Archive for December, 2016

#CoverageMatters: Being Insured Helps Me Fly

December 9, 2016

This post originally appeared on

When you’re riding a BMX bike, it feels like you’re on a roller coaster. But instead of being stuck on a track, you’re free to go wherever you want.

I’ve been really fortunate to get paid to ride. It started out as a hobby when I was younger, and I loved doing it more than anything else. I’m 26, I’m still riding and I’m able to make a living off of it. But the job doesn’t provide health insurance, and you can imagine how important coverage is to a BMXer doing the type of riding that I do.

Thanks to the Affordable Care Act, I was able to stay on my parents’ plan until I turned 26. I stressed out a little bit about signing up on, because I had heard some bad things from critics. But my girlfriend, who had enrolled last year, was like, “just do it; it takes like 15 minutes.” And she was right. It was extremely easy to shop and sign up for a Health Insurance Marketplace plan.

When you’re in your 20s, you feel almost invincible. Your body feels good and you’re healthy, but you can get hurt at anytime, anyplace. Unfortunately, I know a lot of people who couldn’t afford coverage before the Health Insurance Marketplace opened for business, and when they got injured, they went into debt for thousands of dollars.

Some of my friends refused to get care because of the cost. When you get hurt, the last thing you should be thinking about is how much it’s going to cost; you should just be focused on getting checked out and taking the steps to recover.

I was blown away by how affordable the Marketplace plan is. I pay only $32 a month after the tax credit and have a $500 deductible. Because of the Affordable Care Act, most Marketplace customers can qualify for a plan that costs $75 or less a month after financial assistance.

So if you’re in a similar situation, and you’re figuring out your own insurance for the first time in your life, I absolutely think you should check out the Marketplace at

It’s important for me to keep my coverage, because I don’t want to go into huge debt if I get hurt or sick. I want to keep doing what I do as long as I can. I was blown away with how affordable the whole process has made it and, yeah, it was a huge weight off my shoulders.

You can now enroll in your own coverage for 2017. Marketplace Open Enrollment goes until January 31, 2017, but if you want your coverage to start on January 1, 2017, you have to sign up by December 15.

Check out your options for affordable, quality coverage at Financial assistance may be available to help you get covered. And you can get 24/7 help comparing plans and enrolling in coverage by calling 1-800-318-2596 or finding in-person assistance in your community at

I’m sharing my story because my #CoverageMatters, just as it does for millions of other Americans. Every story is unique. Share your story on social media using #CoverageMatters.

I love riding my bike so much that I don’t think I could ever stop. But I know it’s not smart to ride without health insurance. So before you get on the bike, make sure you get covered.

Time to Get Covered for 2017!

November 15, 2016

The Marketplace officially opened on November 1st, and now is the time to enroll or change your Marketplace health insurance for 2017. There are a few key dates to remember as you think about your coverage needs for 2017:

  • December 15, 2016: Last day to enroll in a plan for your coverage to start January 1, 2017.
  • January 1, 2017: 2017 coverage starts for those who enroll by December 15.
  • January 31, 2017: Last day to enroll in a 2017 health plan. After this date, you can enroll or change plans only if you qualify for a Special Enrollment Period.

You may also have questions now that the election is over. Here’s some information to keep in mind:

Open Enrollment 2017 Post-Election is Here!


Find the Spanish version below:

Open Enrollment 2017 Post-Election is Here! (Spanish)

What’s the Deal with Financial Help?

November 9, 2016

So you’ve heard about Obamacare. You want Obamacare. But you’re worried about your budget.

Totally understandable. The good news is that financial help is available to lower your health care costs.

Here are the facts:

  • If you qualify, you can get help paying your monthly health insurance cost, or premium.
  • More than 4 in 5 people who already signed up got financial help.
  • The amount of financial help you qualify for is based on your income and the size of your family.
  • You can see what you might qualify for by entering some quick info into this Calculator.

Remember: If you don’t have health insurance in 2017, you might get stuck with a fine. And the fine is even bigger this year. It’s $695 per adult or 2.5% of your income, whichever amount is higher. So take the first step — see what financial help you might qualify for!

See what you qualify for

What You Need to Know About Plan Types

July 13, 2016

There are several types of plans to choose from in the health insurance marketplace. You might notice that many plans have 3-letter codes in their names: HMO, PPO, EPO, or POS.

Those letters tell you a little bit about what kind of provider options you have under that plan. A provider is a doctor, hospital, pharmacy, or other person or place you visit to get health care services. Here’s a little more about each type of plan:

  • Exclusive Provider Organization (EPO): EPO plans only cover services if you see doctors and other health care providers that are in-network, unless there’s an emergency. While you don’t need a referral to see a specialist, your plan might have fewer providers in-network for you to choose from.
  • Health Maintenance Organization (HMO): Often, an HMO plan only covers doctors and hospitals that are in-network, unless there’s an emergency. You may need a referral from your primary care provider to see a specialist. Many HMOs focus on preventive care and wellness.
  • Point of Service (POS): POS plans often require you to get a referral from your primary care doctor before seeing a specialist. Often, you pay less if you see doctors and other health care providers who are in-network.
  • Preferred Provider Organization (PPO): PPO plans often do not require you to get a referral from your primary care doctor before seeing a specialist. Often, you pay less if you see doctors and other health care providers who are in-network.

