Health Reform 101 – Are you ready for Open Enrollment?

As Minnesota consumers start planning for their insurance needs for Open Enrollment and the opening of Minnesota’s health insurance marketplace, MNsure, starting today, October 1, 2013, the Minnesota Department of Commerce urges consumers to brush up on their insurance terms and learn about the health reform changes that will go into effect. Understanding the terms and components of health insurance coverage will help consumers find health insurance that fits both their financial and health needs.

 Open enrollment and MNsure, our state-based online health insurance marketplace, opens on October 1, 2013.  This is the beginning for the initial open enrollment period for products that will provide coverage beginning January 1, 2014.  Open enrollment for the first year of operation will run six months, until March 31, 2014.

 doctorConsumers who have not bought insurance before, open enrollment might be a new concept.  Open enrollment is the specific time of the year that someone can buy or change their insurance coverage. This year’s open enrollment applies to the new, enhanced benefit plans (including the Essential Health Benefits) and whether someone wants to buy coverage through MNsure or not.


Do I need to buy insurance during open enrollment?

In general, Minnesotans that already have health insurance coverage do not need to buy a new plan.

Consumers that have “minimum essential coverage” which includes government-program coverage like Medicare, Medicaid/Medical Assistance, the Children’s Health Insurance Program (CHIP), veteran’s coverage and TRICARE, or employer-sponsored coverage or individually purchased coverage do not need to purchase new coverage. However, it does not include plans that have limited benefits, like vision or dental plans, disability policies, or worker’s compensation plans. And beginning in 2015, high risk pool coverage and certain self-insured student plans will no longer qualify as “minimum essential coverage”.

Why should I look at new health insurance coverage during open enrollment?

Open enrollment is the best time for Minnesotans to explore coverage options – especially if you are an uninsured individual or family needing private insurance coverage.  If you already have insurance coverage in the individual market, open enrollment is a good time to learn about the new benefits that will be available or to see whether you qualify for financial assistance if you purchase health insurance through MNsure.

If you are uninsured, once open enrollment ends, it will be harder to get coverage.  After March 31, 2014, health insurance companies will not be required to accept people applying for individual policies until the next open enrollment.

Health Reform and Health Insurance – What Minnesotans need to know:

Essential Health Benefits

Individual and small group health plans will need to include a comprehensive set of benefits, covering services like hospitalization, emergency care, maternity care, and prescriptions.

Guaranteed issue

Health plan companies will no longer be able to deny you coverage if you have a pre-existing condition.

Rates and Premiums

Your premiums can only vary based on your age, where you live and whether you smoke.

Open Enrollment

Open enrollment for MNsure, Minnesota’s online health insurance marketplace, begins on October 1, 2014. If you buy a health plan through MNsure, you may qualify for financial help to purchase a policy or to reduce the amount you pay for care.

Help to Find Coverage

Agents, brokers, navigators, and other assisters are available to help you find coverage, whether or not you want to enroll in coverage through MNsure.

Scams and Fraud

Health reform has created new opportunities for scams, but there are many things you can watch out for when you’re buying coverage to prevent being a victim.

Still need help understanding your health insurance?

Check out Insurance 101 for some of the key terms you need to know.

Need more information or have more questions about health reform or health insurance? Visit our website to read more. You can also contact our Consumer Response Team by calling 651-539-1600 or toll-free at 1-800-657-3602 (in Greater Minnesota).

During open enrollment, as with any insurance transaction, the Commerce Department reminds consumers to take time to understand all of the options available. Whether buying coverage online through MNsure, with the assistance of a navigator or through a broker or agent, take time to understand the coverage.

The Minnesota Department of Commerce is here to help.

Call our Consumer Response Team at 651-539-1600 or toll-free at 1-800-657-3602 (in Greater Minnesota) if you have any questions about your insurance or if you believe you have been a victim of a scam or fraud.