As if fall isn’t busy enough for most of us, there’s one more thing to add to your adulting to-do list: open enrollment.
That’s the time – usually just once a year, and usually in the fall – when you may have an option to buy new health insurance, or to shop around and switch plans. The rest of the year, you may not be able to buy insurance at all, unless you have special circumstances like changing or losing your job, or getting married.
How Open Enrollment Works
If you don’t have health insurance, you have a 6-week window to get insured. Because of government cuts to the open enrollment program, you will now have just have 6 weeks, from November 1 to December 15 to shop for insurance and get price discounts. If you miss it, you could start pregnancy uninsured. that can make it more complicated, and more expensive, to get prenatal care. Find out where you can buy insurance directly in your state.
If your income is low or you are unemployed, check your eligibility for Medicaid. It varies depending on where you live, but you could be able to access low-cost or free care through medicaid and other state programs. If you do become pregnant and don’t have insurance, check your eligibility again. there are different rules for pregnant women, and the income cut-offs are generally higher. You can check your eligibility for financial assistance at the same web site where you shop for insurance in your state.
If you get insurance through your employer, you may have options. Some employers have just one insurance plan for employees, but others offer a choice of plans. If you’re married, you may also be able to add yourself to your spouse’s plan or add them to yours. When your employer announces open enrollment (usually in the fall, but it varies) look into what options you have to switch.
And don’t forget your other benefits! Make sure you’re signed up for the benefits you’ll want or need when you’re pregnant. You may have special savings options to help you put aside tax-free money for health care or childcare, and you may be able to select options that pay for maternity or paternity leave.
Sign-ups and changes to these benefits are usually handled during one open enrollment period. If you don’t sign up during this period, you may miss out. A small investment of time to understand your benefits could save you hundreds or thousands of dollars in the end. Read how one baby+co. mom saved thousands by being smart during open enrollment.
How to Compare Health Plans
If you have more than one health care plan option to choose from, focus on the price, out-of-pocket costs, and network.
Price is made up of your premium and deductible. The premium is the amount you (or your employer) pays each month for insurance. The deductible is the amount you have to pay for care (visits, procedures, etc.) before your insurance benefits kick in. In general, if you know you want to get pregnant, going with the lower deductible option will reduce your costs overall. Check out our health insurance abc’s for parents-to-be.
You’ll have to pay for things your insurance doesn’t cover. That includes all of the costs until you meet your deductible, and some types of visits or procedures that aren’t covered. Even when your plan covers something, you may have to pay a portion of covered visits.
Is there already a place you know you want to deliver your future baby? Or do you have a certain midwife or doctor group you love? Make sure you choose a plan that is “in network.” If you haven’t decided where you want to give birth, make sure you choose a plan that offers options, including birth center and midwife options, which are worth exploring.
Still a little confused? Come on into your Baby+Co. center for Plan, a class to help you get smart about money, before baby.
Our insurance specialists will be happy to review your plan and help you understand your benefits. Call and make an appointment today!