Time is Running Out to Sign Up for Marketplace Insurance

Open Enrollment for Marketplace insurance ends January 31st. Even though the future of the ACA is less than certain, there are no changes to Marketplace insurance or Cost Assistance yet. If you are still in need of health insurance for 2017, please sign up at Healthcare.gov or your state’s Marketplace while you still can.

Support Marketplaces and Cost Assistance by Signing Up.

One of the ways you can show support for the ACA or specific provisions of the ACA is using the ones you are eligible for. Open Enrollment for Marketplace insurance ends January 31st.

• Everyone is eligible to use the Marketplaces to shop for and purchase health insurance even if they are not eligible for cost assistance.
• You need to make sure that every eligible qualifying dependent (including siblings, parents, or immediate family members of your current or ex-spouse) who you declare on your taxes, but who isn’t able eligible for a more affordable insurance, is signed up too.
• If you are not the custodial parent, but it would be more cost effective for both you and the custodial parent if you to insured your children, you can divide up the tax credits and deductions related to the children, so that you can sign be eligible for cost assistance to cover them. Having a non-custodial parent insure the children requires a tax form signed by the custodial parent and does not always give you the most tax benefits, so make sure you talk it over with the other parent first.

Show Support for Medicaid

Medicaid, Medicaid Expansion and CHIP are all potentially at risk of being cut, but there are some ways to show your support for Medicaid programs.

• If you live in a state that expanded Medicaid to income levels up to 138% for non-disabled adults and you are eligible, sign up. Expanded Medicaid includes state Medicaid Expansion programs like Healthy Indiana Plan 2.0, which is funded at least in part by Medicaid Expansion funding from an ACA provision. You should sign up even if you are offered employer-sponsored coverage.
• If you live in a state that hasn’t expanded Medicaid to non-disabled adults with low income and you would have been eligible if they had, you can still sign up to show support. At the very least, you’ll get an exemption from the requirement to have insurance or pay the fee for not having it by taking the time to have Medicaid denied. Acceptance by Medicaid is based on income and the state you live in even if your employer offers coverage.
• If your income is too high for Medicaid, your children may still qualify for CHIP depending on your state and your families income level. They can be eligible even is they are offered employer-sponsored coverage. If you think your children might be eligible, please apply for your state’s CHIP program.
• State Medicaid programs offer some additional cost assistance for Medicare covered people who are low income. If you are on a fixed income with SSI or SSDI, you should apply to see if you can get additional cost assistance for Medicare copays and deductibles.
• If you qualify for Tribal Health Benefits you are exempt from the requirement to have any other form of minimal essential coverage. However, signing up for Marketplace insurance results in your Tribal Health providers getting reimbursed for the care they provide (in addition to normal Tribal Health Funding) and they would not require copays for services provided through Tribal Health System.

Support Hardship Exemptions

President Trump’s recent executive order about the ACA may make it easier for those who find themselves in financially difficult situations either because of the ACA, employer insurance or for completely unrelated reasons. There’s no way to know how loosely the HHS will define “hardships” with regards to exemptions from the ACA, but it is an opportunity to try to show support for expanding and easing the process for getting exemptions. If you find yourself without insurance options that you can afford, or you are in a financially difficult position which leaves you unable to afford insurance, please apply for a hardship exemption. Even if you plan to try to maintain Minimal Essential Coverage, you can apply for an exemption and, if approved, you’ll be protected from the fee if you are unable to sustain coverage for financial reasons.

Support the Preventive Care Provision

Use the appropriate preventative care that the insurers are required to provide to everyone at no cost before deductible. Many people do not know that they are guaranteed these services, and it’s not uncommon for insurers to make it challenging to get this coverage at little or no cost.

• Find out what you are eligible for based on your age and other risk factors.
• Call your insurer and ask them directly for the covered billing code for each service.
• Report insurers who try to deny you coverage to your state’s Insurance Commissioner’s Office. Also, each state’s Insurance Commissioner was given additional funding in a provision of the ACA. You can support this provision by utilizing their services if you have any problems with insurers and need help.
• Make sure that you let your provider know the billing codes that your insurer provided at the time of service and that the provider is in the insurer’s network.