Friday, October 31, 2014

Preparing for #ACA Open Enrollment


Families will soon have the opportunity to enroll in health care plans, renew their plan, or change to a new plan in the Marketplace.  Open enrollment is from November 15, 2014 through February 15, 2015. Please note that families can enroll anytime if there have been “life changes” (e.g. lost employment and insurance) or if they are eligible for Medicaid or CHIP.

4-ways-to-applyEnrolling for the first time
There are 4 ways for families to apply.  Families can enroll online, by phone, with a paper application, or with in-person help in your community.
  1. Enroll online
    Go to https://www.healthcare.gov/get-coverage/,  enter your state, and click “apply.”  Fill out an application, find out if you are eligible for subsidies, Medicaid or CHIP, pick a plan and enroll.
  2. Enroll by phone
    Call the 24 hour Marketplace hotline at (800)318-2596 or TTY: (855)889-4325.
  3. Enroll using a paper application
    Applications are found at http://marketplace.cms.gov/applications-and-forms/marketplace-application-for-family.pdf.   Instructions if more information is needed are found at http://marketplace.cms.gov/applications-and-forms/marketplace-application-for-family-instructions.pdf.
  4. Enroll with in-person help
    To find help in their community, families can go to https://localhelp.healthcare.gov/.

Enrolling again
If they enrolled in a plan through the federal Marketplace last year, families will get a notice from their insurance company that will explain if they will automatically be enrolled in the same or similar plan, or if they need to pick a new plan.  The notice from the Marketplace will let them know if they are automatically going to get a subsidy again.
It is important for families to know that they may change their plan, even if they are automatically enrolled.  The steps are the same whether auto-enrolled or not:   Steps to pick a new plan are:
  • Log in at www.healthcare.gov.   In your Marketplace account, find a 2015 application with pre-filled data.
  • Use Update the application with any changes link.
  • Then get new eligibility results, including premium tax credits and other savings.
  • Pick any plan available to complete enrollment.
Families should examine their new plan even if they are automatically enrolled in the same plan, since the plan may have changed in important ways – in premiums, provider networks, deductibles, copayments, and/or benefits.  
Families should also go onto the Marketplace website to see what their subsidy level will be, even if one is automatically provided, because there are some cases where subsidies may change even if family income and their plan’s premiums have not changed. 

And it is important for families to report any changes in income, family size, or other circumstances, since such changes may change the subsidies, if any, to which they are entitled.  (If a family receives a subsidy to which they are not entitled, they will owe money to the government at the end of the year.)
It’s also important for families to remember that their children may be eligible or Medicaid or their State Children’s Health Insurance Program even if the parents are not.

Families may now have access to plans for the first time, want to renew the plan they had last year, or even change to a new plan. 

Resources:

Marketplace (English/Spanish)
Getting Help
by Lauren Agoratus, SPAN, NJ

No comments: