Open Enrollment 2022 – It’s Time Again
Every autumn, people with health insurance enter the ‘open enrollment period’ for the coming plan year and 2021 is no different. This includes employer-based plans, health exchange plans (Affordable Care Act, ACA, or Obamacare), and individual or family plans.
Generally, open enrollment period 2022 dates to remember include:
Open Enrollment begins Monday, November 1, 2021.Open Enrollment ends Saturday, January 15, 2022 (extensions may be added).Coverage can begin as early as January 1, 2022.Enrollment completed between December 16, 2021 and January 15, 2022 will have courage effective February 1, 2022.
Let’s Start at the Beginning
There are several ways that you can participate in a health insurance program.
Employer-based health insuranceHealth insurance that you receive as a benefit of employment that can be either at no-cost to you or with a reduced cost-shareCOBRA coverage — a continuation of a healthcare plan for employees who have left their employment. COBRA is required by law (the Consolidated Omnibus Budget Reconciliation Act) and is mandated to last 18 – 36 months depending on the circumstances. Read More: Everything You Need to Know About COBRA Insurance.Insurance through a State Health Insurance Exchange Marketplace (either state or federally operated) and often referred to as Affordable Care Act coverage (ACA or Obamacare). This program was signed into law in 2010 with the intention of ensuring healthcare for all.Medicare — federally funded healthcare for people over 65 or those with disabilities. As a Medicare participant, you can also choose to join a Medicare Supplement Plan or Medicare Advantage (Part C) that covers additional costs that aren’t covered by Medicare Parts A and B.Medicaid/CHPs — a federal and state funded assistance program serving low-income people, including families and kids.Private alternative sources of insurance which include medical cost-sharing programs, short-term coverage options, and catastrophic coverage.
Most of these insurance options use an open enrollment format, meaning that one time per year for a pre-defined period, participants can make changes to coverage for the coming year.
Why is Open Enrollment in 2022 Required?
Open enrollment has been with us for a long time.
Insurance companies, including federal programs like Medicare, realized early on that allowing people to change insurance at will led to adverse selection risks. They developed a more streamlined system where people could only join or change their insurance one time per year unless they had a ‘qualifying event.’
Defined by each insurer, a qualifying event can include (but not limited to) the following:
starting or stopping a job,loss of health coverage (like when a child turns 26 and can no longer be on their parent’s insurance),getting married or divorced,having or adopting a child, anddeath of a spouse.
But what if you just want to change your plan to a less expensive option or your spouse changes their mind and wants to be on your plan mid-year. Well, that’s where the open enrollment period comes in — you can make those types of changes during open enrollment 2022 and they will be effective for the coming 2022 plan year.
When is Open Enrollment for Health Insurance 2022?
As a participant in one of these plans, you can make changes, additions, or deletions, one time per year when it falls outside of a qualifying event. Be sure to understand your open enrollment 2022 dates, since missing a deadline will cause you to lose the opportunity to make alterations to your plan coverage.
For open enrollment 2022 dates, here is a good general guideline by type of coverage:
Employer-based health insurance — usually a month to six weeks prior to the renewal date. For example, if the renewal date is January 1, 2022, open enrollment would be from either November 15, 2021, or December 1, 2021. Check with your human resources department for the exact dates if this is your type of insurance coverage.Gov/State Health Exchange Marketplace — Open enrollment runs from Monday, November 1, 2021, through Saturday, January 15, 2022. However, for coverage that starts January 1, 2022, you need to enroll or make changes by December 15, 2021.For states that operate their own ACA exchanges, there are different dates for the 2022 Open Enrollment period as follows:
StateState Open Enrollment Period for 2022 PlansCaliforniaNovember 1, 2021 –January 31, 2022ColoradoNovember 1, 2021 – January 15, 2022ConnecticutNovember 1, 2021 – January 15, 2022IdahoNovember 1, 2021 – December 15, 2021KentuckyNovember 1, 2021 – January 15, 2022MaineNovember 1, 2021 – January 15, 2022MarylandNovember 1, 2021 – December 15, 2021MassachusettsNovember 1, 2021 – January 23, 2022MinnesotaNovember 1, 2021 – January 15, 2022NevadaNovember 1, 2021 – January 15, 2022New JerseyNovember 1, 2021 – January 31, 2022New MexicoNovember 1, 2021 – January 15, 2022New YorkNovember 1, 2021 – January 31, 2022PennsylvaniaNovember 1, 2021 – January 15, 2022Rhode IslandNovember 1, 2021 – January 31, 2022VermontNovember 1, 2021 – January 15, 2022WashingtonNovember 1, 2021 – January 15, 2022Washington D.C.November 1, 2021 – January 31, 2022Medicare and most Medicare supplemental plans — For coverage year 2022, open enrollment is October 15, 2021, to December 7, 2021.Medicaid/CHPs — For Medicaid and CHPs coverage, you can apply any time.Private Insurance can vary depending on type and amount of coverage – check with your insurance provider.
How Do I Choose a Plan During Healthcare Open Enrollment 2022?
Whether you participate in the healthcare exchange or one of the other alternatives, like an employer-sponsored plan or a Medicare Advantage Plan, you will likely have a choice of different levels of coverage. These levels of coverage determine the price that you will pay both in terms of your monthly premiums and will also impact your costs when receiving care.
Insurance Plan Cost Split (Exact Costs May Vary)Plan TypeInsurance PaysYou PayBronze60%40%Silver70%30%Gold80%20%Platinum90%10%
Source: HealthCare.gov
So, basically, the higher your portion for deductibles and out-of-pocket expenses when receiving healthcare (like the bronze plan above), the lower your monthly premium. This helps people with their monthly budget but can be burdensome should they or their family need extensive healthcare during the plan year.
