The 2021 COVID-19 Special Enrollment Period: Final Week

While health insurance enrollment is typically only available during the annual Open Enrollment period at the end of the year (unless you have a qualifying life event), the 2021 American Rescue Plan Act (ARP) led to the creation of a Special Enrollment Period to assist Americans during the Covid-19 pandemic.

The 2021 Special Enrollment Period began on 2/15/21 and will close on 8/15/21.

As of June 30 more than 1.5 million people have enrolled in new health coverage since the Special Enrollment Period began, and another 2.5 million have been able to lower the premiums of their existing plans.

ARP subsidies have dramatically improved access and affordability for Americans. The qualification criteria have been expanded to include higher-income households, including those making more than 400% of the federal poverty line. ARP also provides increased subsidies for those who had already qualified, and households with income below 150% of the federal poverty level will benefit from eliminated premiums and decreased deductibles.

If you have not inquired about ARP savings since the income thresholds were loosened, schedule a free 15-minute appointment with a licensed benefits counselor. Remember: enrollment ends August 15.

The 2021 COVID-19 Special Enrollment Period: What You Need To Know

On Thursday, January 28, 2021, President Biden announced plans to reopen the federal health insurance markets for a nation-wide Special Enrollment Period. This action is being taken in response to the massive economic effects of the COVID-19 pandemic which has resulted in some of the highest unemployment rates in decades.

When does it start, and how long does it last?

The 2021 Special Enrollment Period will begin on February 15 and run through May 15, 2021. Coverage effective dates for those who enroll during this time will begin on the first day of the month following an enrollment date. (For example, an enrollment date of March 4 will have an effective date of April 1.)

Will there be another Open Enrollment Period later this year?

Yes. The annual Open Enrollment Period will run from November 1 through December 15. Individuals who enroll during this time will have a January 1, 2022 coverage effective date.

I enrolled during the Open Enrollment period last year. Will I need to sign up for my plan again?

No. If you are currently enrolled in health insurance coverage, you do not need to enroll again. However, if you are interested in changing your coverage, this is your chance to secure ACA-compliant health insurance outside of the annual Open Enrollment Period. Just keep in mind that if you decide to change your plan, your deductible and out-of-pocket maximum will reset based on your new coverage details.

Is this only available to those impacted by COVID-19?

No. Even though this is being called a 2021 COVID-19 Special Enrollment Period, you do not need to have experienced COVID-19, or even a Qualifying Life Event to enroll in (or change) coverage.

Get Ready to Apply

To learn more or to begin shopping plans, visit our Health Insurance page or schedule an appointment to speak with a licensed benefits counselor.

5 Ways to Help You Stay Healthy This Holiday Season

The holidays are going to look a lot different this year due to COVID-19.

Every year millions of Americans pile into each other’s homes to celebrate the season with food, family, and football. That urge has never been stronger than this year. With millions of people working from home and many states enacting safer-at-home measures, Americans are feeling the financial, physical, and mental health effects of living in a coronavirus-infected world.

But in addition to practicing social distancing, there are several things you can do to remain healthy while minimizing the risk of contracting and spreading COVID-19 (or any illness).

1) Consult local, state, and federal guidelines and restrictions before traveling.

According to the CDC, “travel increases the chance of getting and spreading the virus that causes COVID-19. Staying home is the best way to protect yourself and others.” And as COVID-19 cases continue to spike throughout the country, many experts are urging Americans to avoid holiday travel.

Many states are imposing new limitations on gathering sizes, extending mask mandates, and even issuing mandatory quarantine periods (or negative COVID-19 test) for people traveling from other states. If you or your loved ones are considering traveling internationally during the holidays, please be sure to make sure the country you are traveling to is granting entry to travelers from your point of origin.

2) Embrace video chat.

Technology can help us feel connected to our loved ones when we can’t be there in person—something that has proven to be essential for so many people this year.

Video calls have skyrocketed in popularity this year professionally and personally. Zoom did its part to bring people together safely by lifting their 40-minute limit on free meetings for Thanksgiving Day this year.

