Make Your Coverage Selections

There is a lot going on right now. No one would blame you for not knowing that the health insurance market plan open enrollment period recently began. For 2023 health care coverage, the open enrollment period runs from Nov. 1 to Jan. 15, 2023, so it’s time to consider your options. Remember, if you don’t act by January 15, 2023, you can’t get 2023 coverage unless you qualify for a Special Enrollment Period. Enroll by December 15, 2022, for coverage that starts January 1, 2023.

Want a reminder on exactly what the health insurance marketplace is? Of course: “A service that helps people shop for and enroll in health insurance. The federal government operates the Health Insurance Marketplace®, available at HealthCare.gov, for most states. Some states run their own Marketplaces.” [1] There’s plenty more explained at HealthCare.gov.

An important part of living your best life with psoriasis or psoriatic arthritis is finding a treatment that works for you and your unique experience with psoriatic disease. With the right health insurance, you may be able to significantly reduce the amount you spend on your treatments and health care provider appointments.

Because the health insurance market can be intimidating or uncertain, the National Psoriasis Foundation (NPF) has created a number of resources designed to help you navigate the enrollment process, whether you seek commercial insurance or qualify for Medicaid or Medicare.

What to Consider as You Pick a Commercial Plan

Determine your insurance plan needs.

• What was your deductible last year? Did you spend at least that amount?
• How many provider visits, hospital visits, and prescriptions did you have last year? Do you anticipate needing more or less care and services in the upcoming year?

Look closely at plan options to make your selection.

• Are my providers in-networks?
• Does this plan cover my prescriptions and services?
• Will I need a referral to see a specialist?
• Can I afford the monthly premium? Remember that if you miss a premium payment, you may lose your coverage and not be eligible to get coverage again until the next Open Enrollment.
• What is the deductible?
• What is the out-of-pocket maximum?
• What is the rating of this insurance company or plan?

When Can You Enroll in Medicare?

An Initial Enrollment Period is the first opportunity you have to select your Medicare coverage. You have an Initial Enrollment Period when you turn 65 – this includes the three months before you turn 65, the month of your birthday and the three months after you turn 65.

You may have to pay higher premiums if you do not enroll in Medicare when you first become eligible. If you are already receiving Social Security Disability, you will automatically be enrolled for Medicare after two years of receiving disability benefits (learn more with our free guide).

The General Enrollment Period is the period when you can enroll in Part A or Part B if you did not enroll during your Initial Enrollment Period. The General Enrollment Period for Medicare is January 1 through March 31 of each year. Your coverage starts on July 1.

Every year, open enrollment for Medicare plans is October 15 to December 7.

How Do You Enroll in Medicaid?

You can enroll in Medicaid at any time during the year. You can complete an application on the Health Insurance Marketplace or through your state Medicaid agency. If you are eligible, your Medicaid coverage will begin immediately.

 When you submit your Marketplace application, you can choose the option to “See if you may qualify for Medicaid or CHIP.” If you or anyone in your household is eligible for Medicaid, your information will be sent to your state agency. This is because Medicaid is offered through each state. Your state agency will then contact you about enrollment for Medicaid.

Do You Still Have Questions?

There is a lot to consider. That is why NPF’s Patient Navigation Center is ready to help you understand the marketplace and your insurance options. This article contains just a portion of the tips and information available to you for free through the Patient Navigation Center.

Patient Navigators are ready to offer free and personalized assistance, whether it’s figuring out your insurance coverage, finding a treatment that works better for you, or finding the right dermatologist or rheumatologist in your area.

[1] https://www.healthcare.gov/glossary/health-insurance-marketplace-glossary/