By Jonathan Rothschild
On Oct. 1, open enrollment begins for the Health Insurance Marketplace, part of the Affordable Care Act, or ACA, also known as Obamacare. Whether you were for or against this legislation, it’s here, it’s the law of the land, and here’s what you need to know.
Young adults were some of the first beneficiaries of the ACA, which made it possible for them to stay on their parents’ health plans until age 26 regardless of whether they’re in school or where they live. Already, this provision has helped more than 3 million young adults get coverage.
The ACA eliminated many barriers to becoming insured. You cannot be discriminated against for pre-existing health conditions or gender. (The ACA banned the common practice of charging women higher premiums than men.)
The ACA eliminated other questionable practices, too, such as lifetime or annual caps on coverage, or canceling coverage for making a mistake on your insurance application. You cannot run out of coverage because you’ve hit your dollar limit with a catastrophic illness or injury, and you cannot have your coverage canceled—in some cases, retroactively—because you filled out a form incorrectly.
These changes apply to all health insurance plans, whether you get coverage through your employer, your parents or buy it yourself.
Plus, the ACA strengthened Medicare, which has already saved Arizonans nearly $123 million in prescription drug costs.
When the long-awaited Health Insurance Marketplace rolls out Oct. 1, however, the core benefits of the ACA will take effect, with more choice, more competition and more clout for consumers.
The marketplace will let consumers compare different coverage options and get accurate, easy-to-understand information, all in one place.
When you fill out a marketplace health insurance application, you’ll find out if you’re eligible for lower monthly premiums, deductibles, co-insurance (like a co-pay, but based on a percentage of your bill instead of a flat fee) and co-pays. You’ll also find out if you’re eligible for Medicaid and if your child is eligible for CHIP, the Children’s Health Insurance Program.
Beginning Oct. 1, you’ll be able to apply, compare plans and enroll online at HealthCare.gov, at CuidadoDeSalud.gov, over the phone, or in person with a trained navigator or certified application counselor. The websites have helpful, easy-to-find information in a simple format. There’s also a live chat function. You can also call 800-318-2596 to reach customer service representatives who can answer your questions in 150 languages. (TTY users, call 855-889-4325.)
Some organizations will help you apply in person. I’ll post a list on my website, MayorRothschild.com. If you choose this option, make sure you’re going through an organization approved by the Centers for Medicare & Medicaid Services.
The open enrollment period ends March 31. After that, with few exceptions, it won’t be possible to sign up until open enrollment begins again in October 2015. You can’t wait until you’re sick to sign up, just like you can’t wait until you have an accident to buy car insurance.
Millions of Americans are expected to get coverage through the Health Insurance Marketplace. That’s a lot of people finding out about their options. I would advise not waiting until the last minute to decide to join them. Start the process earlier, rather than later.
Finally, if you have Medicare, you don’t need to make any changes to your coverage. Visit Medicare.gov for more information.
Beginning Jan. 1, if you don’t have health insurance, you may have to pay a fee on top of any health care costs you incur. There are exceptions for those who can’t afford coverage. Again, the marketplace is the place to find out what those exceptions are.
With any new program, there are bound to be glitches. But I look forward to the economic and health benefits the ACA will bring our city, our region and our country. Many more Americans, including children, will finally have access to health care. And the savings—whether it’s lower insurance premiums or reduced costs of uninsured care—will put money in people’s pockets. That’s money they can spend on their families, their businesses and their dreams.
Find out what the Health Insurance Marketplace can do for you and the people you love. If you have family members who don’t have access to a computer, or who aren’t comfortable using a computer, offer to help. You can both learn what’s available. Finally, the information is out there. And for the first time, it’s all in one place.