Medical Cost Sharing: An Effective Alternative to Open Enrollment for Health Insurance 2021

woman jumping into water

The relentless increase in health insurance premiums is stressful, and those high deductibles just keep rising. Do you bite the bullet and pay-up for insurance or tempt fate and go without it? Either way, you’ve got to make a decision fast because once open enrollment is over, it’s done. You are stuck with your decision for a whole year. All this makes understanding open enrollment for health insurance 2021 a pretty big deal.

Life is a sea of endless and unpredictable possibilities – you never know what can happen. So you need to protect yourself as best you can from what could go wrong, but without draining your bank account. Traditionally, health insurance has been marketed as the life jacket we need to stay afloat when things get rough. No matter what happens, if we have our jacket on we won’t die. But, what if you can’t get to your life jacket in time? 


What Is Open Enrollment for Health Insurance 2021?

Unlike car insurance or home insurance, you can’t sign up for health insurance whenever you feel like it. Open Enrollment is the period every year when people are allowed to sign up for health insurance. So you have to drop everything during open enrollment to focus on making this important decision about your health insurance coverage for the year.   

Most people don’t know that you can cancel health insurance at any time of the year.  This is really important to realize because if you get a new job with employer-paid health insurance you will want to quit paying for your own health insurance whenever your employer’s health insurance has you covered. Some people quit health insurance mid-year and replace it with a medical cost-sharing plan like Scoop Health instead. Sounds pretty simple and organized right? Well, not really.

Missing open enrollment for health insurance 2021 means waiting a full 12 months until the next open enrollment window opens again for new health insurance options. The only exception to this rule is if you experience a ‘qualifying event’, making you eligible for a special enrollment period. This means enrollment outside of the specified time frame due to extenuating circumstances. Some qualifying events for special enrollment for health insurance 2021 are:

  • Getting married or divorced.
  • Having a baby or adopting a child. 
  • Taking in a child for foster care.
  • Someone on your marketplace plan dies, leaving you no longer eligible.
  • Moving to a different service area where your current plan isn’t available.
  • Moving to a different service area where you have access to new plans.
  • Involuntary loss of health insurance (usually job-related).
  • Becoming a United States citizen.

To get coverage with traditional health insurance in 2021, open enrollment must be completed between November 1 and December 15th 2020. This gives you around 6 weeks to untangle all the options and complete your open enrollment for health insurance 2021. Ever wonder why all the rush to squeeze everyone into such a tight time frame?


Motivation Behind Open Enrollment for Health Insurance 2021

Ever wonder why health insurance is so confusing? There’s co-pays, deductibles, in-network, out of network, and surprise coverage limits (always discovered at the worst possible times). It’s concerning that health insurance companies and hospitals actually get to negotiate all the prices for health care behind closed doors.

Under federal law, health insurance companies are only allowed to raise their monthly premiums as a function of the previous year’s rising claims. They actually profit more from rising health care prices and increased utilization of fee-for-service care. But how does open enrollment for health insurance 2021 support this?

Healthy people are the secret to keeping health insurance premiums stable. They are most needed to fill the insurance risk pool to balance out for all of the really sick people in the pool. So, health insurance needs as many people as possible to enroll in full coverage and spread out the risk. By shortening the enrollment period, people don’t take their time researching alternatives or kicking the can down the road. So, ending the open enrollment for health insurance 2021 sooner helps stabilize the markets.

But market stability is probably not your primary consideration when buying a solution to pay for your healthcare needs. Americans need to start asking themselves – is health insurance an affordable life jacket for me, or am I just another tiny bobber keeping the insurance industry floating high and dry?


Sinking with Open Enrollment for Health Insurance 2021

There are ways open enrollment for health insurance 2021 complicates your healthcare situation. There are a few things for you to be wary of before enrolling for individual or family health insurance. For example, open enrollment for health insurance 2021 can:

Make Research Tricky

Getting ready for open enrollment for health insurance 2021 requires a lot of preparation if you care about your health and want to be well protected. You need to do your research to understand all the numerous versions and plans available. This is tricky for most people. Understanding deductibles, co-insurance, in and out-of-network providers, HMO, PPO, XYZ, and coverage limitations are not quick or easy. 

After all, we’re not all insurance lawyers or rocket scientists!  Sometimes, it seems like insurance companies make things intentionally confusing and hard to decide. The open enrollment period is so short that some people just end up tossing a dart or flipping a coin to pick a health insurance plan. 


Proper Planning Prevents Poor Performance 

Most big life decisions benefit from careful planning. Health insurance is no exception. It’s important to shop around every year for the best health care solution because the individual market is volatile, especially after the COVID virus and pandemic.