Consider using video chat services or avoiding in-person contact altogether through the holidays if you or a family member are at a high risk of contracting the COVID-19 virus.

3) Do your holiday shopping online.

You may want to consider skipping the check-out lines this year and put your health first by shopping for gifts online.

Traditional brick and mortar stores will still be dangerous areas despite heightened cleaning measures. The CDC has listed “Going shopping in crowded stores just before, on, or after Thanksgiving” as a higher-risk activity.

Due to the anticipated surge of online shoppers this season, many big-name retailers have announced changes to their traditional holiday sales such as online-only sales, online pick-up options, and more.

4) Wear a mask around others.

Studies continue to affirm the effectiveness of wearing a mask in helping to prevent the spread of COVID-19. And both local and federal government branches have cited the importance of wearing a mask when around other people who do not live in your home. So if you find yourself going out in public or spending time with friends and family, consider wearing a mask to protect yourself and others.

5) Find the right health insurance coverage.

Modern medicine has yet to fully discover the long-term effects of COVID-19 but there are many health conditions scientists can already link to the virus.

According to the Mayo Clinic, “COVID-19 symptoms can sometimes persist for months. The virus can damage the lungs, heart and brain, which increases the risk of long-term health problems.”

Having health insurance coverage for you and your family can help cover the cost of both major and preventative medical care – and now is the best time to get coverage. The annual individual health Open Enrollment period began on November 1 and runs through December 15.

This is the only time of year to enroll in ACA-compliant health coverage unless you experience a Qualifying Life Event.

For more information on health insurance or to start shopping available plans, visit the individual health insurance page today.

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How We Help Members Through the Individual Health Insurance Open Enrollment Process

Shopping for something as important as health coverage can feel overwhelming—especially if you’re looking for a plan to help protect your whole family.

With the health insurance landscape changing every year, we know that it can be difficult to stay on top of which carriers and plans are available, so we do all that for you.

Tap Into Our Knowledgebase

By scheduling a 15-minute appointment with one of our licensed benefit counselors you’ll gain access to experts with vast industry insight—who are have studied state regulatory changes and are familiar with the latest available coverage options. Our counselors take the time to get to know your needs, concerns, and budget, to help find you the right plan, not just any plan.

Preparing for Your Appointment

After scheduling your appointment, you’ll want to gather the following information:

  • The basics: your address, phone number, date of birth, SSN, household size, income level
  • Plan and premium details for any employer-based plan available to you or your household
  • List of current medications
  • Name and zip code of the current healthcare providers that you’d like to continue using
  • Payment information

Having this information ready when your counselor calls will help them efficiently guide you toward the best coverage for your needs.

Taking the Next Step

This year’s Open Enrollment period is November 1 – December 15. If you enroll in an ACA-compliant health insurance plan during this period, the effective date will be January 1, 2021. This is the only time of year to receive ACA-compliant health insurance coverage, unless you were to experience a qualifying life event.

If you’re ready to see what the 2021 individual health insurance marketplace has to offer, we recommend scheduling an appointment with a licensed benefit counselor now. (Appointment availability becomes more limited beginning in the second half of November.)

For more information or to start shopping plans, visit the individual health insurance page today.

Knowing the Difference Between the ER and Urgent Care Could Save You Thousands

Not knowing where to go when you or your child gets sick can be terrifying. Your family doctor may not always be available when you need them, but your circumstances may not be severe enough to warrant a trip to the ER.

But how do you know if a visit to an urgent care center will work just as well and save you money?

Seeking Urgent Care

Thousands of urgent care centers and walk-in clinics have sprung up around the country to help families receive quick medical attention for a variety of issues. According to a December 2019 Forbes article, the number of urgent care centers in the U.S. (9,272) increased by 6% from the previous year. This is just the latest in a series of positive annual growth statistics specific to the urgent care industry.

