely see this as a unique opportunity for folks to protect their families, to make valued decisions during a pandemic,” Alford said. “It just gives folks an opportunity to find the right coverage at the right time.”
If you’re looking for options, Health First Health Plans can help. Visit myHFHP.org or call 1.877.904.4914 to speak with a licensed health plan expert.