How (and why) to switch your individual health insurance plan this Open Enrollment | hioscar Blog | Oscar
How (and why) to switch your individual health insurance plan this Open Enrollment
Here’s an easy, step-by-step guide to switching your health insurance carrier this Open Enrollment period.
Picking a Plan Oscar Health Insurance
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If you’re unhappy with your current health insurance plan, you’re in luck, because Open Enrollment (opens in new tab) is right around the corner, and it’s the perfect time to make a change. There are many different reasons to switch insurance carriers: your rates went up, or complicated network issues resulted in your doctor no longer taking your insurance. Maybe it’s as simple as wanting a better customer service experience. Whatever the reason, use Open Enrollment as an opportunity to break free and find a new plan!
You may be thinking, “Am I even eligible for another insurance company?” The answer is yes! If it’s available in your state, you can sign up.* The real question is, is the insurance company right for you? Let’s dive in to what you need to do to find the right plan.
Get your info together
Doing some research up front will help you find the best possible plan. Plus, getting this info together ahead of time will get you through the sign-up process much faster.
Look back: Review your medical expenses for 2019. Other than your monthly premium, where were you spending money? Was it a copay (opens in new tab) for a routine doctor visit like an annual physical or blood test, or was it an ongoing issue related to a more complex condition like diabetes or a mood disorder? Do you anticipate that you’ll need the same kind of care in 2020? Take a moment to recall your experience with your current insurance carrier - how easy was it get the help you needed?
Look forward: What’s your income looking like for the next year? Your income and family size determines whether you can get financial aid for your monthly premium. You’ll need to provide estimated household income for 2019 to see if you qualify for tax credits or financial aid. You can find more details on how to calculate your modified gross adjusted income here (opens in new tab).
What are your deal-breakers? List the doctors and medical facilities you can’t do without and then check which insurance carriers your preferred doctors and clinics accept. If you have prescriptions you depend on, you’ll want to make sure they’re listed in the 2020 formulary (opens in new tab) before you switch to a new plan.
Who else is going to be on your plan? If you’re covering any dependents, you’ll need their date of birth, social security numbers, immigration paperwork (if applicable) and job information for everyone you’re adding to the plan. For detailed information on adding dependants to your plan, visit our FAQ on enrollment (opens in new tab).
Now that you’ve reviewed your personal info, it’s time to choose a network type (opens in new tab) and metal tier (opens in new tab) for the coming year. If you’ve signed up for health insurance in the past, you already know this is where things can get confusing, so we’ve broken it down.
Network Type
The network you should choose depends on the amount of money you want to spend, as well as what benefits you’ll get:
The benefit of having no referrals: With Oscar, you don’t need a primary care doctor to give you permission to see a specialist - if you already know which doctor you need, you can contact them directly for an appointment. This makes seeing a dermatologist, chiropractor, allergist, pediatric endocrinologist, etc. much faster and easier. If you’re not sure what kind of specialist you should see, Oscar’s Concierge team (opens in new tab) can help you find the right doctor.
A premium (opens in new tab) is a bill you pay monthly to keep your health insurance plan active, and a deductible (opens in new tab) is the amount you owe for covered services before your insurance company starts paying for your care. Which one should be higher? That depends on your needs.
Word to the wise: Check and see what basic preventive care (opens in new tab) is included with your plan free of cost. Certain services like annual physicals from a primary care doctor, OB-GYN or pediatrician, flu shots, and newborn care may be made available for free in your state. Visit our blog for a full list of Oscar’s free preventive care benefits (opens in new tab).
Pick a metal tier
Now that you have an idea of how much you want to spend on your premium and deductible, the last step is picking a metal tier. Health plans are broken into Bronze, Silver, Gold and Platinum tiers - each plan offers the same benefits, but the monthly premium and annual deductible vary.
The perks of switching to Oscar
Oscar combines technology and customer service to provide a member-first approach that makes managing your health care as easy as possible. There are a number of perks, too!
Oscar is an EPO, which means lower premiums and no referrals needed to see a specialist.
Get a diagnosis and prescription 24/7 with Doctor on Call (opens in new tab). You can send a request via the app any time day or night and a board-certified doctor will call you within 15 minutes. It’s free with every individual Oscar plan.
See everything in one place: Plan details, labs, prescriptions, health history, bills, and ID cards are all viewable right in the Oscar app (opens in new tab) or on hioscar.com.
Securely message your Concierge team: You don’t have to go through an annoying automated phone system to get help because your dedicated Concierge team (opens in new tab) can answer messages securely right from the app.
Get paid for walking: Earn Amazon Gift Rewards for every day that you hit your step goal (up to $100/year).
Now that you’re ready to switch, here’s where to sign up:
Visit Healthcare.gov (opens in new tab) or your state’s Marketplace to sign up for your new insurance plan. If you think you qualify for financial aid, this is where you’ll need to go to get it.
If you already know what private insurance carrier you want to switch to, you can sign up with them directly.
If you still aren’t sure which insurance company you want, or you have more questions, you can contact an insurance broker.
Remember, switching to Oscar is easy! Ask your broker, get an instant quote (opens in new tab), or call 1-855-672-2788 to speak with an Oscar Enrollment Guide
You can sign up with a new health insurance carrier during Open Enrollment, from November 1st through December 15, 2019. In Colorado, Open Enrollment runs from November 1, 2019 through January 15, 2020. In New York, Open Enrollment runs November 15, 2019 - January 31, 2020. In California, Open Enrollment starts on October 15, 2019; visit coveredca.com (opens in new tab) to find out when it ends.
*Medicare and Medicaid are both government coverage programs that have specific eligibility requirements, so if you’re looking to sign up you’ll need to visit Medicare.gov or Medicaid.gov for instructions.
