By Jason Alford, Director of Individual Sales and Product Innovation, Health First Health Plans
Since the Affordable Care Act was passed in 2010, healthcare reform continues to make national headlines and was a defining issue in the last presidential election. From employers to employees, self-employed to the unemployed, healthcare reaches across party lines and impacts
many demographics.
During this time of transformation, there have been many changes in the industry, including the number of participating insurance companies, penalties for being uninsured and expansion of narrow physician networks.
While healthcare is being fiercely debated in Washington, D.C., it is important to know how to navigate the current environment and secure the right coverage. Whether signing up for a new health plan or renewing an existing policy, it is crucial to stay informed and connected to the right resources in the community.
A significant change for 2018 is the rollout of a shortened Open Enrollment Period (OEP). Every year, the OEP allows customers to enroll in individual health insurance (generally for those under the age of 65 without employer-based coverage). In previous years, enrollment lasted between 90 to 120 days with multiple effective dates available. This is no longer an option – there is only one effective date, which is January 1, 2018.
Also this year, the OEP is being shortened to 45 days – November 1 through December 15, 2017. Outside of these dates, customers can only enroll in individual health insurance if they qualify for a “special enrollment period.” Examples of life or circumstantial changes that would qualify include marriage, divorce, relocation or losing employer-based coverage.
There are many pieces to the health plan puzzle, such as out-of-pocket-expenses, access to network physicians/hospitals, service of healthcare needs and affordability. In addition to core medical benefits, there are also other health plan options to consider, such as fitness center access, pediatric dental coverage and care coordination.
While some choose to research the many options in the marketplace, numerous community and online resources are available to help consumers find the most appropriate plans. These include independent insurance agents, government-appointed navigators and health plan representatives.
As the nation again awaits the potential for significant shifts in the healthcare industry, it can be easy to miss the current requirements to enroll in coverage for 2018. Selecting the right options hinges on having the right information and the right partners – a recipe for successfully making decisions in the healthcare industry waiting room.
Jason Alford is director of individual sales and product innovation with Health First Health Plans in Rockledge. Health First Health Plans insures more than 20,000 individual insurance members in Brevard, Indian River, Volusia and Flagler counties.
