Note: Aetna, United HealthCare, Humana, Oscar, or Scott and White are all withdrawing from the marketplace in 2017. If your 2016 coverage was with any of these carriers and you purchased it through the marketplace, we recommend contacting us to schedule an appointment to strategize for 2017.
Under the Affordable Care Act (ACA), online insurance exchanges called Marketplaces were created to help standardize and streamline the individual insurance market. By enrolling in a health plan through the Marketplace, you can receive guaranteed consumer protections while maintaining the flexibility to choose a plan that’s right for your individual needs. Open enrollment for 2017 begins Nov. 1, 2016, and ends Jan. 31, 2017.
There are four steps to obtaining coverage through the Marketplaces.
- Set up an account. You’ll provide some basic information to get started, like your name, address and email address.
- Fill out an online application. You’ll provide information about you and your family, such as income, household size, current health coverage information and more. This will help the Marketplace find options that meet your needs.
- Compare your options. You can see all the options for you and your family, including private insurance plans and free or low-cost coverage through Medicaid and the Children’s Health Insurance Program (CHIP). The Marketplace will tell you if you qualify for lower costs on your monthly premiums and out-of-pocket costs on deductibles, co-payments and coinsurance. You can see details on costs and benefits before you choose a plan.
- Enroll. After you choose a plan, you can enroll online and decide how you 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. Help is available if you have questions along the way.
Marketplace Application Checklist
When you apply for coverage in a Marketplace, you’ll need to provide some information about you and your household. It is a good idea to get this information together now so that you are ready when the time comes to enroll. Items required to enroll include:
- Social Security numbers (or document numbers for legal immigrants)
- Employer and income information for every member of your household who needs coverage (for example, from wage and tax statements such as pay stubs or Forms W-2)
- Policy numbers for any current health insurance plans covering members of your household
- A completed worksheet—called an Employer Coverage Tool—for every job-based plan you or someone in your household is eligible for. You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.
Some states run their own Marketplaces. In Texas, the Marketplace is run by the federal government. Either way, you get the same access to all of your Marketplace coverage options.
For help enrolling in the Marketplace, or for more information about individual insurance and health care reform, contact Tammera L Hollerich, Insurance Benefits Team today.