As of November 1st, Americans have another opportunity to sign up for health insurance for 2022. This is also the only time to switch your health insurance during open enrollment to a different plan, like one with a lower monthly premium.
In addition, new expanded federal subsidies are making health insurance plans more affordable for almost everyone. If you’ve been denied a subsidy in the past because of your income, there’s a very good chance that you now qualify.
Q: Should I change health insurance plans during Open Enrollment?
Not everyone needs to change plans during Open Enrollment. But if you are currently uninsured or looking to reduce your monthly costs, Open Enrollment is the time to do it.
This guide will help you determine whether or not it’s a good time to switch plans.
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Key Facts: Health Insurance Open Enrollment 2021
- Health Insurance Open Enrollment begins on November 1st every year and goes through December 15th. A number of states have already extended the deadline to January 15th or later.
- Open Enrollment is the only time of year to sign up for a marketplace plan or switch from one plan to another.
- Expanded federal subsidies mean that health insurance premiums are lower for most people. This includes individuals and families who earn more than 400% FPL, a group that used to not qualify for subsidies.
- The most common reasons to switch plans are to find a lower premium, get a different provider network, or change the plan’s annual deductible.
- Traditional health insurance is not the only option. Versatile, creative solutions like Direct Primary Care and Health Sharing Plans can provide critical health protection at a fraction of the cost.
When is Health Insurance Open Enrollment? [State by State Deadlines]
The 2021 Health Insurance Open Enrollment Deadline is December 15th. But as of the date of publication, 11 U.S. states have already extended this deadline.
States with Extended Open Enrollment 2021:
- California: Extended to January 31st
- Colorado: Extended to January 15th
- Connecticut: Extended to January 15th
- Massachusetts: Extended to January 23rd
- Minnesota: Extended to December 22nd
- Nevada: Extended to January 15th
- New Jersey: Extended to January 31st
- New York: Extended to January 31st
- Pennsylvania: Extended to January 15th
- Rhode Island: Extended to January 23rd
- Washington: Extended to January 15th
- Washington D.C.: Extended to January 31st
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Checklist: How to Know if it’s Time to Switch Insurance Plans
1.) Have Your Health Needs Changed?
Have you developed a new condition that is going to require more coverage? Or, alternatively, have you noticed that you’re not using your plan much? You could be either under or overinsured depending on the changes that have occurred in your life.
2.) What Are Your Health Insurance Goals?
Whether you need to lower your monthly premium or just don’t like your insurance company, it’s important to know what you want out of an insurance plan.
3.) Has Your Current Plan’s Premium Gone Up?
Just because you’re happy with your current plan doesn’t mean that you’re not overpaying. Rates change all the time, and it’s easy to not notice. The good news is: There’s almost always a more affordable plan available, even with comparable coverage.
4.) Did Your Current Doctor Stop Accepting Your Insurance?
Medical providers often change the health insurance plans that they work with. While it’s not very common, there’s a chance that your doctor will not be accepting your current health insurance company for 2022.
If this is the case, you can either choose a doctor that is still within your network, or use Open Enrollment to sign up for a new plan.
5.) Are Your Prescriptions Still Covered?
From time to time, health insurance companies will modify the list of prescription drugs covered under a specific plan. (This list is called a Formulary). They can also modify how much of a specific prescription drug is covered.
If your plan’s formulary is changing for 2022, then you should have received a notice by mail. If you didn’t get a notice or are still unsure, call your plan’s member assistance line.
6.) Is Your Plan Still Being Offered in Your Area in 2022?
Most major health insurance companies will make certain changes to their coverage areas from year to year. If your plan is going away, your health insurance company will automatically enroll you in a similar plan, but your costs could change.
Pro Tip: Most health insurance companies are expecting to increase their coverage areas in 2022. This means that there could be some new plans in your area that weren’t available for 2021.
7.) Have You Found Out How Much Your Expanded Subsidy is Worth?
Under the American Rescue Plan, the federal health insurance subsidy has increased for a significant number of people. This includes individuals and families who earn more than 400% of the Federal Poverty Level (FPL). (Previously, this income level was disqualifying for subsidies).
Even people who already qualified for a subsidy can receive these extra savings in 2022.
8.) Have You Considered All the Alternatives to Health Insurance?
Even with a bigger subsidy, some insurance plans are still too expensive to be viable. It’s even worse for people who are pretty healthy and don’t use their coverage very much.
If health insurance just isn’t working out for you, you’ve still got some options:
- Medical Cost Sharing Plans – Also known as Healthshare, these low-cost healthcare programs can keep you protected against emergency or unexpected medical costs. Unlike health insurance, you’re not paying for coverage that you’re not using. In addition, healthshare plans have no enrollment periods, making it possible to sign up any time of year.
- Direct Primary Care (DPC) – DPC is a membership-style healthcare program. Members pay a monthly fee to their doctor, and in exchange, they can get as much primary care as they need. These primary care visits will not only keep you healthy but also help catch any potential health issues before they get worse.
