Open Enrollment Has Arrived. Here’s What You Need To Know
Fall brings jack-o’-lanterns to doorsteps and leaves to the ground — and open enrollment to the forefront.
If you purchase your health care through the government marketplace or get your coverage through Medicare, the open enrollment window is an important one: It’s (usually) the only time during which you can make changes to your plan.
So here’s what you need to know about this important time frame — including some changes that are new for 2024.
What (and when) is open enrollment?
Open enrollment is the period of time during which you can change or renew Medicare or Obamacare health insurance plan.
While initial Medicare enrollment is age-based (starting three months before your 65th birthday), for Marketplace (also known as Obamacare) plans, open enrollment is the only window in which you can sign up, unless you experience a qualifying life change (like getting married or losing your employer-sponsored health insurance coverage).
You can successfully apply for health care coverage through Medicaid or the Children’s Health Insurance Program (CHIP) at any time, so long as you are eligible.
The open enrollment season starts a little earlier for Medicare than it does for Obamacare and is already underway, running from Oct. 15 through Dec. 7.
For plans on the Marketplace, open enrollment generally starts on Nov. 1 and runs through Jan. 15, though there is some variability by state.
If you want your new health insurance coverage to start in January, you must finalize your selection by Dec. 15. Those who make their changes later in the period won’t see their new plan kick in until Feb. 1.
What’s changed about open enrollment in 2024?
There are a few factors that make this year’s open enrollment season special.
For starters, those who live in states affected by Hurricane Helene may have extra time added to their open enrollment periods. Check with your local governance to ensure your county is covered and learn the new deadline in your area.
Secondly, Medicare Part D plans are undergoing substantial changes. A new out-of-pocket cap ensures enrollees will pay no more than $8,000 per year in 2024, a figure that drops to $2,000 in 2025, if you reach the catastrophic coverage phase.
Additionally, the coverage gap — a temporary limit on coverage that kicks in after you’ve spent a certain amount on prescription drugs — will be eliminated in 2025. Both of these changes stand to save seniors significant amounts of money.
Finally, sweeping Medicare Advantage contract terminations will affect a whopping 1.8 million Medicare Advantage members, who are currently enrolled in plans that will cease to exist in 2025. Just 230,000 members were in such a predicament last year — and it means a lot of seniors are going to need to take this time to shop for the coverage that’ll work best for them.
Changing your plan could help you save money
Even if you’re happy with your plan, it’s worth taking the time to shop around and compare coverage. Regardless of whether or not you keep your same plan, your premium is likely to increase each year, and carriers can simultaneously change coverage. It’s a good idea to know what, exactly, you’re getting for your money.
This year, more seniors than ever before are enrolled in Medicare Advantage plans (according to data analysis from KFF), many of which offer $0 premium coverage and a slate of extra benefits not offered under Original Medicare, like vision, dental and fitness program coverage. However, many of these plans also require prior authorization (unlike traditional Medicare), and provider networks may be limited. Which is to say: Actual out-of-pocket costs on these plans might not end up being so low, if enrollees need access to out-of-network providers.
When comparing plans, be sure your preferred providers and prescriptions are covered under any prospective policies. Along with basic costs, like provider co-pays, look into extras like acupuncture, massage and chiropractic care, which could save you money if you regularly seek out these alternative treatments.
Of course, the upcoming election may cause further changes to our nation’s medical insurance systems, including Medicare. Vice President Kamala Harris has proposed a first-in-history plan that would add home care coverage to Medicare, along with vision and hearing coverage.
Medicare drug price negotiations are also still under way, which Harris has also promised to work to build on should she achieve the presidency.
For now, the best thing Americans can do is shop around — and cast their votes.
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