The end of the year marks the opportunity for Californians to get insured during the open enrollment period. We want to make sure you have the best information available so you can decide about the coverage that is right for you and your family.
In addition to this FAQ, we offer resources for more information and can also walk you through your options for free.
Q: What is open enrollment?
A: Open enrollment is the time when everyone has a chance to choose their health care and insurance coverage for the next calendar year. People can switch to another plan if they feel it does a better job of meeting the health care needs for them and their families. They can also stick with the plan they have.
There are some important things to know like:
- The cost, or premiums
- Which doctors and hospitals you can visit
- How much office visits, prescriptions, or other services cost
- How much you will have to pay out of pocket
- If additional services like dental, vision, or counseling is covered
Open enrollment is also the time when those on Medicare can choose the doctors or health systems they want to use. We can help you switch if you want to see AltaMed doctors in 2022.
Q: When is open enrollment?
A: The deadline for Medicare is Dec. 7. Open enrollment for Covered California is Nov. 1 through Jan. 31.
Q: Who is eligible for Medicare?
A: Medicare is usually reserved for people 65 years old and older. In addition to the open enrollment period, you can sign up three months before you turn 65. Younger people who require dialysis for kidney failure or need a transplant, are also eligible.
Medicare has two parts: Part A and Part B. Part A is hospital insurance and Part B is medical insurance. Part A is free if you’re at least 65 and you or your spouse paid Medicare taxes for at least 10 years. There is a monthly premium for Part B which comes out of your monthly Social Security check. The premium is based on income. In 2021 it ranged from $148.50 to $504.90.
Q: Should I just take the insurance offered by my employer?
A: That may be the simplest thing to do, but it might not be what’s best for you and your family. It could be expensive, even if your employer pays for part of it, and it might not provide you the right coverage. That’s why it’s important to research your options.
You could be eligible for coverage through Medi-Cal or qualify for discounts through the Covered California marketplace.
Q: What happens if I don’t choose?
A: It’s likely your plan will continue if you’re covered through Medicare. You may also get automatically assigned to a plan offering comparable coverage at a price similar to your coverage through your employer or Covered California. Otherwise, you might have to re-enroll each year.
Q: What happens if I don’t have coverage and miss the deadline?
A: If you miss the deadline for your employer’s insurance, you have to wait until next year unless you have a qualifying life event. You could get a short-term plan, be eligible for Medi-Cal, or the Children’s Health Insurance Program (CHIP), or be eligible for Covered California. If you miss your deadline to sign up for Medicare, you can enroll during the general enrollment period that runs from Jan. 1 to March 31 every year. Your coverage, however, won’t start until July 1.
Q: What is a qualifying life event?
A: These are events that allow you to change, cancel, or enroll in new coverage outside of the open enrollment period, they include:
- Getting married
- Having a baby
- Losing a job or experiencing a change to your income
- A death in the family
- Moving to a different ZIP code
- Becoming a U.S. citizen
Q: How can I save money on coverage?
A: You can apply for tax credits or cost-sharing reductions if you purchase a plan through Covered California. That can reduce what you pay.
Some health insurance plans offer discounts if you maintain a healthy weight, enroll in an exercise program, or take part in activities your company requests. Other ways to save money include:
- Choosing in-network doctors
- Visiting the emergency room for true emergencies ONLY
- Taking advantage of covered health screenings like preventive cancer screenings, diabetes screenings, HIV and STI tests, and many others at no cost
- Ask for generic options of your prescriptions
Q: Where can I get help choosing the right insurance?
A: AltaMed has professionals dedicated to help you understand your health care options. They can provide you with:
- Free one-on-one enrollment assistance over the phone
- Bilingual certified enrollment counselors
- Information about a variety of health care options including:
- Covered California
Make your appointment today by calling (877) 462-2582.
Learn other ways to get the most from your coverage, regardless of the plan you’re on. And remember, we’re here for you. Call with your questions about selecting coverage that can help your whole family grow healthy – in 2022 and for years to come.