Deadline Ahead

It’s the second week of January and we have another hard deadline coming up. Today is January 10; January 15 is the final day for open enrollment for Marketplace insurance. If you have not made a selection, and you need coverage for 2023, please make sure you reach out to me. We do still have time to pick a plan and ensure that you have Marketplace coverage for 2023. If you have already selected a plan, and you’ve decided that possibly you don’t like this plan, or maybe you want to look and see if there’s something better, we can still make a change. This change will be effective February 1 – as the start date for coverage.

I have been asked, “Is January 15, the final deadline?”, “Am I just stuck without coverage if I don’t do it by January 15?” The answer to that question is, it depends. For traditional Marketplace coverage, if you don’t have a special or qualifying event, such as getting married, getting divorced, having a child, losing a job, or a death in the family, then you would not be able to enroll until the next open enrollment period. But if you do experience any of those qualifying events, you would then be allowed to enter into a special enrollment period. However, you only have 60 days to make a selection. If this happens after January 15, yes, then we can review plans and get you some coverage on the Marketplace. The other option, of course, is private insurance. There are many kinds of private insurance that are short-term, but the catch on these kinds of plans is that they do ask underwriting questions. This means that if you’re not a very healthy person, there is a chance that you could not be eligible for coverage depending on what your health issues are. Basic health issues such as high blood pressure, cholesterol, and thyroid issues wouldn’t count against you, but if you have something serious such as being an insulin-dependent diabetic, you’ve had cancer, or you’ve had a heart attack recently, those things require a lot of underwriting and you’re not going to qualify. This means it is really important you get Marketplace coverage. If you have a serious condition or take a very expensive medication, (one that comes to mind is Humira. which is $6,000 a month cash price) which doesn’t have a generic, you do want to make sure you get that medication coverage, even it means paying a bit more for the monthly premium. You would then get that medication at a lower cost, usually with a copay.

Again, January 15 is the hard deadline for marketplace insurance if you don’t have a special enrollment period. Please, please, please get covered. More people are covered by subsidies than ever before. And if you’ve not checked, let me check for you because a lot of times people don’t know the right information to put in and you can end up overpaying for coverage or thinking you don’t qualify when you actually do.

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