We’re dedicated to helping everyone get the care they need to grow healthy—and that means empowering you to make the best decisions about you and your family’s health care needs.
This open enrollment FAQ can help you better understand your choices. If you need additional information, we’re here to help, and we can walk you through your options for free.
Q: What is Open Enrollment?
A: Open Enrollment is the period when you can make decisions about your health care and your insurance coverage for the next calendar year. You can choose to stay with your current plan or select a new plan that works better for your budget or your health needs.
The plan you pick can affect:
- The price of your premiums, or the amount you pay every month for your plan
- Which doctors and hospitals you can visit
- How much you pay for office visits, prescriptions, and other services
- How much you will have to pay out of your own pocket for the entire year
- If you can get certain kinds of care (for example, dental or optometry visits)
Q: When is Open Enrollment?
A: It depends on what kind of insurance or medical coverage you have. If you get your benefits through Medicare, your Open Enrollment period runs from October 15 to December 7. If you get your care through Covered California, your Open Enrollment period runs from October 15 to January 31.
Q: If I’m Offered Coverage at My Job, Should I Take It?
A: Many people believe that if your job offers you an insurance plan, you should take it. That’s not always your best move. Even if your employer pays for part of your plan, it can still be expensive and not offer you the right kind of coverage.
Our advice is to research available plans. Depending on how much you make, you may still be eligible for coverage through Medi-Cal. You may also qualify for discounts through the Covered California marketplace. Just because your employer selected it doesn’t mean it’s the best plan for you.
Q: What Happens If I Don’t Choose?
A: If you’re covered through Medicare, you will likely continue with the same plan you were already on. If you are on a plan through Covered California or your employer, and your plan goes away, you will automatically get assigned to a plan that offers similar coverage at a similar price.
Q: What Happens If I Don’t Have Coverage and Miss the Deadline?
A: If you are at a job that offers coverage but miss the deadline, you won’t be able to enroll until the following year unless you have what’s called a Qualifying Life Event (see below). You may be able to get a short-term plan, or you may be eligible for Medi-Cal or Children’s Health Insurance Program (CHIP). The same is true for Covered California. If you miss your deadline to sign up for Medicare, you can enroll during the General Enrollment Period that runs from January 1 to March 31 every year. Unfortunately, your coverage won’t start until July 1.
Q: What’s a Qualifying Life Event?
A: Most people need to pick their insurance plan during Open Enrollment. However, if you experience certain events (called a Qualifying Life Event, or QLE) you may be able to change, cancel, or enroll in new coverage. QLEs include:
- Getting married
- Having baby
- Losing a job or experiencing a change to your income that affects your eligibility for certain plans
- 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: If you are purchasing a plan through Covered California, make sure you apply for tax credits or cost-sharing reductions that can reduce the amount you will have to pay.
Some health insurance plans provide discounts based on your health and activities – for example, if you maintain a healthy weight, enroll in an exercise program, or participate in other activities the company requests.
If your plan doesn’t offer those discounts, there are many ways to save money on your health expenses:
- Choose in-network doctors
- Only visit the emergency room for true emergencies
- Take advantage of covered health screenings: you may qualify to get preventive cancer screenings, diabetes screenings, HIV and STI tests, and many others at no cost
- If you are given a prescription, ask if a generic version is available
Learn more about getting the most out of your coverage, no matter what plan you’re on. And don’t forget, we’re here for you. Call us with your questions about selecting coverage that can help your whole family grow healthy – in 2020 and for years to come.