The Affordable Care Act, commonly known as Obamacare, offers millions of Americans affordable health insurance at no cost or low costs. People can apply for coverage during Open Enrollment; or in special situations like marriage or losing coverage outside this period.
Open Enrollment Period
Open enrollment is a yearly window that gives consumers a chance to enroll in Affordable Care Act health insurance plans. Under special circumstances, such as having a baby, getting married, or losing job-based coverage, people may sign up outside the annual open enrollment window as well.
eHealth assists consumers with selecting Affordable Care Act (ACA) plans that best meet their lifestyles and budgets, as well as calculating costs and identifying possible sources of financial assistance.
The Affordable Care Act, more commonly known by its initial acronym Obamacare, is an omnibus healthcare reform law passed in 2010 that seeks to both lower healthcare costs and increase access to quality, cost-effective coverage. It includes individual marketplaces where individuals can purchase health plans directly from insurers as well as small business exchanges known as SHOP that help small businesses cover employees. Consumers making less than 400% of federal poverty levels may qualify for premium assistance programs under this law.
Special Enrollment Period
Open enrollment period for individual ACA-compliant marketplace plans on and off of exchange is typically November 1-January 15, but certain qualifying life events can allow individuals to sign up outside this window.
People who become newly engaged, get married, give birth or voluntarily lose health coverage are all considered involuntary losers of health coverage. It also applies to people moving and survivors of domestic abuse/violence or abandonment who would like to enroll in separate plans from those responsible.
Notable life changes include divorce or legal separation that leads to you losing current coverage and death of a family member, qualifying you for a special enrollment period that typically lasts 60 days after such events occur and enrollment can be completed either online or over the phone. Even those without qualifying events may purchase marketplace plans through exceptions or go without coverage with a tax penalty payment option.
Qualifying Life Events
Every year, Americans are given an open enrollment period – usually lasting from November to mid-January – to sign up or modify their individual and family private health insurance plans. Under Obamacare, this enrollment period may also extend further if certain qualifying life events arise outside of it.
Life events that qualify as qualifying life events include changes in household size, the death of a family member or losing your current insurance policy. Some events can be verified with simple documents like birth certificates, marriage licenses or divorce papers; others require more substantial documentation like unemployment paperwork or death certificates.
Losing or changing jobs are both qualifying events; regardless of whether they were voluntary or involuntary departures. Furthermore, moving states might trigger its own special enrollment period for individual coverage options; so it is crucial that you know exactly which life events count as qualifying life events.
Changes to the Marketplace
Life events often alter Marketplace coverage, such as getting a pay raise or adding to their family. When they do so, it is crucial that these changes be reported because it could determine whether you save or must return tax credits.
From 2021, the Affordable Care Act will mandate health plans to offer reasonable access to in-network providers for low-income enrollees even when their plans have limited networks. The goal is to ensure these enrollees get access to care that is appropriate and necessary.
Starting January 1, 2023, individuals and families with income at or below 400% of the poverty level can gain assistance paying their Marketplace premiums by taking advantage of the “low-income” Special Enrollment Period. Simply answer some quick questions to determine your eligibility, confirm that any qualifying life events have taken place such as losing other coverage or becoming pregnant before shopping and enrolling.
