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Related: Editorials & Other Articles, Issue Forums, Alliance Forums, Region ForumsCan someone explain "open enrollment" periods to me (as pertains to Obamacare, etc.)?
Maybe it should be obvious, but it's eluding me. The Affordable Care Act (a.k.a. "Obamacare" has an open enrollment period, as does, I believe Medicare part B or D or something.
Why? Why not just have continuous enrollment? Why limit it? Or is it to force people from holding off until the second they need it? (in which case you could get around it with a 30 day period to go into effect or something).
stopbush
(24,397 posts)Obamacare enrollment was based on that model which sets a deadline for enrollment to get people off their asses and enrolled.
IF - however - you lose your job, or get married, or have a kid or any number of other life events occurs, you are allowed to enroll in Obamacare at that point, even if open enrollment is closed.
If you were on a health plan through your employer, you probably didn't qualify for Obamacare. Most employer-based plans have open enrollment once a year. That's when existing members get to make adjustments to their plans, adding or subtracting services, etc. If you're a new employee, you don't have to wait until the once-a-year open enrollment. You usually get your company-provided insurance 90 days after your date of hire.
If you had no insurance, you were given a 6 month "open enrollment" window to sign up for Obamacare. If you didn't take advantage of that, you'll have to wait for the next open enrollment period, unless some life event occurs that allows you to enroll in Obamacare. In the meanwhile, you'll be paying the IRS penalty for not enrolling.
elleng
(131,253 posts)but as a retired federal employee, I can confirm that open enrollment occurs ever year at the same time, so all but 'newbies' register or re-register at the same time.
cbayer
(146,218 posts)switching plans multiple times during the year.
If you have certain changes in circumstances (moving, divorce, having a child, etc.), you can change your plan without penalty at any time.
handmade34
(22,759 posts)"...Again, I think having a defined open enrollment period is one of the ways you make an assessment if you have a pool (old/sick vs. young/healthy) that works or not. You can't have an unlimited open enrollment period with any insurance company because that really doesn't work."
Insurance companies limit enrollment periods so they can figure out who they're insuring, which allows them to calculate how much to charge for premiums..."
Nye Bevan
(25,406 posts)in the ambulance on the way to the hospital.
While the ACA guarantees coverage regardless of health, limited open enrollment periods mean that going uninsured is still somewhat risky.
(Of course it goes without saying that all of these issues would go away under single payer).
Agnosticsherbet
(11,619 posts)It explains it well in the link below. In a nutshell, if you could sign up for insurance anytime, why they fuck would sign up until you are in desperate need of medical attention. Why pay for insurance for years, even decades when you don't need it until you get ill. If you could wait until you are on the way to the hospital and sign up in the back of an ambulance, why would you pay for coverage when you could spend that money for a week in Cabo? This results in plans that are lower priced over the long run, because there are lots of healthy people who will not use it.
The rationale is that you want to restrict the ability of people who wait until they get sick or need health insurance to buy it, Leida said.
That makes selling plans outside of open enrollment a big risk for insurers, he said.
The main risk is that they would be the only one that decides to continue selling plans, Leida said.
Doing so could position an insurer to take on a large number of mostly unhealthy customers with higher costs.
stopbush
(24,397 posts)the uninsured to some extent. As of today, there are about 7-million people newly on Medicaid through the ACA who will be getting health care and who will most likely get preventative treatments that lower overall health costs.
Those who post-ACA elect to go uninsured and who end up in the hospital with major expenses will be on the hook for those expenses, just as they have been all along. The difference is that responsible people now have the option to get insurance through the ACA, so they can avoid those massive bills, when before they had no option.
Agnosticsherbet
(11,619 posts)But I've always tended to be more of an ant than a grasshopper.