When & How Do I Enroll (or Re-Enroll) in the Marketplace?

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.

When 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 2015. 
  • 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.”

How 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 programs.

Enrollment at HealthCare.gov takes four steps:

 

  1. Set up an account. You’ll provide some basic information to get started, like your name, address, and email address. 
  2. 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. 
  3. 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. 
  4. 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 time.  

 

Where 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.

You 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.

Navigators 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.

Below 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. 

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Contacts: 

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

 

Marcus Cooper
phone: (512) 370-1382
cell: (512) 650-5336 
Marcus Cooper  

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. 

Last Updated On

March 14, 2018