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Exchange Shopping Starts Now, But No Need To Rush

Filed by KOSU News in Health.
October 1, 2013

Well, today’s the day health insurance marketplaces open for business. And despite a partial shutdown of the federal government and some technical jitters, they’re available for insurance shoppers.

While Oct. 1 is a milestone in the implementation of the health law, other dates are likely more critical for consumers planning to shop for health insurance on their state marketplace.

Few consumers are expected to enroll in a plan right away, and that may be wise. It’s a good idea to start looking at the options early and to give yourself plenty of time for the application process. “Expect glitches” has become the catchphrase for officials working on implementation of the marketplaces.

“In the first week, first month, first three months, I would suspect that there will be glitches,” President Obama told NPR. “This is 50 states, a lot of people signing up for something. And there are going to be problems. And I guarantee you, there will be problems because we’ve got precedent. When Massachusetts, just one state, set this up, it took quite a long time. It took several months before everything was smoothed out.”

That’s not all. Health insurance is complicated. Understanding how the plans work and picking one that fits will take time, perhaps several visits to the marketplace website or conversations with people trained to help with enrollment.

“I think it’s going to be a pretty thoughtful process for most people to make a decision,” says Mila Kofman, executive director of the DC Health Benefit Exchange Authority.

The open enrollment period for 2014 marketplace coverage runs through March. The uninsured and people who usually buy their own policies on the individual market will make up the bulk of the 7 million people expected to buy coverage on the marketplaces, also called exchanges.

Dec. 15 looms large on the insurance calendar. The health law’s mandate that most people have coverage goes into effect Jan. 1. But consumers can’t wait until New Year’s Eve to meet that deadline.

In general, consumers who want insurance to begin on the first day of any month have to enroll by the 15th day of the previous month. So someone who wants coverage to start on Jan. 1 should buy a plan by Dec. 15. If someone signed up from Dec. 16 to 31, coverage would begin Feb. 1 at the earliest.

That could lead to a rush of activity around Dec. 15 before the Jan. 1 coverage requirements kick in and again in mid-March before the open enrollment period ends.

Second thoughts are OK. If people sign up for a plan but then decide during the annual enrollment period that they want to switch, they can do so as long as their policy hasn’t yet become effective, according to the Department of Health and Human Services.

If someone signs up in November for a plan that starts Jan. 1, for example, she could switch to another plan until Dec. 31. If she waited until after Dec. 15 to make a change, however, the new coverage wouldn’t begin until Feb. 1 and she would be without coverage in January.

Once a consumer’s plan actually becomes effective, in general no changes may be made until the following open enrollment period. Next year that will be between Oct. 15 and Dec. 7. There are exceptions if someone experiences a significant change in life circumstances, such as a birth, divorce, job loss or permanent relocation. [Copyright 2013 Kaiser Health News]

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