Revenue Cycle
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Open Enrollment for 2021

by | Oct 28, 2020 | Affordable Care Act (ACA), Health Cost, Healthcare, Open Enrollment

What you need to know for Open Enrollment 2021

It is that time of year again, open enrollment season is only a few days aways.  Open enrollment is the period of time when individuals can enroll in an Affordable Care Act (ACA) health insurance plan or make changes to their current plan.  

For your coverage to start January 1, 2021, you must enroll in a plan between November 1, 2020, through December 15, 2020. Because we like to offer our clients the flexibility of enrolling patients early, if you are a client of American Exchange and use our online assessments to enroll, you can start your 2021 ACA Assessments NOW!

This year’s enrollment is sure to be unlike any other due to the Covid-19 pandemic, so it is important that you not delay in picking out a plan and get enrolled.

How to Choose a Healthcare Plan

Choosing a healthcare plan can be confusing.  It is important when evaluating your options to be careful to review the plan’s network of doctors and hospitals.  You will want to make sure your preferred doctor is in that network. Generally, the cheaper health plans have smaller networks, meaning you have less facilities and doctor’s offices to choose from.

Another important factor to consider is your medications and preferred pharmacy.  If you take medication regularly, whether it be for a chronic condition or something else, it is pertinent that you make sure your plan’s pharmacy (Rx) benefit covers what you are prescribed and what pharmacy you use.  Take time to go over the plan’s formulary, which is a list of prescription drugs that are covered by a specific plan.

Formulary – A list of prescription drugs covered by a prescription drug plan or another insurance plan offering prescription drug benefits. Also called a drug list.

Individuals that take a lot of generic prescriptions are encouraged to look for plans with “tiers.”  Tiers are groups of drugs that have a different cost for each group.  Lower tiered drugs will cost you less than a drug in a higher tier.  Make sure that you take the time to carefully compare the total cost of coverage for each plan you have in mind. 

Tiers –  The multiple levels of coverage based on the type of usage of the medication. Each tier will have a defined out-of-pocket cost that the patient must pay before receiving the drug.

2019 Patient Advocate Foundation

It is key that you do not look solely at premiums.  Make sure to note the deductible for your plan as well as any predefined copays and/or coinsurance costs.  Depending on your household income, you could be eligible to receive a premium tax credit to help you pay your monthly premiums. You can calculate your estimated monthly subsidy using this calculator.

Premium – The amount you pay for your health insurance every month.

Deductible – The amount you pay for covered health care services before your insurance plan starts to pay.

Copay – A fixed amount ($20, for example) you pay for a covered health care service after you’ve paid your deductible.

Coinsurance – The percentage of costs of a covered health care service you pay (20%, for example) after you’ve paid your deductible.

Premium Tax Credit – A refundable credit based on household income that helps eligible individuals and families cover the premiums for their health insurance.

I’m Ready to Enroll, What Now?

  1. Get your basic identification and required documents ready including:
    • Date of birth
    • Social Security number (if applicable)
    • Information about the members of your household (i.e. tax documents)
    • Home address
    • Immigration documentation (if applicable)
    • Tax returns (if applicable)
    • Employer and income information (if applicable)
  2. Go online to fill out your American Exchange 2021 ACA Assessment, using your client-specific URL.
  3. Be sure to upload any eligible documents to the assessment (see list of documents above).
  4. American Exchange will complete the rest of the enrollment process and submit each assessment for enrollment in a plan.
  5. Coverage starts Jan.1, 2021, and American Exchange helps ensure our patients maintain their enrollment throughout the year.


Do not be afraid to reach out to us if you have any questions. Our licensed insurance experts are on standby to assist you.

If you need assistance filling out your assessment, call us and we will connect you with an American Exchange licensed agent that will walk you through the entire questionnaire process and ensure your assessment is submitted successfully.

If you already know your client-specific American Exchange customer service phone number, please use it to call for information or questions about your assessment. Otherwise, feel free to call us at 888-995-1674 or email us at