What You Need to Know About Open Enrollment

This week, Maggie gives you a bunch of helpful facts about open enrollment and making sure you have health insurance coverage.


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The theme music is called Escaping Light by Aaron Sprinkle. The podcast artwork design is by Maggie’s dear husband, Dan Rader.


Maggie Germano: 00:00 Hey there and welcome to the money circle podcast. Don’t forget to subscribe, rate and review this podcast so that more people hear about it and listen, my name is Maggie Germano and I am a financial coach for women and your host every week. If you’d like to learn more about me and my coaching and workshops services, visit Maggie germano.com this week in honor of open enrollment season. I’m going to talk about all the things you need to know about enrolling in health insurance next week. Make sure to listen again because I’m interviewing my friend Nina Serrianne who is a healthcare expert and gives lots of great resources on getting healthcare coverage this week since it’s the first Monday of November, which is when open enrollment season starts. I’m going to give you a series of helpful facts about open enrollment to help you feel comfortable picking an insurance plan and enrolling in health insurance for 2020 so as I’ve already mentioned, open enrollment season is from November 1st until December 15th it used to last until December 31st but the Trump administration has shortened the time frame.

Maggie Germano: 01:13 If you’re not seeing much information online or elsewhere, it’s because the administration has also reduced the amount of money being spent on advertising and helping people kind of figure out the enrollment process. So then in of itself, can make an already frustrating and confusing period a little bit harder. So that’s why I’m here. To give you a little bit more information, go to healthcare.gov to find out what plans are available to you to learn more about enrolling in health insurance and to start the process of enrolling this site. We’ll also link to your state’s exchange site if they have their own. So for example, I used Maryland’s exchange and for 2018 and so I was redirected to their website to do the enrollment process. Some States have different enrollment periods, so they might be a little bit longer than that December 15th cutoff. So go to your state’s exchange website to find out when that open enrollment period ends.

Maggie Germano: 02:13 But regardless of whether or not your state offers a little bit more time to enroll, don’t wait until December 15th to enroll in health insurance coverage. You might have lots of questions, I’d need to do your own research so you don’t want to leave it until the last minute. If you don’t have health insurance through your employer and you miss the marketplace enrollment deadline, you’ll have to wait until the end of next year or until there’s a qualifying life event, like getting a new job, losing a job, getting married, et cetera to enroll again. So that could leave you with up to a whole year without health insurance, which you don’t want. So as I mentioned, starting at healthcare.gov is a really good starting point in order to find ways to enroll in health insurance and to find your States exchange website. However, I have the DC and Maryland websites handy, uh, since a lot of people that follow me and listen to me are in the DC area, I thought I would give those on air so that you have them easily in Maryland. That website is Marylandhealthconnection.gov. In DC the website is DChealthlink.com. I know other folks are based in Virginia who listen and elsewhere, but if you want to find the exchange information for those States, just go to healthcare.gov or do a Google search and find more information about that. Another important thing to know that you might end up seeing, especially if you do a Google search, is something about using a health insurance broker. And basically that means you’re using a third party, uh, individual to help you figure out what insurance plan to use and how to enroll. Um, and you should certainly shop around to make sure that you’re getting a health plan that works best for you, but it’s also possible to do that yourself and not pay a third party to do that for you. You’ll hear a little bit more about that next week on my episode with Nina, so please do tune in to learn more about that.

Maggie Germano: 04:15 Um, but there are navigators on the state’s exchange websites. There’s navigator on healthcare.gov and places like planned Parenthood actually also have a system to help you help you navigate the process so you don’t have to hire a broker to do it for you. There are ways to do it yourself or to have someone who is not financially inclined to help you choose a health plan. Another important thing to know is that preventative care is still 100% covered by all legitimate insurance plans. That means that you’re well, women visits your annual physicals and things like that will be covered with no copay required. That’s still legally required by the affordable care act and speaking of the affordable care act, it’s still the law of the land. It’s been challenged in Congress and in the courts many times over the past several years. There’s even a court fight going on right now, but it has continued to be upheld, so as long as it continues to be upheld, it’s still the law of the land.

Maggie Germano: 05:16 You still have the legal right to health care coverage, especially when it comes to preventative care and things like birth control and something else. That’s really important. You know, it can come up that if you have to buy insurance through the marketplace, because you don’t have insurance through an employer, that it’s going to end up being too expensive and that you’re better off just going without health insurance. But the truth is that nine in 10 people, which is 90% of people who are looking for health insurance on the marketplace, are actually eligible for financial help of some kind on their insurance plan. One in three people are eligible for health insurance plans that costs less than $10 a month, which if you think about it, $10 a month is a pretty easy line item when it comes to your budget. And we’ll save you a lot of bigger costs down the road.