- Healthshare Plan + Direct Primary Care – Health Sharing and DPC can be combined into a health strategy that includes both preventive care and emergency cost sharing. MPB Health offers a healthshare plan that is designed to work directly with an existing DPC membership. Even together, this option is more affordable than many insurance plans.
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What You Need to Know About Special Enrollment Periods
Open Enrollment is normally the only time of year to sign up for a health insurance plan. But if you qualify for a Special Enrollment Period, then it is possible to enroll outside of Open Enrollment.
In order to qualify for a health insurance Special Enrollment Period, there must be a qualifying life event.
The 4 Qualifying Life Events [How to Qualify for a Special Enrollment Period]
- If You Lose Your Coverage. This can include turning 26, losing your job, or no longer being eligible for Medicaid / Medicare.
- If There are Changes in Your Household. Getting married or divorced, having or adopting a child, or having a death in the family can qualify you for a Special Enrollment Period.
- If You Move. If you move to a different county or zip code, you might not be able to keep your current plan and will be given the opportunity to enroll in a new one.
- Other Changes. There are a number of less-common life events that can qualify someone for a Special Enrollment Period, including:
- Becoming a U.S. Citizen
- Getting out of prison or incarceration
- Joining or leaving AmeriCorps
- Gaining membership in a tribe recognized by the Alaska Native Claims Settlement Act (ANSCA).
Health Insurance Open Enrollment 2021: Frequently Asked Questions [F.A.Q.]
Q: Should I Switch Health Insurance Plans During Open Enrollment?
A: If you need to lower your premium or increase your coverage, then switching plans is a good idea. By making plan changes through your Personal Benefits Manager, you can be certain that you’re getting the best rates possible.
Q: Can I Change Health Insurance Plans Mid-Year?
A: The only way to change health insurance plans mid-year, or outside of Open Enrollment, is to qualify for a Special Enrollment Period. The section above details the different life events that can qualify you for a Special Enrollment Period.
Q: Is There a Penalty for Canceling Health Insurance?
A: As of 2019, the Obamacare “Individual Mandate” fee no longer applies to people who don’t have coverage. In other words, most people don’t have to worry about a penalty for canceling health insurance.
However, individual healthcare mandates have been instituted in six U.S. states. If you live in one of these states, you could still face a penalty for not having coverage.
The U.S. States with an individual healthcare mandate currently include:
- California
- Washington, D.C.
- Massachusetts
- New Jersey
- Rhode Island
- Vermont
Q: Can I Change My Health Insurance During Open Enrollment in Time for 2022?
A: Yes, if you sign up for a health insurance plan during 2021 Open Enrollment, your new coverage will take effect on January 1st, 2022.
If you are in a state with an extended enrollment deadline, like Colorado or California, you could sign up as late as January. In this case, your new plan would become active on February 1st, 2022.
Q: When is Health Insurance Open Enrollment 2021?
A: Open Enrollment begins on November 1st and extends through December 15th nationwide. 11 different states have already extended this deadline into January.
You can find a full list of the states with extended deadlines towards the top of this page.
Q: What if I Need to Change Plans Outside Open Enrollment?
A: The only way to change plans outside Open Enrollment is to qualify for a Special Enrollment Period. Qualifying life events include getting married or divorced, having a kid, or moving outside of your current plan’s coverage area.
Q: When Can I Buy Health Insurance?
A: Health insurance plans are available every year between November 1st and December 15th. Individual states often extend their deadlines beyond this. In addition, the federal government can choose to re-open the enrollment period under special circumstances, as they did with COVID-19 in 2021.
Q: What Should I Look for When Comparing Health Insurance Plans?
A: Comparing health insurance plans can be overly complicated, and everyone’s ideal plan is going to be a little different.
But in general, here’s what to look for when comparing plans:
- Premium. How much can you afford to pay for a plan per-month?
- Deductible. If you get sick or injured, you’ll have to pay this amount before your insurance kicks in. Choosing a deductible is all about risk tolerance.
- Provider Network. Who is included in the network? Will you be able to use the doctor you prefer?
- Formulary. The plan formulary dictates which prescription meds are covered. If you have ongoing prescriptions, you’ll need a plan that includes them.
There are dozens of considerations when it comes to choosing a plan. But once you have an idea of what you’re looking for in terms of the premium, deductible, provider network, and formulary, it’s much easier to narrow it down to the best one for you.
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Ready to find out how affordable a health insurance plan can be for 2022? Click here to get your very own Personal Benefits Manager (PBM). Your PBM will work with you to find the most ideal plan for your circumstances, whether you’re looking for lower costs or more robust coverage.
Here are some additional articles on health insurance during open enrollment: When is Health Insurance Open Enrollment 2021? [Dates and Deadlines] | Health Insurance Open Enrollment in California Lasts All Year