Many of these locations can test, diagnose, and treat common viral infections, administer stitches to minor lacerations, and much more. But not all urgent care centers or walk-in clinics provide the same services. Before making an appointment or visiting a physical location, be sure to find out which services they offer first (most will have their range of services listed online).

Another increasingly popular service, telehealth, is helping to bring the doctor’s office to the convenience of your couch. Telehealth (also known as telemedicine) has provided relief for overwhelmed doctors offices and urgent care centers alike throughout the COVID-19 crisis and has allowed families to get the care they need while staying safe.

Regardless of how you seek treatment, you may be referred to an ER, specialist, or follow-up appointment if your condition warrants further medical attention.

When to Visit an Emergency Room

Going to an ER may seem scary (not to mention, expensive) but in some cases, it may be necessary.

According to Scripps, if you are experiencing any of the following symptoms you should be evaluated in an emergency room, where medical professionals have access to a full range of resources to treat you:

  • Chest pain
  • Breathing difficulties
  • Weakness or numbness on one side of the body
  • Slurred speech
  • Fainting
  • Changes in mental state
  • Serious burns
  • Head or eye injury
  • Broken bones or dislocated joints
  • Fever accompanied by a rash
  • Seizures
  • Severe cuts
  • Facial lacerations
  • Severe cold or flu symptoms
  • Vaginal bleeding with pregnancy

Covering the Cost of Care

Major medical health insurance can help cover the cost of these types of healthcare. The annual open enrollment period for ACA-compliant health plans runs from November 1 to December 15. If you’ve experienced a qualifying life event (QLE) outside of that period, you may be eligible for a special enrollment period. For more information on QLEs, as well as non-ACA “short-term” health insurance plans (which are available all year long), visit https://osteopathic.memberbenefits.com/health-insurance/.

happy family on couch browsing health insurance options on tablet

Getting the Most out of Open Enrollment

With 2020 Open Enrollment period in full swing, families across the country are reviewing their current insurance coverages and seeing what other options may be available to them. Below are a few tips to help you navigate the process.

  1. Learn the Language

Insurance jargon may be enough to make some people’s heads spin but learning just a few key terms could help you pick the best health coverage for you and your family. To make it easy, here are a few words we feel you should know:

  • ACA-compliant” refers to plans that follow all the guidelines and regulations in the Affordable Care Act. These plans are only available during the annual Open Enrollment period or through a Special enrollment period, if you have a qualifying event.
  • Non-ACA plans” also known as short term health plans do not adhere to all of the Affordable Care Act’s guidelines and regulations.
  • Deductible” the amount of money you must pay out of pocket before your insurance kicks in
  • Premium” the amount you pay to your insurance company every month
  • In-network” refers to a provider that has a contract with your insurance provider
  • Out-of-network” refers to a provider that does not have a contract with your insurance provider
  1. Think of the Future

No one can predict the future, but you may be able to take an educated guess as to what the next 12 months could hold. Thinking about the coming year could help you determine how much coverage is right for you and your family. Have you had any health issues in the past year? Are you taking any medications? By examining your current health status and concerns you may be able to narrow down your health insurance plan options.

  1. Utilize Your Resources

Did you know as a benefit of your AOA membership, you have access to our team of licensed Benefits Counselors? Our Benefits Counselors are experts in their field and are standing by to help you navigate the Open Enrollment process and find the best health insurance for you and your family’s needs.

We’ve been providing health insurance answers and guidance for over 30 years. Be sure to visit the AOA Insurance Marketplace for access to appointment scheduling services, webinar replays, and other informational resources designed to help make the Open Enrollment process as quick and easy as possible.

  1. Know Your Deadlines

Like last year, the annual individual health insurance Open Enrollment period began on November 1 and will run until December 15. For those who enroll in one of these ACA-compliant plans, you can expect an effective date of January 1.

Non-ACA plans typically do not follow the ACA open enrollment period dates and are available in most states year-round.

Ready to make your decision? Visit https://osteopathic.memberbenefits.com/health-insurance/ today to secure ACA-compliant coverage for you and your family in 2020.

