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Open Enrollment Fact Sheet

Open Enrollment Fact Sheet – What to Know to Get Coverage for 2021

The Health Insurance Marketplace Calculator provides estimates of health insurance premiums and subsidies for people purchasing insurance on their own in health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA).

GENERAL FACTS FOR 2021

  • You should review your plan each year to ensure it meets your health and budget needs.
  • Open enrollment for 2021 is November 1, 2020 to December 15, 2020.
  • There is a Special Enrollment Period available from February 15, 2021 to August 15, 2021.
  • CareSource and Celtic/MHS/Ambetter are offering Marketplace coverage for 2018 in all 92 counties for 2021.
  • Anthem is offering off Marketplace coverage in Lake, LaPorte, and Porter Counties. Anthem is also offering off Marketplace catastrophic coverage in Benton, Jasper, Newton, Warren, and White Counties.
  • Certified Indiana Navigators are available to help you enroll in a plan. Find one near you at by clicking this link.

THE PROCESS FOR GETTING COVERAGE

  • Review: review your coverage and look for a letter from your plan about how your benefits and costs may change next year.
  • Update: starting November 1, log in to the federal Marketplace and update your 2021 application – make sure your household income and other information is up-to-date for next year.
  • Compare: compare your current plan with other plans that are available in your area.
  • Choose: Select the health plan that best fits your budget and health needs. Contact a certified Navigator to enroll in your plan. Make sure you discuss:
    • What hospitals and doctors are “in-network”?
    • Are your current medications covered by the plan?
      • Is there a deductible associated with my medications?
      • Is a prior authorization required in order to have my medications covered?
    • Ask to look at the Summary of Benefits and Coverage, which provides an overview of what is covered under the plan as well as any costs to you associated with using the benefits.
  • Enroll: Open enrollment for 2028 coverage is from November 1, 2020 to December 15, 2020. There is also a Special Enrollment Period available from February 15, 2021 to August 15, 2021.

WHAT TO DO IF YOUR 2020 COVERAGE WILL NOT BE AVAILABLE FOR 2021

  • For Marketplace Plan Enrollees
    • The Centers for Medicaid and Medicare (“CMS”) will automatically enroll you in either a CareSource or Celtic/MHS/Ambetter plan.
      • You do not have to stay in this plan if it does not work for you.
      • You can enroll in a different plan on healthcare.gov during Open Enrollment.
      • If you do not enroll in a different plan on healthcare.gov, you will remain in the plan that CMS selected for you.
      • Regardless of what plan you will have for 2021, you must pay the first month’s premium to make your plan effective.
    • You will receive two notices: one from your current carrier and one from CMS.
      Information in Notices
      Carrier NoticeCMS Notice
      When your current plan endsThe plan name and plan ID for the new plan you are enrolled in
      When you can select a new planThe option to enroll in a different plan
      What you need to do to select a new planContact information for the Marketplace
      Contact information for the Marketplace 

  • For Off Marketplace Plan Enrollees
    • You will not be automatically enrolled in a plan like a person enrolled in a Marketplace plan.
      • You will actively need to select a plan during Open Enrollment.
      • You must pay the first month’s premium to make your plan effective.
    • You will receive a notice from your current carrier, which will contain:
      Information in Carrier Notice
      When your current plan ends
      When you can select a new plan
      What you need to do to select a new plan
      Contact information for the Marketplace