Guide to Open Enrollment: Making Sure You Are Insured for Next Year

Updated: Sep 20

‘Tis the season! That doesn’t just apply to the holidays, but also to health insurance. You have probably heard the phrase “open enrollment” tossed around either on the news or at work. For some people, open enrollment is more important than for others. Regardless, anyone who has or needs health insurance needs to pay attention. When it comes to enrolling in a healthcare plan, the deadlines are very strict. If you do not enroll within the window, you could end up without health coverage for the following year. Insuravita is your guide to open enrollment.


Your Guide to Open Enrollment


Let’s start with the basics. Open Enrollment is the time of year when you can enroll and make changes to your insurance coverage. This is important for everyone who has insurance. Even if you don’t need to make changes, you need to re-enroll by selecting all of your current options. This will ensure that you have continued coverage.

Of course, it is important to recognize that the open enrollment periods differ by companies and states. Generally, the time period lasts from October to January. Some employers might have an earlier deadline, requiring that you submit your selection by early October. You will likely be sent information by Human Resources with instructions to enroll via your online portal. Make sure that you do your research prior to making your selections. Check out the additions to this post that provide a guide to open enrollment for individual states.


What Do You Need to Consider?


The next step in this guide to open enrollment is assessing personal needs. First of all, have there been or will there be any big changes in your life? Did you get married? Do you need to add any children to your policy? Did any of your children age out of your health insurance?

The next thing that you want to do is to evaluate your current coverage. Are you taking any prescription medications? Are they covered under your current policy? Would they be cheaper with another plan? You might also want to think about whether you like your doctor. If you are not satisfied with the care you are receiving, you might want to explore physicians outside of your current network. Switching to a different carrier or plan could give you more options.


What Kind of Coverage Do You Need?


As part of this guide to open enrollment, we want to make sure you consider the types of coverage you need. Think about which of the following are important for you:

  1. Emergency care

  2. Hospitalization

  3. Outpatient care

  4. Pregnancy and newborn care

  5. Mental health and substance abuse services

  6. Prescription drugs

  7. Rehabilitation services and devices

  8. Lab tests

  9. Preventive and wellness services

  10. Dental and vision care for children

Who Needs to Pay Special Attention to This Guide to Open Enrollment?


As stated earlier, Open Enrollment is critical for all adults. However, there are certain groups of people who need to pay extra attention. For example, people who do not yet have coverage have a lot of decisions to make regarding what will work best for them.


That is what this guide to open enrollment is for. to If it is your first time enrolling in a plan after being dropped from your parents’ plan, you need to figure out what coverage you need. If it is your first time enrolling with a new employer, you will have to take a look at their specific offerings. What plans do you have access to? Also, what are the employee costs associated with each? And, what is covered? Do you want an HMO or a PPO?


This guide to open enrollment is also crucial for people who have had changes in their lives. People who have gained a spouse will have to decide which employer’s plan is more cost-effective. Also, if you now have a newborn, you might want to be able to choose a certain pediatrician that is not currently accessible with your plan.


What Happens if You Miss the Deadline?


The final part of this guide to open enrollment is about deadlines. The deadlines for Open Enrollment should be taken seriously. If you fail to enroll, you could be left without coverage for the following year. This could leave you scrambling for temporary coverage during the lapse. You can enroll outside of the Open Enrollment window if you have been affected by certain qualifying life events. These are things like moving, getting married, having a baby, adopting a child, or losing your coverage. In general, you have 60 days after the event to enroll in coverage during the special enrollment period.

Overall, the takeaway of this guide to open enrollment is to make sure that you check your state’s rules. Then, check with your employer on their policies and deadline for enrolling. Do your research and plan ahead. Submit all of your selections well before the end of the Open Enrollment window. If something major that is considered a qualifying event comes up, you can make changes during a special enrollment period.


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