Insurers change plan designs, coverage network, doctors and hospitals, and coverage limitations year to year. We all have a lot on the line so it’s worth your time to consider each healthcare option during open enrollment. You need to find a plan that is the perfect fit for your health, lifestyle and budget. Shortening the open enrollment window makes it more difficult to explore better options or alternatives to health insurance.

Fortunately, the best alternative, called medical cost sharing, is open for new enrollments all year long. So when you regret the choice of overpriced health insurance you picked during open enrollment 2021, you are not stuck. You can always quit health insurance without penalty and cut your costs by enrolling in a medical cost sharing organization, like Scoop Health.


Complete with General Insurance Caveats

Besides the open enrollment cons, there are other accompanying drawbacks to health insurance in general. When it comes to signing up for health insurance it’s Buyer Beware, because not all ‘Health Insurance’ is created equally. There are thousands of variables to be considered and circumstances to be aware of before the start of open enrollment for health insurance 2021. These include:

  • Some diagnostics, procedures and alternative medications will be excluded from coverage in every health insurance policy. This can lead you to compromise your care or be on the receiving end of surprise bills even after your deductible is already met.   
  • When insurance companies switch network providers, you can lose coverage for your doctor right in the middle of your treatment plan. 
  • There will be restrictions for some medical procedures, facilities and prescription medications. If you care about these things, you will need to read a lot of the small print to be sure you can live with the limits and restrictions.


Qualifying Events Are Too Narrow

The measure for what is considered a qualifying event for special enrollment is small. It doesn’t account for people who have simply procrastinated and left health insurance considerations to the last minute. Voluntarily terminating coverage or not paying premiums does not make you eligible for special enrollment. But what if your insurance carrier can’t help you or you can’t afford to make a payment? This leaves you with no other options for health insurance for the entire year. 

Create Easily Missed Communications

Badly crafted healthcare communications can be dense and confusing. Health insurance plans and designs can be very complicated, even for an expert to compare side-by-side.  You also have to frequently check communication channels to stay up to date with your enrollment information. This is time-consuming and frustrating for busy moms and professionals. It’s even more challenging for those less tech-savvy individuals and families who are searching for affordable health insurance protection.

Requires Constant Vigilance

Eagle-eyed focus is usually needed when sizing up health insurance renewal quotes and information. New plan designs can appear to be very similar but not identical. You don’t want to realize you picked the wrong health insurance plan when you are sick or in the hospital. It’s never good to find out your expensive health care is not covered by the health insurance you rushed into during the 2021 open enrollment window. You have to be highly aware of subtle changes in the coverage when re-enrolling because as they say, the devil is in the details.

Pay close attention to things that might matter in your personal situation. Like the network the insurance covers. You need to be sure your doctor is in-network or it could end as an expensive surprise the next time on your next visit. Of course, you will pay close attention to the obvious changes, like how much your premium has increased or how changes in co-pay will impact your budget for healthcare costs. You won’t have the chance to make changes to your insurance coverage if you were caught off guard. Once open enrollment for 2021 is over, you are completely stuck with your choice until open enrollment 2022. 

There is one big exception to the annual open enrollment limitations.  Some people are so frustrated with the hassle of open enrollment and ever-increasing health insurance premiums that they searched around and found medical cost sharing as a better way. They discovered there is actually a way to get off the annual open enrollment loop forever by dropping health insurance and switching to a medical cost sharing membership like the one offered by Scoop Health.

Open Enrollment for Health Insurance 2021

Considerations for Employers During Open Enrollment for Health Insurance 2021

Employers have more than a responsibility to make healthcare plans affordable for their employees.  

  • Employers need to attract the best employees to run their business properly. Especially after the Covid-19 pandemic, really great employee benefits might be the most important thing for job seekers coming back to work after the shutdown. 
  • Employers want to reward employees for loyalty and great performance. Health benefits are considered to be the number one employer benefit employees want the very most after the paycheck. 
  • Employers need to retain great employees long term. Employee retention is a prerequisite for growth in any business. Losing well-trained employees can be devastating to a business. Long term employees need to feel appreciated by their employer. Nothing shows appreciation like employer-paid health insurance.


During the annual enrollment is the only time your employees can adjust benefit elections, deductibles or plan designs. Open enrollment for health insurance 2021 is the one time your employees have to make these changes to their benefits. 

It is important for you as the employer to help your valued employees understand the health insurance options you are willing to pay for. Most employers expect the HR person or insurance broker to help educate employees on their choices and help with the decision making.

There are two concerns with this. First is that most HR people are not licensed health insurance experts. The second is that the more you spend on health insurance, the more money the broker makes.  Because 100% of insurance brokers get paid a percentage of the premiums you and your employees pay for health insurance.  

