How long will it take me to enroll in a health plan?
- Online enrollment is efficient and fast.
- Shorter OEP means more pressure on those who help.
- If you’re already enrolled in 2020 and are considering switching to a new plan for 2021, it will be relatively quick.
- If you’re enrolling for the first time and need to create an account, expect to set aside at least 30 to 60 minutes.
- Come armed with your personal info.
- You can ‘phone it in’.
- Applying in person may reduce confusion.
As we get closer to the ACA’s eighth enrollment period, the exchanges have long-since worked out their initial bugs, and have been improving their user interface systems ever since. Enrollment is a fairly smooth process now, although it might still take you some time to figure out which plan you want.
But when it comes to the logistics of the enrollment process, a little advance planning will help to make your enrollment as simple as possible.
Online enrollment has become much more efficient – and fast
During Obamacare’s first open enrollment period, there was no shortage of media reports about the agonizing delays and online crashes that slowed users’ exchange enrollment – or brought it to a complete standstill.
But round two was much smoother, and round three was so smooth that there were very few extensions issued at the end of open enrollment in 2016. Most people had their enrollments sorted out prior to the start of the year; enrollment during January 2016 was relatively light, but total year-over-year enrollment continued to grow.
The fourth open enrollment period (OEP) began during President Obama’s final months in office, but President Trump was inaugurated when there were still several days remaining in open enrollment. His first executive order, signed just hours after taking office, instructed federal agencies to be as lenient as possible in enforcing the ACA’s penalties and taxes. And the Trump Administration opted to cut advertising and outreach for HealthCare.gov in the final week of open enrollment.
These actions resulted in lower total enrollment in HealthCare.gov for 2017, compared with 2016. Enrollment dropped again in 2018, after the Trump administration shortened open enrollment and simultaneously reduced marketing funding for HealthCare.gov, reduced Navigator funding, and ended contracts for enrollment assistance centers in 18 cities (but effectuated enrollment ended up being slightly higher in 2018, although, as Charles Gaba explains, it’s not an apples-to-apples comparison).
Enrollment dropped again in 2019, following more funding reductions for HealthCare.gov’s marketing and enrollment assistance, the elimination of the individual mandate penalty (effective January 2019) and the Trump administration’s decision to expand access to short-term health plans and association health plans.
Enrollment dropped again in 2020, but only slightly: The overall enrollment drop across states that use HealthCare.gov was mostly offset by an overall increase across the states that run their own exchange platforms.
$10 million in Navigator funding was distributed in HealthCare.gov states in advance of the open enrollment period for 2020 health plans, which was the same amount that Navigator organizations received the year before; the year-over-year funding cuts have stopped, at least for the time being. But that $10 million is in sharp contrast with the $62.5 million in Navigator funding that CMS distributed in HealthCare.gov states in 2016, before the Trump administration took over. Although there is still enrollment assistance available throughout the country, it’s spread more thinly than it once was.
But the fact remains that the enrollment process has become easier and smoother over time. The ACA itself faces other challenges from the Trump administration, Congressional Republicans, and in some cases, attorneys general who represent red states. But glitchy exchange websites are no longer making headlines, and that’s been the case for a few years now. People are able to sign up with relative ease, as long as they’re able to find a plan that fits their needs and budget.
Shorter OEP means more pressure on those who help
The enrollment window for 2021 coverage is just over six weeks long, as has been the case for the last few years. In most states, open enrollment will end on December 15, 2020, with all plans effective January 1.
Due to the funding cuts for the Navigator program, there are fewer Navigator organizations providing enrollment assistance in HealthCare.gov states (states that run their own exchanges provide their own Navigator funding, and have not been affected by the Trump administration’s Navigator funding cuts). This has resulted in fewer enrollment assisters and potential backlogs at enrollment assistance centers during the open enrollment period. In addition, insurers reduced or eliminated commissions for brokers in many states over the last few years, resulting in fewer brokers working with the exchanges to help people enroll (this trend has been reversing in many areas as commissions started to rebound in 2019 due to increasing insurer profits).
The enrollment process itself will vary from one applicant to another. If you’re already enrolled in 2020 and are considering switching to a new plan for 2021, it will be relatively quick — typically under an hour. But the compressed open enrollment period and reduced number of enrollment assistance centers mean that there could be a longer-than-usual wait if you need help picking a plan.
If you’re enrolling for the first time and need to create an account with the exchange, expect to set aside more time to complete the enrollment. The average new enrollee who receives enrollment assistance takes about 90 minutes to complete the process, although some enrollees will find that it goes faster than that (again, it varies from person to person; if you’ve got a long list of medications that you need to check against each plan’s covered drug list, it’s going to take longer to pick a plan than it would for someone who doesn’t take any prescriptions).
Come armed with your personal info
To make the process as smooth and fast as possible, make sure you have the following information available when you begin your enrollment:
- Names, address, social security numbers, birthdays, citizenship status and email address. Most of this information will be needed for all family members who will be included on the application.
- Household size and income. (Here’s how income is calculated under the ACA. A pay stub, W2, or 2019 tax return will help make this info as precise as possible; in some cases, you’ll have to provide concrete proof of your income in order to obtain a subsidy for 2021.)
- Coverage details and premium for any employer-sponsored plan available to you or anyone in your household. HealthCare.gov has a form (referred to as an employer coverage tool) that you can ask your employer to complete in order to determine whether the coverage that’s offered to you via your job is affordable and provides minimum value (if yes on both counts, you won’t be eligible for a premium subsidy in the exchange, and neither will your spouse or dependents if they’re eligible to be added to your employer-sponsored plan).
- Payment information (bank account or credit card) to submit the first month’s premium either to the exchange or directly to the carrier once you’ve enrolled.
- Your doctors’ names and zip codes, and a list of any medications you’re taking. Pre-existing conditions are no longer a barrier to enrollment, but you’ll want to check the networks of the available plans to see which ones include your doctors, and you’ll want to verify which local hospitals are on the networks of the plans you’re considering. If you’re taking prescription drugs, you’ll also want to see which of the available plans include your drugs in their covered drug list (formulary).
You can ‘phone it in’
If you’re not comfortable applying online — or if you do have difficulties setting up an account or completing the online application — you can enroll by phone. You could even have someone on the phone to help you go through the process of completing a paper application.
Health and Human Services (HHS) phone application and enrollment support is available 24/7 at 1-800-318-2596. State-based exchanges also have call centers that offer assistance by phone.
Some online health portals — hailed as a source of quick health insurance quotes — are now devoting more resources to phone support, with agents licensed in each state to help customers through the enrollment process. (You can call one of healthinsurance.org’s partners at 1-844-608-2739 to talk with a licensed, exchange-certified broker who can enroll you in an ACA-compliant plan.)
Applying in person may reduce confusion
As always, if you’d prefer to get help in person, your state exchange site or HealthCare.gov can help you find someone who can provide in-person help in your area (here’s the page on HealthCare.gov where you can find local assistance). But as noted above, you’ll want to plan ahead for this, as in-person assistance centers are likely to be quite busy during the open enrollment period for 2021 coverage.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.