It’s Beginning to Look A Lot Like Open Enrollment

The holiday season and Open Enrollment have arrived (whether we’re ready for it or not), and so have opportunities for your clients to spend time with their loved ones. Food, laughs, and gifts are likely on their agenda, but something else – something more important – may be as well: health.

Whether your clients are catching up with Uncle Mark who complains about aches and pains he didn’t have 5 years ago or they’re hanging out with Michelle from college who has a pre-existing condition and can’t afford major medical coverage, the topics of health and healthcare are likely to pop up. Have you helped your clients understand available coverage options? Let’s take a look at some of the features your clients could take advantage of:

Limited Medical Coverage

  • Helpful for those anticipating rising medical expenses, unable to afford major medical, not eligible for short-term medical, and/or looking for supplemental coverage to their major medical plans
  • Guaranteed issue coverage if eligibility is met and available in state
  • Premiums often lower than major medical, but also lower and more restricted benefits
  • Benefits such as $50-$100 paid toward doctor and specialist visits available
  • Not required to use a network of doctors – freedom to choose any doctor or facility (*Note: clients can still exceed eligible benefits)
  • Preventive care available for as low as $50
  • Next day coverage available or little to no waiting periods for accidental injuries or sickness
  • 12 month waiting period for pre-existing conditions
  • Does not count as minimum essential coverage required by the Affordable Care Act and is not suitable to serve as sole medical coverage

Short-Term Medical Coverage

  • Helpful for those facing life-altering transition periods such as pre-Medicare retirement, change in employment status, rolling off parental or student insurance, bridging a gap in major medical coverage or those who missed Open Enrollment (*Note: these policies are designed solely to provide healthcare coverage during unexpected coverage gaps)
  • Flexibility in coverage length and cost; coverage duration varies by state and is non-renewable
  • Variety of deductible and coinsurance options
  • Low copay options for in-network benefits
  • Limited preventive care available
  • Ability to cancel at any time without penalty
  • Benefits may be limited and subject to exclusions and restrictions
  • Does not cover pre-existing conditions
  • Coverage is not guaranteed
  • Not intended to be a replacement or alternative to ACA or other major medical plans and does not provide the minimum essential health benefits that are required; may result in a tax penalty

ACA Coverage

  • Helpful for those seeking major medical but who may not be able to afford it, those with pre-existing conditions, and those who need a broad array of health benefits
  • Option to change plan every year and to stay on policy as long as needed
  • Renews annually
  • Provides coverage for pre-existing conditions; applicants can’t be rejected based on health
  • Provides preventive care for individuals and families
  • Those enrolled may qualify for subsidies to lower costs
  • Provides minimum essential health benefits
  • Those who want to enroll must do so during the Open Enrollment period, the Special Enrollment period, or when a qualifying life event occurs

Critical Illness Coverage 

  • Helpful for those seeking an added layer of financial protection in the face of critical health concerns
  • Pays benefits directly to those enrolled or their designees
  • Benefits can be used to pay living expenses such as mortgage, rent, and car payments as well as prescriptions, copays, medical bills, and a myriad of other costs
  • Those enrolled can choose benefits up to $50,000
  • Limitations and exclusions may apply
  • Little to no waiting period

 

Help ease the minds of your clients this holiday season by educating them about available coverage options. While they add extra layers of clothes to stay warm, you can add extra layers of health and financial coverage to help protect them from potentially costly health concerns.

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This blog is for informational purposes only and is not intended to make any product recommendations. Encourage your clients to review any product details, such as costs, limitations, exclusions, restrictions, and benefits prior to any purchasing decisions.

Health Insurance Innovations, Inc. is a leading developer and administrator of affordable, web-based individual health insurance plans and ancillary products. We help consumers address their health insurance needs by offering access to a number of products offered by various insurance carriers.

For agent use only – not for use with the general public