Oct. 22, 2014
The second open
enrollment period for marketplace health insurance is just weeks away, but many
Americans remain confused about the what the marketplace does and what steps
they need to take to make sure they have health coverage.
Nine out of 10
uninsured Americans are unaware the second open enrollment period begins in
November, according to the latest Kaiser Health Tracking Poll. The Texas Medical Association (TMA) wants to
ensure Texas patients understand how to get and use their coverage through the
marketplace. That’s why TMA is relaunching its “Hey, Doc” education campaign to
offer clear, nonpartisan, updated answers to the most frequently asked
questions about the Affordable Care Act marketplace.
This week, TMA’s “Hey,
Doc” answers Texans’ questions about when
they can sign up for marketplace insurance, how to apply for coverage, and
where to get help enrolling.
Can I Sign Up?
Here are some important
dates you should know about 2015 enrollment in the marketplace:
- Nov. 15, 2014: Open enrollment
begins. That’s when you’ll be able to compare plans in the marketplace, find
out if you can get financial assistance, and enroll for coverage for 2015. If
you already have a marketplace plan from 2014, you can still shop around to
change plans, or keep your current one.
- Dec. 15, 2014: Unless you automatically
renew your current marketplace plan, this is the last day to sign up for
insurance in the marketplace for it to be effective as of Jan. 1, 2015. Check
with your health plan to make sure you pay your first premium on time.
- Dec. 31, 2014: All 2014 marketplace
coverage ends, regardless of when you signed up.
- Jan. 1, 2015: 2015 coverage begins.
Your new insurance will start on this date if you apply by Dec. 15. Or, your
2014 marketplace plan will restart on Jan. 1 if you automatically renew for
- Feb. 15, 2015: Open enrollment ends.
This is also the last day to sign up for health insurance coverage for 2015 and
avoid a penalty for going without coverage. (See Who Must Enroll? What If I Don’t?)
Certain changes in your life, like
losing a job, may allow you to sign up for marketplace coverage outside the
open enrollment period. Visit HealthCare.gov
for more information about the “special enrollment period.”
Do I Apply?
Starting Nov. 15, you
will be able to shop for plans, apply for coverage, and enroll in several ways:
online at HealthCare.gov, by phone through the toll-free call center at
(800) 318-2596, by mail, or in person. (See Where Can I Get Help Signing Up?)
There is just one application
regardless of which health insurance plan you end up choosing. Once you submit
the application, you will automatically find out if you qualify for breaks on
the insurance premium, reduced out-of-pocket costs, or state health insurance
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
- 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 help with out-of-pocket costs on
deductibles, copayments, or coinsurance. You’ll also see details about the
costs and benefits of each 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 apply for Medicaid or CHIP at any
Can I Get Help Signing Up?
Besides using the official marketplace website, Healthcare.gov, to apply for health insurance, the federal government has
created ways for you to get live and in-person help.
You can call a toll-free number, (800) 318-2596, and talk to a trained
customer service representative and get help in 150 languages. Online chats are also available.
Another way to get
assistance is through community health centers. Texas has more than 60 centers where you can get help with information and enrollment.
can also find a “navigator” in your community by calling the federal
government’s toll-free number or by searching
for someone in your area.
are organizations like a local United Way branch that the government has funded
and trained to help you. The navigator will guide you through the process of
selecting a health plan that’s right for you,
figuring out if you qualify for tax credits or state programs, and preparing
your electronic and paper applications. You also can viewa list of all navigators.
Be Covered Texas also
hosts local events to help families learn about the marketplace plans and
programs and enroll right then and there.
Both the federal government and Be
Covered Texas have Facebook, email, and texting campaigns that you can sign up
for to receive updates on the marketplace and reminders of important deadlines.
Reporters and editors, please feel free to use
this content in its entirety or as a basis for a story. You can find each
week’s “Hey, Doc” Q&A and a lot more information at Heydoc.texmed.org as well as in TMA’s
patient blog, MeAndMyDoctor.com.
is TMA’s “Hey, Doc” content schedule through Nov. 6, 2014.
Week of Oct. 29: How can I get ready to sign
up? What exactly is this marketplace and why should I care? Where can I get
more questions answered? Where can I find out more about the marketplace?
Week of Nov 6: Who can/must enroll? What if I
don’t? What if I have insurance through my work or family? Do I have to buy
insurance through the marketplace?
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.
phone: (512) 370-1381
cell: (512) 656-7320
phone: (512) 370-1382
cell: (512) 650-5336
Click here to follow TMA on Twitter. Or visit TMA on Facebook.
Check out MeAndMyDoctor.com for interesting and timely news on health care issues and policy.