Every year around this time, open enrollment begins for individuals and families to select their healthcare coverage options for the following year. For most, 2020 has been an extremely challenging and unpredictable year with the impacts of COVID-19 still lingering. Many have experienced changes to their financial stability which, in turn, may affect their approach to determining what coverage makes the most sense for next year. Staying informed about your plan and coverage options will empower you to take charge of your health. Here’s what to consider this open enrollment season.
Timing and Deadlines
If you get your health insurance through healthcare.gov, your open enrollment will run from November 1, 2020 to December 15, 2020, for coverage starting January 1, 2021. If you live in a state that runs its own health insurance marketplace, there may be some slight differences in the timeframe, but most open enrollment periods begin on November 1st. No matter which state you live in, visit https://www.healthcare.gov/ to find your state’s enrollment period and start shopping for insurance.
If you receive healthcare through an employer, your human resources department will communicate when your enrollment period is (typically in November or early December), and should also note whether or not enrollment is passive or active, which will determine if any actions need to be taken on your part. By staying informed, you will allow yourself ample time to understand any plan changes or differences in costs that your employer may have announced.
No matter where you get your health insurance, pay close attention to deadlines!
With open enrollment comes the opportunity to reevaluate what plan is most suitable for your individual and family needs. Plan types offered typically include high deductible health plans (HDHP), preferred provider organizations (PPO) and health maintenance organizations (HMO) – all of which have different coverage types, benefits and costs. For the type 1 diabetes (T1D) community, understanding your deductible responsibility, out-of-pocket costs for drugs, devices and supplies and if your preferred doctors are in-network are all factors to consider before making a selection. Even if you know you’ll have the same plan again for 2021, you should check if any of your current prescription formularies* have changed because it could affect how your T1D management tools are covered. (*Formularies are the lists of prescriptions, both brand name and generic, that your insurance plan covers. They are usually divided into tiers or categories which help you understand what brands are covered and what their cost will be.)
How Much Will This Cost Me?
Overall, cost is an important factor that many consider when it comes to choosing health coverage. Especially for those impacted by T1D, balancing cost with choice and robust coverage can seem challenging. If you are still unsure about costs and specific medication coverage, talk to your HR department, or get help from Healthcare.gov to get your questions answered.
JDRF also has resources to help! For more information and tools for understanding insurance while living with T1D, visit our Health Insurance Guide.