In 2022, annual out-of-pocket maximums can easily run over $8,000 per individual and over $16,000 per family. Unless you have that cash readily available, your financial well-being can be jeopardized by a single health event.
Types of Health Delivery Plans Available
There are basically four types of care delivery plans that are available and may be presented in terms of the above referenced plan types. With these health delivery models, the plans with the most options are more expensive, and the more tightly controlled plans tend to have a lower monthly premium.
Health Maintenance Organization (HMO) — A tightly regimented plan that defines the doctors and facilities that a patient can use. An HMO requires the patient’s selected primary care physician (PCP) to manage all care, referrals to specialists, testing, and procedures. While an HMO usually has a preventive focus, any care received outside the network is not covered except in the event of an emergency.Exclusive Provider Organization (EPO) — Similar to an HMO, an EPO manages care by requiring patients to see providers and use facilities that are within their system or network. The main difference is that a referral is not required as long as the provider is within the network.Preferred Provider Organization (PPO) — Offering more flexibility and choice, a PPO is a larger network where choosing providers and specialists is largely left to the patient. PPOs are more expensive but may be worth it if you want more choice.Point-of-Service Plan (POS) — a hybrid of PPO and HMO plans, you must designate a PCP to manage your care (like an HMO), but there is no penalty if you go outside the network (like a PPO). If your PCP refers you out of the network, the plan picks up the cost.
Open Enrollment 2022 Guide to Saving Money
There are some vehicles for saving money on your healthcare insurance that you may want to consider during the open enrollment period 2022 before you sign up for a particular plan. If you have access to any of these options, it may be worth considering to save a little cash.
High Deductible Health Plans
Available for more than 10 years, High Deductible Health Plans (HDHPs) were intended to incentivize consumer-driven participation in the overall healthcare system. The thinking was that if consumers were responsible for a greater portion of their cash outlay, they would apply greater pressure on healthcare costs overall.
However, in practice, while healthcare costs have continued to rise unabated, HDHPs have become increasing popular as a way to save money on monthly premiums. As recently as January 2021, 51% of Americans were enrolled in a HDHP – a number that jumped following the recent COVID-19 pandemic as people were struggling with employment options and healthcare insurance choices.
These lower premiums seem like a great idea, however, as mentioned above, the problem arises when there is an expensive health outcome that requires substantial resources. If you pursue an HDHP, just be sure that you are able to maintain the liquidity necessary in the event of a catastrophic illness.
Health Savings Accounts
If you have an HDHP, you may be eligible to open a Health Savings Account (HSA) where you can contribute money on a pre-tax basis to pay for certain qualified medical expenses. These expenses can include deductibles, copays, equipment, medications, and supplies — even eyeglasses and over-the-counter medications. And by paying with pre-tax dollars, you are helping defray some of the costs for the HDHP.
For plan year 2022, you can contribute up to $3,650 individually and $7,300 for a family and the funds roll over from year to year so there is no requirement to spend down the account or lose it. And some employers make matching contributions to their employees’ HSA accounts — a great perk that you should take advantage of if available.
An HSA continues even if you leave employment where you set up the arrangement so you can continue to make annual contributions and pay expenses tax free even into retirement. And once you reach 65 years of age, any money can be used for general living expenses, like mortgage payments, travel, or entertainment, and there are no minimum distributions.
More good news — as an above-the-line deduction, your HSA contributions are deductible on your tax returns as a reduction to gross income even if you don’t itemize.
What Happens if I Miss 2022 Open Enrollment?
Sometimes, even with the best of intentions, it’s possible to still miss the deadline. If you miss the 2022 open enrollment period, you may still have some options until the next life event or open enrollment period rolls around. Consider one of these options to hold you over (and keep you protected) until you can participate in the next year’s open enrollment:
Try Short-Term Health Insurance as a solution. Short-Term Health Insurance can bridge the gap between coverages for a variety of situations, including missing the 2022 open enrollment dates, coverage between jobs, waiting for Medicare eligibility, or aging out of your parent’s policy.
Short-Term Health Insurance won’t cover things like preventive care or preexisting conditions, but it will provide protection against being without healthcare insurance. However, similar to catastrophic coverage, Short-Term Health Insurance tends to have high deductibles and premiums.
Catastrophic coverage might be another solution. Catastrophic Health Plans meet the requirements as a Qualified Health Plan (QHP), so they meet ACA or Obamacare requirements. But they generally have much higher deductibles and lower premiums…and you have to be under 30 years old or have a ‘hardship exemption’.Consider taking a part-time job with a company offering health benefits in the interim. Starbucks, Home Depot, and Trader Joe’s are among a growing number of companies offering health insurance to part-time workers.
Also, according to Stride, a benefits company that works with independent contractors, gig workers are getting insurance and paying less for it thanks to the American Rescue Plan that was geared towards helping people during the COVID-19 pandemic. Now may be the time to get that second income source coming in and score insurance while you’re at it.
Get Started on Open Enrollment for Health Insurance 2022?
So, you have the information. Now it’s time to get started with this coming year’s open enrollment period ready to kick off.
To get ready, gather your details. Based on the type of insurance you have (or want), collect the information you need to talk to a health insurance specialist. If it’s through your employer, then coordinate with your human resources department. It it’s through an exchange, consider talking to a product specialist who can answer your questions and understands the insurance climate in your state.
If you prefer, you can research questions about insurance in your state — just click health insurance state guide.
Contact Einsurance.com for an affordable health insurance quote today. Health insurance can be complicated. Let a trained expert answer your questions and help you get the best price on the health insurance that meet your needs. You won’t have another chance until next year!
Kathryn has a background as a small business owner and currency trader. Kathryn also enjoyed a career as a Regional Director and COO in healthcare, specializing in operations, third-party insurance reimbursement, and revenue cycle management.
