Family sitting by fire during Open Enrollment

Open Enrollment is Coming to Town: Holidays and Your Loved Ones’ Health

The holiday season and Open Enrollment have arrived, and so have opportunities to spend time with your loved ones. Food, laughs, and gifts are likely on your agenda, but something else – something more important – may be as well: protecting the health of your loved ones.

Maybe you’re catching up with Aunt Linda who is facing an illness after losing her job. Maybe you’re hanging out with your roommate Ruben who has a pre-existing condition and can’t afford major medical coverage. No matter who you’re talking to, the topic of healthcare is likely to arise . What do you know about your available coverage options? Let’s take a look at some of the features you and your loved ones can take advantage of:

Limited Medical Coverage

  • Helpful if you (or a loved one) are anticipating rising medical expenses, are unable to afford major medical, are not eligible for short-term medical, and/or are looking for supplemental coverage to major medical plans
  • Guaranteed issue coverage if eligibility is met and available in state
  • Premiums often lower than major medical
  • Benefits such as $50-$100 paid toward doctor and specialist visits available
  • Not required to use a network of doctors – freedom to see any doctor or visit any facility of your choice (*Note: you may still exceed eligible benefit)
  • Preventive care available for as low as $50
  • Next day coverage available or little to no waiting periods for accidental injuries or sickness
  • 12 month waiting period for pre-existing conditions (limitations and exclusions may apply)
  • Does not count as minimum essential coverage required by the Affordable Care Act and is not suitable to serve as sole medical coverage

Short-Term Medical Coverage

  • Helpful if you (or a loved one) are facing life-altering transition periods such as pre-Medicare retirement, change in employment status, rolling off parental or student insurance, bridging a gap in major medical coverage or if you missed Open Enrollment (This coverage is designed solely to provide healthcare coverage during unexpected coverage gaps)
  • Flexibility in coverage length and cost (coverage duration varies by state and is non-renewable)
  • Variety of deductible and coinsurance options
  • Low copay options for in-network benefits
  • Limited preventive care available
  • Ability to cancel at any time without penalty (benefits may be limited and subject to exclusions and restrictions)
  • Does not cover pre-existing conditions
  • Coverage is not guaranteed
  • Not intended to be a replacement or alternative to ACA or other major medical plans and does not provide the minimum essential health benefits that are required; may result in a tax penalty.

ACA Coverage

  • Helpful if you (or a loved one) are seeking major medical but may not be able to afford it, have a pre-existing condition, and/or need a broad array of health benefits
  • Option to change plan every year and to stay on policy as long as needed
  • Renews annually
  • Provides coverage for pre-existing conditions; you can’t be rejected based on health
  • Provides preventive care
  • Provides the option for subsidies to lower costs
  • Provides minimum essential health benefits
  • Must enroll during the Open Enrollment period, the Special Enrollment period, or when a qualifying life event occurs

Critical Illness Coverage 

  • Helpful if you (or a loved one) are seeking an added layer of financial protection in the face of critical health concerns
  • Pays benefits directly to you or your designee(s)
  • Benefits can be used to pay living expenses such as mortgage, rent, and car payments as well as prescriptions, copays, medical bills, and a myriad of other costs
  • Benefits available up to $50,000
  • Limitations and exclusions may apply
  • Little to no waiting period

Talk to your loved ones this holiday season about Open Enrollment, their health concerns, and their current coverage. You’re already adding extra layers of clothes to stay warm; now may be a good time for you and your loved ones to consider adding extra layers of coverage to stay protected from potentially costly health events.

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.

stethoscope during Open Enrollment

Prepare for Your 2018 Healthcare Coverage Needs

Open Enrollment is just around the corner, and it’s the ideal time to evaluate your healthcare coverage needs in the coming year. Consider the following:

  • Do you anticipate seeing your provider more frequently?
  • Are you facing an illness?
  • Will you need to need to see a specialist?
  • Does your current plan meet your budget needs?
  • What changes to your healthcare budget are you considering?
  • Has your family size changed?
  • What coverage changes do you need to make to account for family members?

With the confusion surrounding healthcare legislation, it’s more important now than ever to seek the expertise of those well versed in coverage options and updates.

If you’re considering ACA coverage, here are some important dates to remember:

November 1, 2017

Open Enrollment Period begins

December 15, 2017

Open Enrollment Period ends

January 1, 2018

Plans sold during Open Enrollment become effective

If you’re considering other options, short-term medical coverage may be an appropriate fit for your needs. This type of coverage addresses the needs of those who are:

  • Graduating from college and/or in need of replacing their student insurance
  • Transitioning between jobs
  • Waiting for employer insurance to begin
  • Rolling off parents’ coverage
  • Retiring soon and waiting for Medicare coverage to become effective

Additionally, if you miss the Open Enrollment period, short-term medical coverage may help you face your healthcare needs. You can enroll in that type of coverage at any time!

It’s important to understand that short-term medical coverage plans are limited in duration to a maximum 3-month term. After the plan expires, you will no longer receive benefits under it. You must reapply to receive coverage after the plan expires. Additionally, there may be limits on how many times you can renew short-term medical coverage.

Short-term medical plans can provide features such as:

  • Flexibility in timing of enrollment – there is no special enrollment period enrollment period
  • Preventive care for you and for your family
  • Lower rates than other types of plans
  • Access to providers of your choice
  • Convenience of filing a claim in your provider’s office with an additional option to submit your own claims for reimbursement

Short-term medical coverage is not a replacement for major medical insurance or ACA plans. It does not provide the minimum essential health benefits that are required and it won’t help avoid the fee for not carrying health insurance.

Additionally, there are restrictions and limitations of short-term medical plans. For example, pre-existing conditions are often not covered. Before you make a decision to purchase a short-term medical plan, fully review the benefits, limitations, restrictions, and costs associated with the plan.

With our leading edge tools and technologies, we’re upgrading how you experience your choice of coverage.

Stay tuned to our next blog post!

Click here to join our Facebook community for more information about your health and your healthcare coverage.