Before you pick a plan, it’s a good idea to make sure your doctors and hospitals are included in the plan’s provider network. You can check by calling your doctor or hospital and asking if they accept the plan.

Need a hand comparing health insurance plans? Check out the Plan Explorer.

Get started

Immigrant Families Can Get Covered, Too!

June 23, 2016

If you moved to the United States from another country, welcome! Let’s talk about health insurance options for you and your family. Health insurance helps protect you (and your wallet) in case an unexpected illness or injury happens.

If you’re a U.S. citizen or you’re a lawfully present immigrant, you could sign up for a health insurance plan through the health insurance marketplace during open enrollment. That means you could qualify for financial help to lower your monthly costs — some folks could even qualify for free or low-cost coverage.

If people in your household have different immigration statuses, those who are lawfully present can enroll through the marketplace. Family members who do not apply for coverage in the marketplace will not be asked about their immigration status.

If you or someone in your family moves to the U.S. or their immigration status changes, they could qualify for a special enrollment period. That means they’ll have a 60-day window to enroll if they qualify.

There are a few facts you should know about marketplace plans:

  1. Financial help is available to those who qualify.
  2. You can get free, in-person help with your application. In many areas, you can get help in a language other than English.
  3. All plans offered in the marketplace must cover the important stuff: doctor visits, emergency care, maternity care, free preventive care, and much more.
  4. You cannot be turned down for health insurance based on a family member’s immigration status. And the information you provide to the marketplace cannot be used for immigration enforcement.

The marketplace opens for business starting November 1st, 2016 — mark your calendar, and get ready to get covered!

A Little Tip for New Dads

June 8, 2016

Parenthood comes with a lot of joy-filled moments, sleepless nights, and everything between. There’s also a lot of new stuff to figure out. This Father’s Day, we want to make sure that new and expecting dads know this: Having a baby or adopting a child gives you a special 60-day window to get covered through the marketplace.

Babies need a lot of care to make sure they get the shots they need and everything’s on track. Without health insurance, medical bills could add up fast. With health insurance, you can rest a little easier knowing that you and your baby are covered. Here’s what you need to know:

If you don’t already have health insurance, the whole family can get covered within 60 days of a birth or adoption. And you could qualify for financial help (sometimes your kids can get free or low-cost coverage even if you don’t qualify).

If you do have health insurance, you should update your marketplace account within 60 days of the birth or adoption. The amount of your financial help could change. You can add your baby to your current plan or shop for a new plan that better fits your new situation.

With health insurance, you’ll be one step closer to earning your “World’s Greatest Dad” coffee mug. And all you have to do is make an appointment to apply and get covered within 60 days of your bundle of joy’s arrival!

Make an appointment

What Every Graduating Senior Should Know About Health Coverage

May 24, 2016

Congrats Class of 2016 — you did it! Now what?

Before you turn your tassel to the left and walk down the stage, here’s one thing you should know: If you are under your school’s student health plan, you will likely lose your coverage soon.

But don’t worry! You have some options:

  1. Get covered through your parent’s health insurance plan. You can stay on your parent’s health plan until you’re 26.
  2. See if you could get health insurance through your employer. Ask your employer about the health benefits they offer and take advantage.
  3. Get your own plan through the marketplace. You’ll have 60 days from the date your student plan ends to get covered. Find the right plan that fits your budget and health needs. And remember: Financial help is available!
  4. See if you qualify for free or low-cost coverage through Medicaid. If you qualify, you can enroll at any time.

Here are a couple of post-grad life tips to help you get started:

Having health insurance gives you the peace of mind and protects your wallet. So before you go forth and conquer the world of adulting, make sure to get covered.

2016 Texas State of Enrollment Conference

May 18, 2016

Texas SOE 2016 Logo2


Thank you all for attending the 2016 State of Enrollment Conference! We hope you had a great time, learned a lot, and made many new and exciting connections.

As promised, the slides are available from last week’s plenary and workshop sessions. We look forward to working with you all in the field for the rest of the Special Enrollment Period, Open Enrollment 4, and beyond!

2016 Texas State of Enrollment Conference

Join Enroll America at the State of Enrollment Conference in San Antonio July 14-15.

With two days of plenaries, workshops, trainings, and networking events, the conference offered valuable opportunities to share ideas, learn from each other and plan for the future as we continue to help Texans enroll in and retain health coverage. Connecting with peers and partners from across the state as we took a critical look at what worked during the third open enrollment period for the health insurance marketplaces, what barriers remain to enrolling and retaining consumers in health coverage, and how we can continue working as a community to build and sustain momentum in our ongoing effort to get Texas covered for years to come.

