How to be prepared for Open Enrollment
What to consider when shopping for health insurance during this Open Enrollment period
The leaves are changing color, temperatures are dropping, and everything smells of pumpkin spice. It must be time for our favorite season—Open Enrollment.
Whether you are looking to purchase health insurance for the first time or adjusting your current plan, there are some things you should consider when searching for a plan that is right for you.
What is Open Enrollment?
Open Enrollment is the time each year when you can select a health insurance plan or make changes to your current plan. If you don’t receive health benefits through your employer or your company’s health insurance doesn’t meet your needs, you may shop for insurance and compare the plans we offer through the UPMC Health Plan Marketplace.
Open Enrollment for individuals and families runs from Nov. 1, 2024, through Jan. 15, 2025.
These are other important dates to keep in mind:
- Jan. 1, 2025: If you want your coverage to take effect on this date, you must purchase a plan between Nov. 1 and Dec. 15, 2024.
- Feb. 1, 2025: If you want your coverage to take effect on this date, you must purchase a plan between Dec. 16, 2024, and Jan. 15, 2025.
What to consider while shopping for a health plan
Your health is your most valuable asset. Regardless of your age, health status, or occupation, there are numerous benefits your health insurer can provide to help you manage your health and well-being.
If you miss the Open Enrollment window, you may not be able to sign up for a health plan for another year unless you qualify for a special enrollment period.
5 Open Enrollment Tips:
1 – Consider how often you will use your health insurance.
- Are you going to the doctor’s office a lot? If so, you might want a plan with a low deductible and copays. If you go infrequently, you may want a plan with a low monthly premium.
2 – What network do you need?
- Which network is your doctor in? Use the provider directory on our website to find out.
3 – Are you eligible for a subsidy?
- We can help! Our account managers can walk you through the Pennie® website and help you figure out if you’re eligible for financial savings.
4 – Don’t forget the Open Enrollment deadline!
- Enroll by Dec. 15 for coverage starting Jan. 1, 2025. If you miss that deadline, you can enroll by Jan. 15 for coverage starting Feb. 1.
5 – Our customer service team is here to help. You can get help over the phone or through our easy-to-navigate Marketplace page to find a plan that is right for you.
What is considered a qualifying life event?
Big changes in your life may allow you to have a special enrollment period. This means you can buy coverage outside Open Enrollment.
The following changes are called qualifying life events.
If you have …
- Gotten married
- Had a child
- Lost your existing health coverage (possibly due to a change in employment)
- Moved to a location where your health plan is no longer available
- Turned 26 years old and lost coverage from a parent’s plan or guardian’s plan
- Experienced anything on this longer list of qualifying life events
… then you may qualify for the opportunity to enroll. You have 60 days from the date of your qualifying life event to find a new plan and enroll. Note that in some cases, dependents can remain on their parent or guardian’s plan through the remainder of the calendar year in which they turn 26. Those who are about to turn 26 should check with their current insurer to learn how long they will remain covered by that policy after their birthday.
What should I do next?
If you are new to buying insurance or want to learn more about choosing a plan that provides full in-network access to UPMC’s great doctors and hospitals, call the UPMC Health Plan Open Enrollment helpline at 1-877-563-0292 (TTY: 711) or shop using the UPMC Health Plan Marketplace starting on Nov. 1, 2024.
[1] Eligibility for financial assistance is based on annual adjusted gross income. Annual income amounts are determined by the federal government. To determine your eligibility for financial assistance, you must confirm your eligibility on the Pennie website.
