NEW OPTIONS FOR AFFORDABLE HEALTH INSURANCE
The Health Insurance Marketplaces are a main feature of the Affordable Care Act, or "Obamacare." They are a new way to purchase coverage. Here's what we need to learn and share with others!
What is the Marketplace? The Marketplace is an important part of the Affordable Care Act (sometimes called “healthcare reform” or “Obamacare”). It is a new way to purchase health insurance. You can enroll in coverage through the Marketplace October 1-March 31, 2014.
Where is the Marketplace? The Marketplace is not a physical place. It is helpful tool to compare health insurance plans and to get financial assistance with coverage. The Marketplace is accessible online at: www.healthcare.gov
Who needs to learn about the Marketplace? If you are uninsured, underinsured (your insurance is not adequate), soon to be uninsured, unemployed or currently covered by BadgerCare, you can benefit from learning about the Marketplace!
Does everyone have to use the Marketplace? No. If you have Medicare, employer-based insurance or commercial insurance that works for you, you will not have to purchase new coverage on the Marketplace. Some people on BadgerCare will have to shift into the Marketplace, due to changes in state law. Call BadgerCare member services (1-800-363-3002) to find out if your coverage will change. And be sure to open any letters from BadgerCare!
Under the Affordable Care Act, almost everyone is required to be enrolled in health insurance by March 31st, 2014 or pay an annual fee. This requirement excludes some groups, such as people who would have to pay more than 8% of their income for health insurance, those who qualify for religious exemptions, people who are incarcerated and members of Indian tribes.
What’s so “new” about the Marketplace? Before the Affordable Care Act, if people did not have insurance through their employer, could not afford their employer-offered insurance or were not covered by a public program (Medicaid or Medicare), they had to purchase commercial insurance on their own. This process could be long, costly and confusing. The Marketplace puts many commercial insurance plans in one place so that you can easily compare their costs and benefits.
It also makes coverage more affordable. How?
1) By providing federal subsidies (financial assistance)
- During open enrollment, Oct 1st- March 31st, you will need to fill out an application on the Marketplace to find out how much financial assistance you will receive. Filling out an application does not mean you have to buy insurance!
2) Through new regulations on insurance companies
- Insurance companies can no longer deny coverage or charge more based on pre-existing conditions, including mental illness.
- They cannot end coverage or charge more if you become sick.
- Every plan available on the Marketplace must include a core set of benefits called "Essential Benefits." Mental health and substance abuse services are part of these core benefits.
What if someone is interested in getting coverage on the Marketplace but feels uneasy or confused about it? There will be people to help us apply and understand our options. In Wisconsin, these people will be called Navigators and Certified Application Counselors (CAC). Their assistance will be available online, over the phone or in-person.
What happens if I miss the open enrollment period? (October 1st-March 31st, 2014) After March 31st, you won't be able to get coverage through the Marketplace until the next annual enrollment period, unless you experience a “qualifying life event” (e.g. moving to a new state, marriage, divorce, birth).
Take action! If you are interested in the Marketplace, visit www.healthcare.gov to complete an application. Spread the word to others you believe may benefit from affordable insurance!