Are you one of the many people who got an “Eleventh-hour” extension on your pre-Affordable Care Act (ACA) health plan last year? Chances are, your plan will have its anniversary pretty soon. I want to give you an idea of what your options really are.
Back in November of 2013, the White House notified state health insurance commissions of a “transitional relief policy” allowing non-grandfathered/non-ACA-qualified plans to be extended through 2014. This policy was further extended earlier this year to allow possible policy renewals through 2017 (at each state’s discretion).
If your non-ACA plan is ending in 2014, you qualify for a special enrollment period for an ACA-qualified plan. If your plan is renewing in 2014 you also have a special enrollment period on your anniversary date – but you can also choose to keep your current policy.
What To Do At Renewal Time
If your plan is up for renewal, keeping your current policy may be the best course of action if you are satisfied with your current coverage. These older plans do not have all the mandated coverage (like maternity coverage or preventive care), but in many cases are much less expensive and restrictive.
How Long Do You Have to Get New Coverage When Your Plan Ends?
You qualify for a Special Enrollment Period for 60 days (beginning on the day you lose current coverage or experience a life-event). If you do not take advantage of this open enrollment window, you also have another opportunity to sign up for a new plan during the Annual open enrollment period beginning November 15th.
What To Do If Your Plan Is Terminating
If your plan is terminating you may have already gotten notices from your insurance carrier about your next step. Some carriers will try to “map” you to another of their plans that are ACA-qualified and “comparable” to the one you have now. Or you may get a notice informing you that your policy will be terminated altogether, leaving you to fend for yourself to find a new plan on your own.
The good news is that you also qualify for a SEP for 60 days from the expiration of your current plan. You should get prepared now, however, so you don’t run the risk of missing the SEP window.
Other events that can qualify you for a special enrollment period include:
• A change in marital status .
• The addition of a dependent child to the family.
• Involuntary loss of health coverage (lost job, renewing plan, ending COBRA or other involuntary loss of coverage).
• Relocating your residence outside of your current plan’s area
Remember, you are not obligated to take the transition to an ACA plan offered to you by your present carrier. You have every right to investigate other options and carriers. I strongly encourage you to have a conversation with a licensed, independent insurance broker. What you need is an unbiased advisor with some longtime experience under his or her belt.
Give me your feedback. I’d love to hear some good stories this summer!
Wiley Long is President of HSA for America, and a passionate advocate for consumer-based solutions that will improve price transparency and lower health insurance and medical costs for people purchasing individual and family health insurance plans.