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ACA and You: How to Enroll and Access Your Health Care Options

As of October 1, 2013, the first ever open enrollment period has begun for individual and family health insurance plans under the Affordable Care Act (ACA). This is an important opportunity for women and their families without insurance to access quality and affordable health care options. Those currently without health insurance will be able to shop, compare rates, and choose plans that best fits their needs. Here is some of what you need to know.

What's the latest news?

Following the launch of Healthcare.gov, the Obama administration announced two key updates:

  • Consumers have until March 31 when the current enrollment period ends to enroll and not face fines. The previous deadline was February 15.
  • Website fixes are currently expected to be completed by the end of November.

Additionally, you can apply by phone at 1-800-318-2596. For the latest updates, visit Healthcare.gov.

What is the ACA’s open enrollment period?

The open enrollment period allows individuals and families to purchase health insurance plans that meet the requirements set forth in the ACA. Coverage under these new plans will begin no earlier than January 1, 2014. New health plans will provide coverage for essential health benefits defined by the ACA. Consumers who qualify will be able to apply for government subsidies and enroll without fear of being denied for pre-existing medical conditions.

Who needs to apply for coverage during open enrollment?

The new open enrollment period is for individuals and families who do not have employer-sponsored major medical health insurance meeting the requirements of the ACA. If you already have employer-based major medical health benefits, you do not necessarily need to enroll in a new plan during the open enrollment period, but rather through your employer’s own open enrollment period for group coverage. If your share of your employer-sponsored health insurance monthly premium is deemed too costly under the law, you may choose to opt out of that plan and purchase a qualified health plan with subsidy assistance, depending on your income level

What is an insurance marketplace and how does it affect me?

A health insurance marketplace will be established in each state, and every marketplace will offer assistance to help individuals and employers understand the available plans and decide which one best meets their needs. All insurance plans offered in state marketplaces must be designated as Qualified Health Plans. This means that they will include a set of minimum essential health benefits, comply with limits on cost-sharing (including out-of-pocket costs) for essential health benefits, and meet all applicable private-market reforms specified in the ACA.

Am I eligible for a subsidy to help me pay for insurance? If you purchase insurance through the marketplace, rather than buy directly from an insurance company, you will likely to be eligible for tax breaks and subsidies to help pay for your insurance plan. The assistance is available to those with incomes of up to four times the federal poverty level — this year, that’s $45,960 for an individual or $94,200 for a family of four — and will be calculated on a sliding scale. You can choose to take this subsidy as a tax credit or the government will pay the insurance company directly. All this information is helpful, but I’d feel more comfortable talking to someone.

Information from the Kaiser Family Foundation

Where else can I go for help?

For more information on how to get affordable health-insurance coverage that is right for you, visit www.healthcare.gov. You also can call the consumer hotline, toll-free, at 1-800-318-2596.

Important Dates to Remember

  • If you are not exempted from obtaining insurance, you are required to have insurance by January 1, 2014.
  • If you plan to purchase insurance from a state health-insurance marketplace, open enrollment begins on October 1, 2013, and ends on March 31, 2014.
  • If you purchase coverage through a state health-insurance marketplace before December 15th, 2013, your coverage will start on January 1, 2014.

For more information and to review your enrollment options, visit

www.healthcare.gov.

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