Maggie Germano: 06:08 But if you’re not one of those three people eligible for that cheap of a plan, the majority of people are still eligible for a plan that is less than a hundred dollars a month. So for example, when I was on the marketplace in 2018 my insurance premium was actually $0 million based on my estimated income for my business. So I was still in the first year full time with my business. So I was kind of assuming I wouldn’t be making a ton of money. So that was how they uh, you know, determine that premium price. If you read my blog from this week, you’ll see that that’s not the whole story unfortunately. But when I was choosing that plan and seeing the cost for that, that was something that was really helpful and important to me. Um, if you have a spouse who has insurance and whose income is combined with yours, when you do your taxes, it’s a different situation.

Maggie Germano: 07:01 So please consider your tax implications when you decide to enroll in the marketplace. Like if you know that you will be getting married next year and filing taxes together and having all that income, you know, be viewed as one that’s going to influence how much you are actually eligible for it. So keep those kinds of things in mind. But the majority of people are eligible for a plan that’s less than a hundred dollars a month. Another really important thing to be aware of, especially this year is to be aware of junk plans, which are also known as short term limited duration plans. Again, Nina gets more into this next week on that episode. Um, but these plans have very, very low premium costs and they say that they have equal coverage to other plans, but the truth is that they actually don’t have good coverage. A lot of them won’t cover preventative care, they won’t cover, um, emergency care, which those are the scenarios where you really need that insurance to be kicking in.

Maggie Germano: 08:02 So look closely and make sure that the plan you choose has all the coverage that you need. And, and be careful because these plans, the Trump administration has actually made it so that these plans are allowed to show up in the marketplace. So they will be mixed in there. So make sure that you’re reading the fine print on those different plans and that you’re going to be getting exactly what you need in terms of health insurance. Now say that you are employed and you do have an employer sponsored health insurance plan. You don’t have to figure it all out on your own. There are people at your company whose job it is to explain your health insurance benefits and help you make the decision that is right for you. Find out through HR who that person is and ask them all of your questions. It is literally their job to help you even better.

Maggie Germano: 08:49 Find out if your company offers presentations or webinars that explain any changes to your plan. Insurance plans often change from year to year, even if you haven’t changed employers. So it’s important to know what is changing so that you can again, make sure that you’re getting the coverage that you need. Don’t just do nothing. Make sure that you understand your options. Make sure that you know what each plan has to offer and that you’re getting the coverage that you need. If you take no action, you’ll either end up without coverage or you’ll be defaulted into a plan, which may or may not be what you actually need. So again, reach out to those people at work who have that information that you need, who can sit down with you and answer your questions, give you the details, run through everything and make sure that you feel confident in the plan that you’re choosing.

Maggie Germano: 09:39 And make sure that you know when your open enrollment period at work is. So most places are not going to have a six week open enrollment period within their organization for their, their employees to make their health care decisions. It’s usually a smaller period of time. So at my old job, I think it was like a two week period where we could take the webinar or take the class and ask the questions and read and do research and compare and make the decision which two weeks might feel like plenty of time, but when day to day life gets in the way, or if you put it off to the last minute, it can feel like it was not nearly enough time. So make sure that you understand your own open enrollment period with your employer if you are employed and you do have insurance through your employer. So that you don’t miss that enrollment period because again, you might either be defaulted into a plan that’s not right for you or you will be ending up without insurance for 2020.

Maggie Germano: 10:36 If you have low income, uh, disability or other certain factors, you may qualify for Medicaid. So Medicaid is a federal state program that provides health insurance coverage for folks that fall into those different categories, that income level and other issues that qualify will vary by state. So make sure to do your research in your own state. I’ll link to different Medicaid resources in the show notes, but again, it’s gonna depend on your circumstances. It’s going to depend on your state, right? It’s going to depend on if you’re in one of the States that has expanded Medicaid so that it covers more people of different income levels. Um, but it is a really important and helpful resource if you do qualify. So make sure that you look into that as well.

Maggie Germano: 11:24 In conclusion, the open enrollment period again, is November 1st until December 15th. If you need marketplace insurance, meaning you do not have insurance through an employer, you do not get insurance through your spouse’s employer, you don’t qualify for Medicaid or you can’t afford to buy private insurance elsewhere. Visit healthcare.gov as soon as possible so that you can find it. Enroll in the insurance you need, and like I said, don’t miss next week’s episode of the money circle podcast where I’ll be joined by a healthcare expert, Nina Serrianne.

Maggie Germano: 12:03 if you’d like to get more connected with money circle or with me, there are lots of ways you can do that. To join the free Facebook group, visit facebook.com/groups/moneycirclegroup to stay informed of any upcoming events. Subscribe to my weekly newsletter at maggiegermano.com/subscribe. If you’d like to join the virtual money circle membership group, visit Maggiegermano.podia.com/inner-circle. To learn more about my financial coaching services, my speaking and workshop offerings, or just to read my blog, visit maggiegermano.com.you can also follow me on Instagram and Twitter at Maggie Germano. Thanks so much for listening and please enroll on your health insurance. Bye.