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Time To Make Your Health Insurance Coverage Selections

Posted on November 20, 2020

Article written by
Matt Werbach

There is a lot going on right now. No one would blame you for not knowing the health insurance market plan open enrollment period recently began. For 2021 health care coverage in the U.S., the open enrollment period runs from Nov. 1, 2020, to Dec. 15, 2020. It’s time to consider your options. Remember, if you do not enroll prior to Dec. 15, you will only be able to choose coverage later on if you qualify for a special enrollment period.

Want a reminder on exactly what the health insurance marketplace is? According to HealthCare.gov, the marketplace is “a service that helps people shop for and enroll in health insurance. The federal government operates the Health Insurance Marketplace, available at HealthCare.gov, for most states. Some states run their own marketplaces.” There’s plenty more explained at HealthCare.gov.

An important part of living your best life with psoriasis or psoriatic arthritis is finding a treatment that works for you and your unique experience with psoriatic disease. With the right health insurance plan, you may be able to significantly reduce the amount you spend on your treatments and health care provider appointments.

Because the health insurance market can be an intimidating place, the National Psoriasis Foundation (NPF) has created a number of resources designed to help you navigate the enrollment process, whether you seek commercial insurance or you qualify for Medicaid or Medicare.

What Should You Consider as You Pick a Commercial Plan?

To determine your insurance plan needs, ask yourself these questions:

  • What was my health insurance deductible last year?
  • Did I spend at least that amount?
  • How many doctor visits, hospital visits, and prescriptions did I have last year?
  • Do I anticipate needing more or less care and services next year?

Then, look closely at plan options to make your selection.

  • Are my current health care providers in-network for this plan?
  • Does this plan cover my prescriptions and services?
  • Will I need a referral to see a specialist?
  • Can I afford the monthly premium? (Remember that if you miss a premium payment, you may lose your coverage and be ineligible for coverage again until the next open enrollment period.)
  • What is the deductible for this plan?
  • What is the out-of-pocket maximum payment?
  • What is the rating of this health insurance company or plan?

When Can You Enroll in Medicare?

An initial enrollment period is the first opportunity you have to select your Medicare coverage. You have an initial enrollment period when you turn 65. This includes the three months before you turn 65, the month of your birthday, and the three months after you turn 65.

You may have to pay higher premiums if you do not enroll in Medicare when you first become eligible. If you are already receiving Social Security Disability Insurance, you will automatically be enrolled for Medicare after two years of receiving disability benefits.

The general enrollment period is the period when you can enroll in Medicare parts A or B, if you did not enroll during your initial enrollment period. The general enrollment period for Medicare is Jan. 1 through Mar. 31 of each year. Your coverage start date would be Jul. 1.

Every year, open enrollment for Medicare plans is Oct.15 to Dec. 7.

How Do You Enroll in Medicaid?

You can enroll in Medicaid at any time during the year. You can complete an application through the health insurance marketplace on HealthCare.gov or through your state’s Medicaid agency. If you are eligible, your Medicaid coverage will begin immediately.

When you submit your marketplace application, you can choose to see if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP). If you or anyone in your household is eligible for Medicaid services, your information will be sent to your state agency. This is because Medicaid is offered through each state. Your state agency will then contact you about enrollment for Medicaid.

Still Have Questions?

There is a lot to consider. NPF’s Patient Navigation Center is ready to help you understand the marketplace and your insurance coverage options. This article contains just a portion of the tips and information available in NPF’s insurance guides and fact sheets.

Patient Navigators are ready to offer free and personalized assistance, whether it’s figuring out your insurance coverage, finding a treatment that works better for you, or finding the right dermatologist or rheumatologist in your area.

Matt serves as the creative services manager for the National Psoriasis Foundation. Learn more about him here.

In partnership with the National Psoriasis Foundation

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