The Affordable Care Act (ACA) is a health care reform law designed to increase access to insurance coverage among Americans, reduce costs and improve outcomes through consumer protections, regulations, subsidies, taxes and exchanges.
Obamacare offers an annual open enrollment period during which people can enroll for health plans for the upcoming year. This usually begins in November and typically concludes on January 15, though fully state-run exchanges have the option of setting their own deadlines.
Open Enrollment
Obamacare Marketplace plans are typically open for enrollment between November 1 and January 15 each year in most states, however if you experience a qualifying life event outside of this period you may qualify to enroll early or after January 15. You can also apply for Medicaid or Essential Plan any time throughout the year depending on whether your state has updated their income eligibility criteria as a result of COVID-19.
During open enrollment season, you have access to health insurance plans with various coverage options that suit both your needs and budget. To find one that meets both criteria, compare health plans online to find one that best meets both parameters. Ensure you have all required documents such as proof of citizenship, income documentation and expenses documentation prepared before beginning the application process.
Special Enrollment Period
Special enrollment periods occur when certain life events preclude them from enrolling during open enrollment, such as moving to a different area, getting married, having a baby or losing other qualifying health coverage. A special enrollment period lasts for 60 days following an event and provides the chance for them to either switch plans or apply for coverage all together.
One exception to this rule occurs if someone moves to an area with different qualified health plans (QHPs) available, according to HHS’s newly passed market stabilization rules, in April 2017. Under those regulations, Special Enrollment Period (SEP) eligibility would only apply if coverage existed prior to moving.
Individuals who possess a Qualified State Extended Health Reinsurance Arrangement (QSEHRA) may also qualify for this SEP if they can present evidence proving they lost coverage within 60 days and expect it to end. HHS has implemented a verification program for SEP applications; as part of this process they may delay or deny some applications until its completion.
Eligibility
When open enrollment period rolls around, most people can enroll or modify their existing plan on exchanges or enroll at another provider without incurring a qualifying event penalty.
Americans eligible for subsidies under the ACA health insurance exchanges may be eligible to receive assistance based on their household’s income; typically this assistance applies if it falls between 400% of poverty line or less.
Under the Affordable Care Act (ACA), it has become illegal for insurers to deny or charge higher premiums due to preexisting conditions, helping many Americans gain affordable health coverage. Open enrollment ends this Sunday on federal and most state-based exchanges; however, states with their own exchanges can set different enrollment periods; for instance New York residents can enroll year-round through New York State of Health while Medicaid as well as basic health programs are accessible year-round in Massachusetts and Connecticut.
Plan Choice
Under the Affordable Care Act (ACA), consumers without coverage through either their employer or Medicare can shop and enroll independently in health insurance plans through federal and state health insurance marketplaces, more commonly referred to as Exchanges. Participating companies are required to classify their offerings into four main categories – Bronze, Silver, Gold and Platinum.
These plans are created to keep costs low for both the insurer and consumer, by tailoring coverage specifically to individual needs. If someone is relatively healthy, a higher-premium plan might make more sense than one with lower premiums and larger deductibles.
As such, individuals should carefully assess both the monthly premium cost and out-of-pocket expenses such as copays and coinsurance when selecting an Obamacare plan during Open Enrollment or Special Enrollment Periods. At eHealth’s user-friendly site and licensed health insurance agents are here to assist with finding plans that best meet both their needs and budget requirements.