2020 Open Enrollment Webinar invite

Upcoming 2020 Individual Health Insurance Open Enrollment Webinar

Join us for a free webinar on Tuesday, October 29 from 12:00pm-12:30pm EDT, where we’ll review the upcoming 2020 Individual Health Insurance Open Enrollment period and cover topics such as important dates, preparation tips, industry updates, and more! Reserve your spot by registering today. Can’t make it to the webinar? Register anyway and we’ll send you a link to the video replay later that day.

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Knowing Your Options Outside of Open Enrollment

While the annual Open Enrollment period focuses on ACA-compliant individual major medical insurance, there are still other forms of insurance available for potential enrollees.

Knowing Your Options

According to healthinsurance.org, “ACA-compliant coverage refers to a major medical health insurance policy that conforms to the regulations set forth in the Affordable Care Act (Obamacare)…This means they must include coverage for the ten essential benefits with no lifetime or annual benefit maximums, and must adhere to the consumer protections built into the law.”

Unless you qualify for a special enrollment period, you cannot receive ACA-compliant individual health insurance coverage outside of the annual Open Enrollment Period, which typically runs from November 1st until December 15th of each year.

If you missed out on Open Enrollment but still need individual health insurance, you still have a few options available:

  1. COBRA

According to the U.S. Department of Labor, “The Consolidated Omnibus Budget Reconciliation Act (COBRA) gives workers and their families who lose their health benefits the right to choose to continue group health benefits provided by their group health plan for limited periods of time under certain circumstances such as voluntary or involuntary job loss, reduction in the hours worked, transition between jobs, death, divorce, and other life events. Qualified individuals may be required to pay the entire premium for coverage up to 102 percent of the cost to the plan.”

  1. Qualifying Life Event (QLE)

There are certain life circumstances called Qualifying Life Events (QLEs) that can qualify you for a special enrollment period. Special enrollment periods allow you to obtain ACA-compliant health coverage outside of the annual Open Enrollment period for you and your eligible dependents. The most common QLEs pertain to:

  • Loss of health coverage
  • Changes in household
  • Changes in residence

If you find yourself matching any of the above circumstances or feel your unique circumstance should qualify you for a special enrollment period, please contact us and our team will help guide you in the right direction based on your individual needs.

  1. Non-ACA Compliant plans

Non-ACA compliant plans, also referred to as short-term medical plans, have recently become more appealing to a growing number of people due to their lower rates. According to the Henry J Kaiser Family Foundation, “Late last year (2017), President Trump issued an executive order directing the Secretary of Health and Human Services to take steps to expand the availability of short-term health insurance policies, and a proposed regulation to increase the maximum coverage term under such policies was published in February.”

So, what separates the ACA-compliant health plans from the ones that are not? One of the biggest factors being the ACA’s ten essential health benefits. Non-ACA compliant plans do not need to adhere to the numerous rules and regulations laid out in the Affordable Care Act.

mother with breast cancer smiling and hugging her young daughter

What You Should Know: Home Breast Cancer DNA Tests

In March of this year, ancestry DNA testing giant, 23andMe, announced that they would begin testing user DNA for Breast Cancer genes, more specifically identified as the BRCA1 and BRCA2 genes. While technically able to test for these genes for years, it wasn’t until this past March that the FDA officially signed off on it, therefore, making the 23andMe at-home DNA test, the first FDA-approved direct-to-consumer test to evaluate one’s potential risk for cancer.

What Can Your DNA Reveal

The test is offered as an add-on to 23andMe’s standard ancestry report for a total of $199 and is delivered alongside a variety of other reports designed to tell you if you possess certain genetic markers which may suggest a predisposition to things such as:

  • Macular Degeneration
  • Lung and/or Liver Disease
  • Celiac Disease
  • Hemochromatosis
  • Hereditary Thrombophilia
  • Alzheimer’s Disease
  • Parkinson’s, and many more
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