Open Enrollment

TAKE CARE: Advocacy Blog Series

It’s Never Too Early to Think About Open Enrollment

We are continuing our advocacy blog series meant to help you take care when it comes to important arthritis health care and coverage issues. If you are just now tuning into this series, check out our previous blog posts on accumulator adjustment programs, pharmacist gag orders, President Trump’s drug pricing blueprint, drug rebates, premium increases, and an update on the Affordable Care Act.

This week, we kick off our focus on health insurance benefits – it’s never too early to think about open enrollment! Whether you receive health insurance through an employer, Medicare, or the individual insurance market, late summer is a great time to reflect on the current plan year and begin thinking about health care needs for the upcoming year. Read on to learn about what open enrollment means for you.

What is open enrollment?

The term open enrollment refers to the period of time every year when individuals can sign up for health insurance. Traditionally, this time is in the late fall if you have insurance through the individual marketplace, Medicare, or Medicaid. If you receive coverage through an employer or a spouse’s employer, now is a good time to ask your Human Resources Department about the dates and deadlines.

A recent Arthritis Foundation advocacy survey found that about half of people with arthritis access coverage through an employer or a spouse’s employer; one-third through Medicare; and the remainder through Medicaid, the individual marketplace, and the health program for service members, veterans and their families known as TRICARE.

Why is it important to get covered?

Health insurance helps protect you and your family from the unexpected. Thanks to a number of provisions in the Affordable Care Act, plans accessed through an employer and federal and state exchanges mean that no one can be denied health coverage due to a pre-existing condition like arthritis or high blood pressure. It also means there are guaranteed essential health benefits like prescription drug coverage.

Is there a fee if you do not have health insurance in 2019?

No, there is no fee if you do not have health insurance in 2019. This is a change from prior years. Last year, Congress passed a tax reform bill that included a provision removing the individual mandate penalty for not having health insurance. This means you will not be penalized for going without health insurance starting in 2019. However, if you have a pre-existing condition like arthritis, it is important to enroll in a health plan.

What are the open enrollment timelines?

For 2019, open enrollment deadlines vary depending on where you access health insurance coverage:

  • Individual marketplace: The open enrollment period runs from November 1 to December 15 for plans that start on January 1, 2019. For states that manage their own insurance marketplace, check your state Department of Health’s website.
  • Medicare: Open enrollment will run from October 15 to December 7.
  • Employer-sponsored Insurance: Deadlines are rolling. Check with your employer’s Human Resources Department.

In the coming months the Arthritis Foundation will be raising awareness about the open enrollment period, so stay tuned! The Arthritis Foundation’s Your Coverage, Your Care toolkit is a great resource to help you understand your insurance options, the claims process, and tips to overcome barriers. The toolkit’s Arthritis Care Checklist covers ten key areas of health care services that people with arthritis may need and can help jump start conversations as open enrollment approaches in the fall.

Additionally, if you have any questions about your health care, we have licensed clinical social workers on staff that can talk with you 24 hours a day for your convenience. You can reach the Arthritis Foundation Helpline at 1-844-HELP (4357).  If you’d like to stay informed of federal and state-based health care issues, consider signing up to be an Advocate. Becoming a part of our Advocacy grassroots network is an easy way to get involved and stay informed.

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