If you don’t have a health insurance plan, consider enrolling during the Affordable Care Act (ACA) Open Enrollment Period. The ACA requires most people to have health insurance. Follow the steps below to make choosing and enrolling in a health insurance plan easy.

What is Open Enrollment for Health Insurance?

Generally speaking, open enrollment is a period of time when you are able to enroll in a health insurance plan, whether it is for an employer plan, or an individual plan. For individuals who buy their own health insurance, the period of interest is the Affordable Care Act Open Enrollment Period.

When is Open Enrollment for the Affordable Care Act?

Open Enrollment for 2019 plans: November 1, 2018 through December 15, 2018.

What if I Don’t Enroll in a Health Insurance Plan?

If you don’t have health coverage, you won’t have the protection from health and financial risks that health insurance provides. Enrolling in a health plan means that you'll have this protection, and if you qualify for Affordable Care Act subsidies, you will pay less to have it.

The Affordable Care Act requires that most individuals have health insurance, however the Tax Cuts and Jobs Act eliminated the penalty for not having health insurance, starting in 2019.

If you did not have health insurance in 2018 and did not qualify for an exemption, you will have to pay a penalty, which is the higher of these two amounts:

  • 2.5 percent of your yearly household income. 
  • $696 per adult and $347.50 per child for children under 18.

What if I Miss the ACA Open Enrollment Period?

If you didn’t enroll in a 2019 health plan before December 15, 2018, you will have to wait until the next Open Enrollment unless you have a qualifying life event.

How to Buy Health Insurance

Step One: Check if You are Eligible for a Subsidy

You may qualify for a tax subsidy from the federal government to help cover some of your costs. If you are eligible, you can choose and enroll in a health plan on the public Marketplace (also known as the “public exchange” or “on exchange” plans). Medical Mutual has several plans on the public Marketplace and also offers you direct access to enroll online.

If you don’t qualify for a subsidy, you can still choose and enroll in a health plan that meets your needs. Medical Mutual has many plans available outside of the public Marketplace (these are also called “off exchange” plans). You can apply for these plans online, through your insurance agent or by calling 1.866.488.3266.

For help choosing your plan, both on-exchange and off-exchange, contact your insurance agent or speak to a Medical Mutual licensed agent at 1.866.488.3266.

Note: If you qualify for Medicaid, you need to apply through your state.

Step Two: Choose the Health Insurance Plan that is Right for You

There is a lot to consider when choosing the best health plan for you. You will need to see if you’re eligible for a subsidy from the federal government and estimate your costs. This includes the monthly premium you can afford and the amount of medical services you typically use. You will also want to determine what type of plan is best for you – a copay or a high-deductible plan – and what metal tier fits your needs.

Medical Mutual offers copay and high-deductible plans in different metal tiers. We are sure to have one to fit your needs. You can search our provider network to make sure your favorite doctor or hospital is included.

If you need help comparing different types of health insurance plans, review our in-depth article.

Step Three: Enroll in your Health Insurance Plan

Based on whether you are eligible for a subsidy or not, you can apply for a plan through the public Marketplace, through your insurance agent or directly from a health insurer, like Medical Mutual. To speak to a Medical Mutual licensed agent for assistance with choosing and enrolling in a health insurance plan, call 1.866.488.3266.

No matter how you choose and enroll in your plan, remember to keep these key dates in mind:

  • November 1, 2018 – Affordable Care Act Open Enrollment begins. This is the first day you can enroll in a 2019 plan.
  • December 15, 2018 – Affordable Care Act Open Enrollment ends. This is the last day you can enroll in a 2019 plan. If you don’t enroll in a health insurance plan by this day, you will have to wait until the next Open Enrollment period unless you have a qualifying life event.

Enrollment dates for 2020 plans will be added when they are available.

Enrolling in a subsidy-eligible health insurance plan:
If you are receiving a subsidy from the federal government, you can choose and enroll in your plan using the public Marketplace. Be sure to gather the information on this checklist before you apply.

You can also enroll online directly through Medical Mutual. For help with choosing and enrolling in subsidy-eligible plans, talk to your insurance agent or call Medical Mutual at 1.866.488.3266. 

To determine if you may be subsidy eligible use our Tax Subsidy Calculator.

Enrolling in a non-subsidy-eligible health insurance plan:
If you’re not receiving a subsidy, you can buy a plan directly from your insurance agent or from Medical Mutual. Choose and enroll in a plan online or by calling our team of licensed agents at 1.866.488.3266.

Please note: If you live in the Columbus area, you must enroll in a Medical Mutual plan through the public Marketplace, even if you are not using a subsidy. You can apply directly through Medical Mutual here.