Who: Enroll America and partners from all aspects of the outreach and enrollment effort

Where: Encino Ballroom, CentroMed, 3750 Commercial Ave, San Antonio, TX 78221

When: July 14-15, 2016

Conference Program



Program Overview

Enroll America convened our third state conference July 14-15, 2016, bringing together hundreds of attendees, including state and federal government officials, state-based and local partners, enrollment networks, and stakeholders in the health care sector. Attendees had the opportunity to hear and share lessons learned, new research, and best practices for ongoing outreach and enrollment efforts. With interactive and hands-on trainings, workshops, keynotes, and events, the conference offered valuable networking with Enroll America partners and staff from across the state and served as a premier opportunity to exchange learnings and build momentum for years to come. We hope to see you next year!

The agenda included sessions on:

  • Improving health insurance literacy
  • Helping consumers choose the right plan
  • Using data to support partner coordination
  • Digital/social media outreach
  • Working with city and county health departments
  • Consumer advocacy
  • Messaging and communications strategy
  • Overview of enrollment tools


Who Attends the State of Enrollment Conference?

The conference brings together attendees from all aspects of the outreach and enrollment effort, including navigators and assisters, state and federal government officials, state-based and local partners, hospital systems, health plans, enrollment networks, along with other stakeholders leading and implementing enrollment in Medicaid and the Health Insurance Marketplaces.

Conference Attendees



Conference Sponsors

Enroll America Texas would like to thank the following sponsors for making the 2016 Texas State of Employment possible!

Gold Sponsor:

CFHP Logo_stacked_tag_color

Silver Sponsors:




Scholarship Sponsor:

Ambetter%20from%20Superior%20HealthPlan%20Main Logo

5 Quick Facts About Health Insurance and Your Taxes

April 5, 2016

It’s tax time! While it may not be your favorite time of year, there are a few things you should know about how health insurance could impact your taxes.

  1. You must tell the IRS whether you had health insurance for the whole year.
  2. If you got financial help to pay for health insurance, you’ll get a form in the mail with info about your financial help. It’s called a Form 1095-A. You should enter this info on your taxes much like you would a W-2.
  3. If your income or family size changed during 2015, that could change the amount of financial help you qualify for. It’s possible that you’ll get a larger refund or owe some money back if either of these situations happened to you.
  4. If you had Medicaid or health insurance through work, you’ll simply check a box saying that you had coverage for 2015.
  5. If you did not have health insurance, you might face a fine of $325 per adult or 2% of your income. If you didn’t have coverage for part of 2015, the fine will be adjusted based on how long you were uninsured. (Some people may not have to pay the fine — learn more about exemptions here.)

If you don’t have health insurance, you should know that the fine increases for 2016. It’s $695 per person or 2.5% of your income — whichever is more. Yikes! Why not see if you could get covered?

Learn more

New Data: More than 1.3 Million Texans Got Covered During Affordable Care Act’s Third Open Enrollment Period

February 4, 2016

New HHS data shows Texans eager to enroll in quality, affordable coverage through the Affordable Care Act.

AUSTIN, TEXAS – Today, the U.S. Department of Health and Human Services (HHS) announced that more than 1.3 million Texans enrolled in health coverage through the Affordable Care Act during the third open enrollment period of the Affordable Care Act, which ended on January 31, 2016.

“Today’s announcement from HHS shows what we’ve been seeing in communities across Texas – consumers are hungry for affordable health coverage and jumped at the opportunity to protect themselves and their family,” said Mimi Garcia, Texas State Director for Enroll America. “And of the 1,306,208 Texans that enrolled or reenrolled in coverage, we know the vast majority of them received financial help to lower the monthly premiums and make their plan truly affordable. Despite these encouraging statistics, we know that there is more work to be done across the Lone Star State to continue educating Texans about their coverage options.”

During the third open enrollment period, Enroll America and its partners in Texas worked together in the final weeks to help Texans get covered. Eight out of 10 of the fastest growing markets between Week 12 and Week 13 are in Texas: Corpus Christ (17 percent); Harlingen (16 percent); Laredo (16 percent); El Paso (14 percent); Odessa-Midland (14 percent); San Antonio (14 percent); Abilene-Sweetwater (13 percent); and Lubbock (12 percent).

In fact, during the third open enrollment period alone, Enroll America and its partners offered consumers nearly 600,000 free appointments through the digital Get Covered Connector to meet with enrollment assisters across Texas that could sit down with them, answer their questions, and help them through the enrollment process.

With the open enrollment period now closed, Enroll America and its partners will continue to educate Texans on their health care options and also help those who qualify for special enrollment periods get the coverage they need.

Uninsured Texans who did not take action before the January 31 enrollment deadline will likely face a fine of at least $695, on top of having to pay out-of-pocket for treatment during 2016.

Though the marketplace enrollment period has ended, uninsured Texans who experience a qualifying life event such as having a child, losing job-based coverage, or getting married may be able to enroll in coverage before the next open enrollment period begins. Enrollment in Medicaid is also year round, so qualifying Texans can enroll in Medicaid today.

If any Texan has questions about their coverage or wants to learn more about their current enrollment options, they can schedule a free appointment with an enrollment expert in their community by using the Get Covered Connector.

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