2018 Open Enrollment: Understanding Your Options
During the fall is when most people must make decisions about health care for the coming year. First, decide where your health insurance is coming from – for example is it provided through your employer, will you buy it on your own or are you eligible for Medicare? Then, focus on information specific to your situation. You can use our annual health insurance check-up table for tips on deadlines and important questions to ask. Most Americans access health in one of three ways:
Employer-Sponsored. If you’re already covered by an employer-sponsored plan, pay close attention to your enrollment options. Premiums and coverage limits may have changed. If you’re changing jobs, you may be subject to a probationary period, up to 90 days, during which you are not eligible for group coverage. If you lost coverage from a previous employer, you typically have 60 days to enroll in private individual insurance through a Special Enrollment Period.
Public Healthcare Programs. Medicare and Medicaid are government programs that help pay for health care. Medicaid is jointly funded by federal and state governments and eligibility is means-based. For more information, contact the Louisiana Department of Health.
Medicare is a federally funded program available to residents age 65 or older. People younger than 65 also may be eligible for Medicare if they are disabled. Louisiana Department of Insurance counselors can help you understand plans and options. For more information, contact our Senior Health Insurance Information Program (SHIIP) at www.ldi.la.gov/shiip.
Individually Purchased Health Insurance. Open enrollment for health insurance through the Health Insurance Marketplace runs November 1 to December 15. Here are a few things to keep in mind during open enrollment:
- 2018 plans may be different from those offered last year.
- Review the doctors and other medical providers in a plan’s network (more on that below).
- You must elect coverage by December 15, 2017 or you may have to wait until next year or for a special enrollment period.
You can qualify for a Special Enrollment Period due to a life change such as marriage, having a baby or losing other coverage. If you choose a plan during the open enrollment period, it will begin January 1, 2018. The Louisiana Department of Insurance encourages you to contact an agent for assistance if you have questions or don’t know how to determine which health plan is right for you. You may also be able to receive free help from a Health Navigator.
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Checking your Healthcare Network
However you get your health insurance, it's important to understand which doctors and hospitals are in your health insurance plan's network. A network refers to the groups of doctors, labs, hospitals, surgery centers and others who have a contract with your health care provider to provide medical care. Some plans limit your choices or charge you more if you use providers who are out of the network.
If you are provided services from outside of your network, you may receive what is sometimes referred to as a "surprise" medical bill. This can happen if you receive care from an in-network provider but other providers, such as anesthesiologists and radiologists, are brought in who are not part of your network.
For more information, please visit www.ldi.la.gov/checknetwork.
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