The Health Insurance Marketplace:
Open enrollment begins October 1st.
The Arthritis Foundation is here to help you.
The United States Department of Health and Human Services (HHS) has recognized the Arthritis Foundation as one of the organizations helping Americans learn about the health care coverage available in the Health Insurance Marketplace. The Arthritis Foundation has been listed by HHS as a Champion of Coverage, recognizing our efforts to help consumers understand the coming options for quality, affordable coverage as a result of the Affordable Care Act passed in 2010.
Meet Jennifer Griffiths, PhD, chief mission officer of the Arthritis Foundation. She talks about what the Affordable Care Act means for people with arthritis, and gives a preview of the resources the Arthritis Foundation will offer to guide people through the Health Insurance Marketplace Open Enrollment Period.
What is the Health Care Marketplace?
The Marketplace is a new way to find health coverage that fits your budget and meets your needs. When you use the Health Insurance Marketplace, you'll fill out an application and find out if you can get lower costs on your monthly premiums for private insurance plans. You'll find out if you qualify for lower out-of-pocket costs.
Reminder: Open enrollment starts October 1, 2013. Coverage starts January 1, 2014.
Frequently Asked Questions
Health Insurance Marketplaces are state-based competitive Marketplaces where people and small businesses can shop for and buy private health insurance. The Marketplaces are not private insurance companies or government-run health plans.
With one application, consumers can find out if they qualify for health plans in the Marketplace, and other programs like Medicaid and the Children’s Health Insurance Program (CHIP), tax credits and cost-sharing reductions.
Consumers can apply for coverage and enroll in a health plan through the Marketplace starting October 1, 2013, and coverage starts January 1, 2014.
Whether you need health insurance coverage or have it already, the health care law offers important rights and protections.
Here are 10 ways the health care law protects you today and in 2014:
- Creates the Health Insurance Marketplace, a new way for you to get health coverage.
- Requires insurance companies to cover you if you have a pre-existing health condition.
- Provides free preventive care.
- Covers young adults under age 26.
- Helps you understand what you’re getting with a clear Summary of Benefits and Coverage.
- Holds insurance companies accountable by reviewing rate increases and making sure you get more value for your premium dollars.
- Makes it illegal for health insurance companies to arbitrarily cancel your health insurance just because you get sick.
- Protects your choice of doctors.
- Ends lifetime and yearly dollar limits on coverage of essential health benefits.
- Guarantees your right to appeal a health plan decision.
- Learn even more about how the Affordable Care Act affects you.
If you have job-based health insurance you like, you can keep it. You're considered covered. You may be able to change to Marketplace coverage if you want to.
Any job-based health plan you currently have qualifies as minimum essential coverage. You don't need to change to a Marketplace plan in order to avoid the fee that uninsured people may have to pay for 2014. If you'd like to explore Marketplace coverage options, please check here for more information.
No matter where you live, you'll be able to use the Marketplace to apply for coverage, compare your options and enroll.
The federal government offers its Health Insurance Marketplace education effort through a new, consumer focused website. Consumers can access this website 24 hours per day/seven days per week. Visit www.healthcare.gov.
You can also get information by phone 24 hours per day/seven days per week: 1-800-318-2596.
In addition, consumers can go to the healthcare.gov website and sign up for email and/or text message updates.
Se habla espanol? Go to www.CuidadoDeSalud.gov or call 1-800-318-2596.
If you are going to be access the Marketplace in your state, then we suggest you start thinking about the following items.
7 things you can do to get ready now:
- Learn about different types of health insurance.Through the Marketplace, you’ll be able to choose a health plan that gives you the right balance of costs and coverage. While plans and prices won’t be available until October, you can get a personalized checklist. Go to: https://www.healthcare.gov/quick-answers/#step-1
- Make a list of questions you have before it’s time to choose your health plan. For example, “Can I stay with my current doctor?” or “Will this plan cover my health costs when I’m traveling?”
- Make sure you understand how insurance works, including deductibles, out-of-pocket maximums, copayments, etc. You’ll want to consider these details while you’re shopping around. Visit Insurance Basics to learn more about how insurance works.
- Start gathering basic information about your household income. Most people will qualify to get a break on costs, and you’ll need income information to find out how much you’re eligible for.
- Set your budget. There will be different types of health plans to meet a variety of needs and budgets, and breaking them down by cost can help narrow your choices.
- Find out from your employer whether they plan to offer health insurance, especially if you work for a small business.
- Explore current options. You may be able to get help with insurance now, through existing programs or changes that are in effect already from the new health care law. Use our resources to get information about health insurance for adults up to age 26, children in families with limited incomes (CHIP), and Medicare for people who are over 65 or have disabilities.
When open enrollment starts on October 1, 2013, the US government will have official navigators who will be available in-person or via phone to help people without health insurance apply and understand the options for health insurance in their state. Navigators could be an individual or an organization that is trained and able to help consumers, small businesses, and their employees as they look for health coverage options through the Marketplace, including completing eligibility and enrollment forms. These individuals and organizations are required to be unbiased. Their services are free to consumers.
The Arthritis Foundation will not be serving as an official navigator. The Arthritis Foundation will, however, assist people with arthritis in finding the right insurance either in the Health Insurance Marketplaces or through Medicaid by connecting them to the navigator in their state.
Early this fall, the Arthritis Foundation will have a list of key questions that are arthritis specific for people with arthritis to use as they work with the official navigator to get enrolled in health insurance and to see if they qualify for tax credits or subsidies.
Please never give ANY of your personal or financial information to anyone who calls or emails you — ever. This includes date of birth, your Social Security Number, bank account and credit card numbers.
Scammers are always determined to find ways to deceive consumers, and the confusion citizens may experience with the Affordable Care Act’s upcoming implementation provides an opportune vehicle for deception. Anyone who is the victim of a scam attempt or is aware of one can file a complaint with the FTC at http://ftc.gov/complaint, and more information about current scams is available via the BBB’s Scam Stopper at http://www.bbb.org/scamstopper.