Dear Tom and Alan:
I’m pretty mixed up about the different open enrollment periods that are going on right now.
My parents are in the process of changing their drug plans, but since I’m in my forties that doesn’t apply to me.
I’m between jobs and so don’t have any health insurance (and very little money).
The least expensive plan I could find would cost me almost $400 per month (which I don’t have).
Tom: OK, let’s take your case first.
The Affordable Care Act (ACA, ‘Obamacare’) has not gone away; it’s still the law.
The penalties for not having health insurance have not gone away either.
For example, if you have been without insurance for more than three months this year, you are subject to a penalty of $695 or 2.5 percent of income, whichever is greater.
Of course, in your case it would be prorated on a monthly basis because you had some coverage on your last job.
However, if it has been less than 60 days since you lost your group insurance at your last job, you don’t have to wait for the open enrollment to start, and you don’t have to wait for a Jan. 1 effective date. And…there will be no penalty.
If more than 60 days, you can begin your application anytime and start your coverage on Jan. 1.
What could really work in your favor is if your household income is less than $47,520 for the year, you might qualify for a subsidy to help pay your monthly premium. Definitely worth exploring.
Al: As for your parents: the Annual Enrollment Period (AEP) has not changed.
Beginning Oct. 15 and ending Dec. 7, every year, Medicare recipients can change their individual prescription drug plan.
If they happen to be on a Medicare Advantage plan (Kaiser Senior Advantage, SCAN), they can change that too.
The strict limit of Oct. 15 to Dec. 7 has been in place for several years now. The effective date for any change is Jan.1.
About the only way around this strict limit is a Special Election Period (SEP) in which a change can be made for a specific reason.
The Centers for Medicare & Medicaid Services (CMS) has determined that residents in Lake, Napa, Solano and Sonoma counties are eligible for an SEP because of the recent wildfires.
The guidelines to qualify for this SEP are liberal: the beneficiary simply needs to attest that he/she lives in the area, or show proof using a driver’s license or utility bill.
This particular SEP runs through Dec. 31 and may be used only once. Enrollments taken Dec. 8 through Dec. 31 are effective Jan. 1.