“Hey, Doc”: When and How Do I Sign Up in the Marketplace?

Sept. 30, 2013

This week, TMA’s “Hey, Doc” education campaign answers Texans’ questions about when and how to sign up for coverage in the new health insurance marketplace.

[Editors and reporters: Please feel free to use the content in its entirety or as the basis for a story. TMA physician experts are available to answer your questions. Also, every Wednesday, TMA will post a new video featuring TMA Board of Trustees Chair Carlos “ ‘Hey, Doc’ ” Cardenas, MD, answering questions about the Affordable Care Act’s health insurance marketplace. Check out our first and second installment videos, and a lot more information at HeyDoc.texmed.org.]

TMA’s third week of “Hey, Doc” education programming

When can I sign up?

Here are some important dates you should know relating to enrollment in the marketplace:

Open enrollment is expected to begin Oct. 1. That’s when you’ll be able to compare plans in the marketplace and enroll for coverage.

Dec. 15 is the last day to sign up for insurance in the marketplace for it to be effective as of Jan. 1, 2014.

Jan. 1, 2014, is when the individual mandate kicks in requiring most people to get insurance or pay a penalty.

The marketplace enrollment period will be open until March 31, 2014 — the last day to sign up for health insurance coverage for 2014. Certain circumstances may allow you to sign up after that date. Visit Healthcare.gov for more information.

How do I apply?

It is anticipated that starting Oct. 1, you will be able to shop for plans, file a marketplace application, and enroll in several ways: online at Healthcare.gov, by phone through the toll-free call center at (800) 318-2596, by mail, or with the help of in-person assistance programs. (See “Where can I get help signing up?”)

There is a single application regardless of which health insurance plan you end up choosing. Once you file, you will automatically find out if you qualify for breaks on the insurance premium, reduced out-of-pocket costs, or state health insurance programs.  

Enrollment at Healthcare.gov takes four steps:

Set up an account. You’ll provide some basic information to get started, like your name, address, and email address.

Fill out the online application. You’ll provide information about you and your family, like household income, household size, current health coverage information, and more.

Compare your options. You’ll be able to see all the options you qualify for, including private insurance plans, Medicaid, and the Children’s Health Insurance Program (CHIP), and any tax credits toward your monthly premiums or out-of-pocket costs on deductibles, copayments, or coinsurance. You’ll also see details about the costs and benefits of each plan option before you choose.

Enroll. After you choose a plan, you can enroll and decide how to pay your premiums to your insurance company. If you or a member of your family qualifies for Medicaid or CHIP, a representative will contact you to enroll.

You can find this information and more at MeAndMyDoctor.com and HeyDoc.texmed.org.

Below is TMA’s “Hey, Doc” content schedule through Oct. 30, 2013. We have content in the works through January 2014.

Where to Get Help, When to Sign Up

Week of Sept. 30: When can I sign up?
How do I sign up?

Who can/Must Enroll? Who Doesn’t Have to? What Are the Penalties?
Week of Oct. 7: Who can enroll?

Week of Oct. 14: Who must enroll?
If I have insurance through my work or my spouse or my parents, do I have to give that up and buy insurance through the marketplace?
Does the individual mandate mean I have to buy health insurance through the marketplace?

All about the Plans
Week of Oct. 21: Who can sell me this insurance?
How do I pick a plan?
How many plans can I pick from?
Can I keep the plan I have now?

Week of Oct. 28: What is covered by this insurance?

TMA is the largest state medical society in the nation, representing more than 47,000 physician and medical student members. It is located in Austin and has 112 component county medical societies around the state. TMA’s key objective since 1853 is to improve the health of all Texans.



Contact: Pam Udall
phone:(512) 370-1382
cell: (512) 413-6807

Pam Udall  

Contact: Brent Annear
phone: (512) 370-1381
cell: (512) 656-7320

Brent Annear  

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Check out MeAndMyDoctor.com for interesting and timely news on health care issues and policy.