Many employers will absorb any premium increases and choose a passive enrollment because it simply re-enrolls all the employees with previous benefit choices. Only the new employees and those specifically requesting to make a change will need extra hand holding. This saves confusion and admin time, and means employees won’t lose any benefits in the new year 2021. On the face of it, this seems to ease the burden of open enrollment on employers. But does it really?

Here are ways that open enrollment for health insurance 2021 can leave employers disgruntled:

Increased Admin Burden

Employers almost always need to hold meetings for employees to prepare for open enrollment. This is in addition to sending out personalized renewal information to each of them. Personal situations do change and your employees could have complicated questions about their health, the coverage, or their plan options during open enrollment for health insurance 2021. Questions that an employer might not be able to answer about coverage alternatives like medical cost sharing plans. Your employee might ask for an employer contribution towards the cost of a medical cost sharing plan instead of paying their health insurance premiums.   

Status Quo Leads to Money Loss

Passive enrollment makes it easy for employees to just stick with the same plan every year.  This can blind employers to more affordable alternatives available, like medical cost sharing memberships. It can also leave employees feeling stuck with a plan that is not really in sync with their financial and healthcare needs. So if an employer just lets  the enrollment period slip by, they could end up paying a lot of money for coverage that no longer serves its purpose: to attract, retain and reward great employees. 

Employers Who Drop the Ball

Business owners are busy people. There are many pressing matters when you are an owner operator of a business, but this is a priority. If the employer forgets to enroll employees during open enrollment for health insurance 2021, they won’t have coverage. Something like that could undermine the confidence of your employees and lead to a mass exodus of your best employees.  This oversight affects employees’ lives, causing ill feelings, and a poor workplace culture.


What If You Miss the Boat for Open Enrollment for Health Insurance 2021? 

Let’s say you miss open enrollment for health insurance 2021. Missing open enrollment makes short term plans seem attractive, as they offer cheap ‘coverage’. But you know what they say, – you get what you pay for. So just how beneficial are cheap short term plans, instead of traditional health insurance? 

Most short term insurance plans pay you cash when certain events happen, like a stay in the hospital or a surgery. The amount of the payment is tied to the event and not the size of your medical bills. So while $1,000 per day for a 3 day hospital stay might seem like a lot of money, it might only pay a fraction of your large medical bills.

Remember short term providers are not required to cover essential health benefits and will cherry-pick what they will and won’t cover. These plans place a huge emphasis on an applicant’s health status. Short term plan providers might want to know the following before they’ll offer coverage: 

  • Plans for pregnancy.
  • Whether you currently need prescription drugs.
  • Current diagnosis, history and treatment for serious health conditions.
  • Substance abuse

These plans usually last less than a year and allow you to reapply at the end of each term. If you’ve been ill during this period or have developed a condition, you might get rejected. But are you buying coverage in case you’re healthy? Of course not! You want healthcare coverage that will protect you from high medical bills in all possible situations. 


Is Open Enrollment for Health Insurance 2021 Really Your Only Option?

Americans have been taught to think that insurance is the only protection against large medical bills and health care disasters. This narrative has entrenched many myths about the healthcare industry, like: 

  • Quality healthcare is expensive.
  • Doctors don’t accept cash.
  • Because of their size, insurance providers are the best at negotiating the best prices.
  • You have to be part of a good insurance network to get the best care.


But this couldn’t be further from the truth. There is no binary choice between protecting your family and gambling against fate. There is no reason to feel forced to consider health insurance options that confuse you or are just too expensive. There is another, even better, option – medical cost sharing. 

Fortunately, health insurance is no longer required for individuals, families, and small business employers. In one important way, medical cost sharing works a lot like health insurance. It pools the resources of a lot of people to protect them from expensive health care risks. The big difference is that In times of need, cost sharing members look to their community instead of a big insurance company.

It is an affordable alternative to traditional health insurance options because it eliminates much of the profits and overhead of a large insurance company. Medical cost sharing is a membership and new members can enroll anytime they like. No open enrollment for health insurance 2021 hurdles in sight!

Missing open enrollment for health insurance 2021 leaves you treading water, vulnerable to every wave life can throw. But medical cost sharing is a large life raft, built on the strength of a growing community with like minded ideas about health and paying each other’s large medical needs. 


Final Thoughts on Open Enrollment for Health Insurance 2021

There is no profit motive with medical cost sharing, but a mission to grow the community. The larger the community, the more diversified the risk pool becomes. Think of it as a swimming pool. If the pool is too small, then one person could make some waves. But if the pool is large then even a giant cannonball can only make a short splash.