First published in Landings, October, 2015.
It’s hard to believe the summer has passed and health insurance open enrollment is right around the corner again! This will be the third open enrollment period under the Affordable Care Act. Open enrollment for 2016 health insurance coverage starts November 1 and will end January 31, 2016. If you enroll in a plan before December 15, your coverage will start January 1.
The open enrollment period for 2016 is even shorter than in previous years so be sure to plan ahead to make your enrollment as simple as possible. And since the first two months overlap with the holiday season, if you wait you could get stuck scrambling during the closing weeks of open enrollment. The last few weeks are always extremely busy, so to avoid long waiting times on the phone or any technical issues with the healthcare.gov web site, it’s best to start the process early. Navigators are here to help you in person as well, but schedules have been known to fill up fast!
If you miss the open enrollment period you can only enroll in a plan for 2016 if you meet “special enrollment” criteria, meaning you have some sort of life event that would qualify you: for example, if you have a baby or get married or move outside your plan’s service area.
Maine residents will have even more choices this year as Aetna becomes the fourth company offering plans in the Maine marketplace along with Anthem, Community Health Options (formerly Maine Community Health Options) and Harvard Pilgrim. Plans offered by all four companies will range from bronze to gold level, with catastrophic plans available to those people 30 years old and under. All plans will cover the essential health benefits required under the Affordable Care Act, such as prescriptions, emergency services, preventative care, and pregnancy, maternity and newborn care. You’ll want to take your time to look through plan options and choose a plan that suits your needs. The MLA will be here to help you look through plan options, help answer questions and assist with enrollment if needed.
If you already have insurance through the Marketplace, re-enrollment will be similar to the previous years: if you enrolled in a plan using www.healthcare.gov you will be automatically re-enrolled in the same plan or, if your current plan is no longer available, in a similar plan. Insurance companies are required to let you know about any changes to existing plans or new plans offered during open enrollment. If you have experienced any changes to your contact information, household size or estimated household income over this past year it is best to update your healthcare.gov account as soon as possible to reflect your current situation. Federal health insurance subsidies are based on household size and estimated household income; lack of accurate information could affect your future eligibility.
Healthcare.gov will also reach out to you through mail or email to let you know about your re-enrollment.
Ways to enroll will be the same as before: online, in person with an assister or over the phone at the healthcare.gov call center (1-800-318-2596 open 24 hours a day, 7 days a week). Enrolling through healthcare.gov will allow you to apply for federal subsidies, which could help lower your health insurance costs each month.
If you have any questions regarding how to make updates, what plan options are available or how to enroll, please contact the MLA. We are here to help you understand your options and enroll in the best plan for you and your family.