It’s open enrollment season for health insurance plans, but the coronavirus pandemic has changed what employees and other insured people can expect. Open enrollment at most employers typically runs from late October to the end of November, and the government’s health insurance marketplace for individuals (both new and repeat enrollees) is open through Dec. 15. Here’s what you need to know before you sign up.
- Open enrollment for health insurance has begun at many employers and the federal government's health insurance marketplace.
- Most major health insurance companies are waiving cost-sharing for COVID-19 treatments through the end of the year and possibly into 2021.
- The federal government has mandated free COVID tests, but some insurers have taken advantage of loopholes to send a bill anyway.
- Telehealth has become more widespread, so if you expect to use it, check to see what any plan you're considering will cover.
You’ll Have More Choices, But Some Uncertainties
In recent years, health insurance companies have expanded their selection of plans, primarily with changes to deductibles and provider network sizes. This year, enrollees can expect even more choices.
While a wider selection may be a good thing for some, it will require people to spend more time researching. In fact, 71% of employees expect to spend more time reviewing their options this year, according to Voya Financial.
Many employers are stepping up to help make open enrollment go more smoothly, offering webinars, virtual enrollment fairs, and online enrollments. However, COVID-related benefits are still up in the air for the coming year, muddying the decision-making process.
For example, most major insurers have waived cost-sharing for treatments related to the virus through the end of 2020. Some have indicated that they are considering doing the same through at least a portion of 2021, especially as infection rates increase. But there’s no guarantee.
Also, while the federal government has mandated that health insurance companies provide free coronavirus testing, some insurers have taken advantage of vagueness in the wording to hand customers a bill for hospital and lab fees—sometimes in the thousands of dollars.
Consumers should make sure to check whether an insurance plan covers all COVID tests, including hospitals and labs outside the plan’s network, and whether there are any out-of-pocket costs associated with testing.
Virtual Doctor Appointments Are Here to Stay
Virtual doctor visits have been around for years, but they haven’t been widely used. During the pandemic, however, many physicians have made it the default option unless an in-person visit is necessary.
According to a report by McKinsey & Company, a management consulting firm, providers have seen a huge increase in telehealth visits, with 50 to 175 times the number of patients. What’s more, 76% of consumers have shown an interest in using telehealth in the future, compared with the 11% of consumers who actually used such services in 2019.
So if you want to take advantage of telehealth in 2021, check each plan’s benefits for copay and coinsurance information.
Medicare Advantage Plans May Also Offer New Benefits
In 2019, some Medicare Advantage plans began to offer supplemental benefits beyond basic medical care, allowing for better care and support for chronically ill and elderly patients.
But it’s important to note that not all plans offer these benefits, so be sure to read the plan description before applying. Also, just because a plan offers a benefit, it doesn’t mean you’ll qualify. And, unfortunately, you may not find out if you’re eligible until after you enroll. If you find a plan's description unclear, don't hesitate to call the insurer or to cross that plan off your list.
If you expect to sign up for a Medicare Advantage plan, the plan comparison tool at Medicare.gov can help you find one with the benefits you're looking for.