Healthcare open enrollment is a time period during which individuals can purchase or make changes to their current health insurance coverage. Under the Affordable Care Act, individual health insurance plans will have an open enrollment period for both On Exchange Plans and Off-Exchange Plans. In the past, before open enrollment, individuals could apply at any time but had to go through medical underwriting. If an individual had a serious pre-existing health condition they could have their request for coverage declined in its entirety or have the policy issued with a modified plan or with their pre-existing condition excluded.

Public and Private Exchanges – Healthcare Open Enrollment

A health insurance “exchange” is an online portal containing information, plan choices and enroll capability for health insurance. There are two types of exchanges – public and private. A Public Exchange is offered by a government entity. A Private Exchange is sponsored by a private entity such as insurance companies.

On Exchange and Off-Exchange Plans

On Exchange are those plans that are offered on the Public Exchange only such as Healthcare.gov. If you qualify for a subsidy then shopping On Exchange is your best option.
Off Exchange means those plans that available outside of the Public Exchange. The Open Exchange is supposed to offer a greater choice of plans. Unfortunately, this is not the case in Missouri. Most private insurance companies have chosen to remove themselves from the Open Exchange. With only a few companies competing the plans offered have been very limited and very expensive.

To make matters worse both the On Exchange and Off Exchange will not make their rates available in advance. This leaves the responsible consumer with the experience of not being able to become familiar with the different plans and prices in advance.

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