What You Need to Know During Open Enrollment

The open enrollment period for 2020 is here! It’s time to consider whether or not to enroll in a new health insurance plan or change your health insurance plan. To begin, you need to understand what benefits you can receive with minimum essential coverage. If your employer offers Minimum Essential Coverage and you’ve been hesitant to enroll, let us help you understand how MEC can give you the essential health benefits you need most.

What is MEC?

Minimum essential coverage is an insurance plan that meets the Affordable Care Act requirements for health insurance coverage. Plans under MEC include marketplace, job-based plans, Medicare, and Medicaid.

Before the Affordable Care Act, insurers would not cover people who had preexisting medical conditions. Those who had used too much of their medical coverage in the past were also at risk of not receiving insurance coverage. MEC ensures that insurance is offered to all enrollees regardless of health status, or the plan selected.

What is open enrollment?

Open enrollment is a period where individuals and employees can change or enroll in health insurance. During this period employees can also set up a flex spending account or health savings account. They can also sign up for and adjust the number of various types of insurance, including:

• life insurance
• disability insurance
• vision insurance
• dental insurance
• legal insurance
• supplemental benefits

What coverage uses open enrollment?

Most types of health insurance use open enrollment periods, including Medicare, job-based health insurance, and individual market health insurance. Outside the open enrollment period, individuals must show proof of a “life event” such as marriage, childbirth, or new employment to be able to change insurance coverage. However, Medicaid, CHIP, travel insurance, and short-term health insurance do not use an open enrollment period.

Why should I consider MEC during open enrollment?

MEC covers ten essential benefits in order to ensure everyone can receive proper coverage. These benefits include:

• Laboratory services: preventative screening tests and diagnostic lab tests
• Emergency services: emergency care at a hospital, even at a hospital out of network.
• Prescription drugs
• Mental health and substance abuse: includes counseling, psychotherapy, mental health, inpatient services, and treatment for substance abuse.
• Maternity and newborn care: services during pregnancy, delivery, and after delivery
• Pediatric services (including oral and vision): These services keep your children healthy. They include dental checkups, eye exams, vaccinations, and well-child visits.
• Rehabilitative services and devices: A patient with disabilities, injuries, or chronic conditions receives coverage for physical, occupations, and speech therapy visits.
• Habilitative services and devices: A patient can receive coverage for services and devices that help them learn and improve daily skills.
• Ambulance patient services: services in outpatient care
• Preventative/ wellness services and chronic disease management: including cancer screenings, annual checkups, and more at no cost.
• Hospital visits: if you are in the hospital for inpatient care, your plan will help you pay your medical bills. However, it may only cover you for a certain period of time.

Minimum essential coverage can be an affordable option to ensure you and your family are covered during times of need. At SBMA we provide affordable coverage for all of our clients, with a variety of options, including telehealth, vision, and dental voluntary benefits.