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Open Enrollment Time on Healthcare

Open Enrollment at Healthcare.gov

November 1 – December 15, 2020


It is Open Enrollment time on Healthcare.gov November 1 – December 15, 2020. You can enroll by yourself; however, at no cost to you there are licensed agents trained to work through the confusing maze of insurance and save you money.


Know your needs first then review the plans offered.  ‘Doctor visits, medications, potential procedures, deductibles, etc’.  


There are three categories of providers available through the Marketplace (Healthcare.gov)


HMO – Health Maintenance Organization = managed care with referrals required.


EPO – Exclusive Provider Organization = you must use the doctors within the EPO network.  Out of network costs are not covered. 


PPO – Preferred Provider Organization – just like HMO and EPO the plan offers a larger network of providers who are participating without the need for a referral. 


The higher the deductible the lower the premium.  Look carefully at what is covered.  Always review the Summary of Benefits, this document will detail what is covered, and when, what will be your prescription cost, etc.  Understanding this will assist you in making a choice that works best for you.


When choosing a plan confirm that your preferred providers are in the plan; or, decide if you are willing to change.


For 2020 the maximum Out of Pocket amount has been increased to $8,550 single; or, $17,100 family. This is the most you will pay for healthcare for the year.


Each year, the participating companies determine deductible amounts as part of their risk management structure.  The participating companies are required to provide clear and consistent levels of care across all plans.


If you are taking medication for which the manufacturer offers assistance; then, always use their program.  Remember the amount of assistance provided will count toward your deductible.  Plan prescription refills to maximize the use of manufacturer assistance to cover your annual deductible.  For example, Victoza, will carry a cost of approximately $2,400 – the manufacturer assistance program will cover all but $25.  The difference of $2,375 counts toward your annual deductible.


Work with your agent to get the right plan for you within your budget.


For those blessed to have earned Medicare, contact your agent to review the many options available to you.  There are new plans available in Broward County for 2021.


Provided by Mark with Beg for More Insurance – 678-699-0848

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