Let’s Be Prepared for 2021 Benefits Open Enrollment – LR-J Can Help  

If 2020 has taught us anything, it’s to expect the unexpected. This year has shown us how much can change in such a short amount of time, and how resilient we can be, especially if we’re prepared. As health insurance brokers serving both Arizona and California, LR-J Health Solutions continues to strive to be here for our clients through all of life’s moments. As we approach the open enrollment period, we understand that it can be overwhelming to keep up with all the changes in the health insurance industry and to sift through all of the changing health care packages while calculating the rising cost of health care coverage to determine the right amount of coverage for you and your family. Whether you’ve been buying your own health insurance for years or you are new to the individual market, LR-J is here to answer your questions and to work with you to determine what plan makes the most sense for you and your family in 2021.

When is Open Enrollment?

Open enrollment for ACA-compliant 2021 health coverage begins in every state on November 1, 2020, and will end on December 15, 2020 in most states (Arizona included). Since LR-J is proud to be licensed in both Arizona and California, Californians should be aware that California is one of very few states that have permanently extended their open enrollment periods. In California, individuals can openly enroll in healthcare coverage from November 1, 2020 until January 31, 2021. 

In Arizona, all plans will take effect on January 1, 2021. In California, people enrolled between November 1, 2020 through December 15, 2020 will be covered effective January 1, 2021, and those who enroll during the extended period (December 16 – January 31), will have coverage effective February 1, 2021.

What If I Miss the Open Enrollment Period?

If you miss the open enrollment period, you won’t be able to add insurance coverage or make any changes unless you qualify for a life event. Qualifying life events are as follows:

• Loss of Health Coverage: Aging out of your parents’ plan, the loss of a job or qualification for Medicare or Medicaid services.
• Changes in Household: Marriage, divorce, birth, adoption, or death in the family.
• Relocation: Moving to a new region outside of your current insurer’s coverage.
• Other Qualifying Events: Becoming a naturalized citizen, leaving incarceration, joining or leaving the AmeriCorps.

LR-J Health Solutions – Living Healthy Starts at Open Enrollment – Wellness Coverage

Is There a Penalty for Not Having Insurance?

Yes, and no. 

First of all, you need health insurance, whether it’s “mandated” or not. Insurance is a cost-saving measure, and this year has shown us what happens when unexpected illness hits. According to healthcare.gov, “Nobody plans to get sick or hurt, but bad things happen — even to healthy people. A broken leg can cost $7,500 to treat. Three days in the hospital can cost $30,000. That’s a lot of money to come up with out of your own pocket. Having that kind of medical debt can really limit your options.”

While the Affordable Care Act (ACA, or Obamacare) remains mostly intact, since 2019 there has been no federal government penalty for being uninsured in most states, like Arizona. As of 2020, California does impose an individual mandate and a penalty modeled on the ACA’s penalty. The requirement applies to each resident, their spouse or domestic partner, and their dependents. The penalty for non-compliance is based on the 2018 federal individual mandate penalty (ie, $695 per uninsured adult, or 2.5 percent of household income), but exemptions and maximum penalties are specific to California. The calculator is available at ftb.ca.gov/healthmandate. 

Medicaid, CHIP, and Medicare Open Enrollment for 2021

Medicaid and the Children’s Health Insurance Program (CHIP) were created to provide health insurance coverage for low-income individuals, families with children, pregnant women, the elderly and people with disabilities, and you can enroll anytime of the year if you qualify. At any point in the year, if your income lowers to a Medicaid-eligible level, you’ll be able to enroll at that point. Similarly, if you’re on Medicaid and your income increases, you’ll have an opportunity to switch to a private plan at that point.

 LR-J Health Solutions 2021 Open Enrollment Guide – Prescription Coverage

As covered in a previous blog, Navigating Your Health Insurance Policy Amidst the COVID Pandemic, even if you don’t think you can qualify for Medicaid, it’s worth checking out. Medicaid coverage can take retroactive effect as far back as three months, if you were eligible during that period of time, and offers free or low-cost and comprehensive benefits. 

Medicare is the federal health insurance program for people who are 65 and older and certain younger people with disabilities. Initially, some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically, and others have to sign up for it, usually depending on whether or not they receive Social Security. Unlike Medicaid and CHIP, for Medicare, there is an “open enrollment period,” better known as Medicare’s annual election period. These dates are October 15th to December 7th. During this upcoming annual window, Medicare Parts A and B enrollees can reevaluate their coverage, change between Original Medicare and Medicare Advantage Plan (Medicare Part C), apply for Medicare Advantage and/or Medicare prescription drug coverage (Part D).

For Medicare options in either Arizona or California visit:https://www.medicare.gov/

Is There an Open Enrollment Period Dental and Vision Insurance? 

No! You can enroll in dental and vision insurance year-round. However, there may be certain dental or vision plans that are only available during open enrollment for health insurance, especially if you are bundling them with your health insurance plan. 

How Can I Know Which is the Right Health Insurance Plan For Me and My Family?

It can definitely be overwhelming to sift through all the options when it comes to health coverage. At LR-J Health Solutions, we want you to feel confident about your coverage options, especially if you are not offered coverage through an employer, or if the employer-sponsored coverage for your family is overpriced. We pride ourselves on taking the confusion out of the process – we can build you a package that includes an affordable health insurance policy, as well as supplemental coverage for you and your family. Before open enrollment begins, get an online quote on our website, or book an appointment online for either an in-person or virtual meeting.