Archive for November, 2016
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:
Find the Spanish version below:
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.
- Some may even qualify for plans with lower out-of-pocket costs (lower co-pays, lower deductibles, etc.).
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!
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.
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:
- Financial help is available to those who qualify.
- You can get free, in-person help with your application. In many areas, you can get help in a language other than English.
- All plans offered in the marketplace must cover the important stuff: doctor visits, emergency care, maternity care, free preventive care, and much more.
- 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!
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:
- Get covered through your parent’s health insurance plan. You can stay on your parent’s health plan until you’re 26.
- See if you could get health insurance through your employer. Ask your employer about the health benefits they offer and take advantage.
- 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!
- 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:
- If you’re worried about paying for your new health insurance, find out here to see if could qualify for free or low-cost coverage through the marketplace or Medicaid.
- If you have questions or need help with your marketplace or Medicaid application, free, in-person help is available.
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
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
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.
Enroll America Texas would like to thank the following sponsors for making the 2016 Texas State of Employment possible!
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.
- You must tell the IRS whether you had health insurance for the whole year.
- 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.
- 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.
- If you had Medicaid or health insurance through work, you’ll simply check a box saying that you had coverage for 2015.
- 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?
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.
Steven’s Health Care Story: “I Still Intend on Living A Whole Lot More”
January 21, 2016
This post originally appeared on WhiteHouse.gov.
Today is National Youth Enrollment Day, a collaborative effort to educate young adults cross the country on the importance of having health insurance. Find out how you can get covered at HealthCare.gov.
It was a cold February day like any other in Washington D.C., and my recreational soccer team was meeting up after work to prepare for our game. As we played that night in the snow, I began to notice some pain in my lower back. I shrugged it off. I was playing hard, I wanted to win, and I figured I had probably just hurt myself in the gym.
After ignoring the pain for several weeks, I finally convinced myself to go see a doctor at my local urgent care. The doctor there checked me out and noticed that I had developed some swelling in one of my testicles. She referred me to a specialist right away, and in one week I saw a urologist, had an ultrasound done, an MRI, a CT scan, blood work, and eventually an oncologist only to learn that I had stage III testicular cancer with a 7.5 cm tumor growing in my abdomen.
I remember being shocked when I heard the “C-word” for the very first time, as I imagine anyone would be. How could this have happened? I’m an active, healthy 25-year-old guy. I felt as though my whole world was spinning out from under me. It turns out that testicular cancer is just bad luck, an unfortunate mutation of my DNA. But let me tell you, that doesn’t make the diagnosis any easier to bear.
Fortunately for me, testicular cancer, even at stage III, is curable. But not without a fight. After two major operations, three months of chemotherapy, and more doctor visits than I can count, I was given the news I was always hoping for, but never promised. I was declared cancer-free in October, and this horrible burden was lifted from my shoulders.
The holiday season just came and went, and I have a lot to be grateful for. Most importantly my health, but I have a lot to be thankful for in terms of what went right for me. I am grateful that I never hesitated to go to the doctor when I first suspected something was wrong. I was able to do that because I had health insurance. In fact, I was still on my parent’s plan. I am grateful that as I turned 26, halfway through chemotherapy mind you (that was a fun birthday), I was able to enroll in a plan of my own, no questions asked. I’m even more grateful that I don’t have to worry about having a pre-existing condition follow me around the rest of my life, because although I was diagnosed with cancer at the age of 25, I still intend on living a whole lot more.
This was a journey I never intended to take, but was one that showed me the value of having health insurance and the importance of seeing a doctor. When I was first diagnosed, I remember my doctor saying, “You know Steven, men usually have a pretty good idea when something is wrong with their bodies, particularly their sexual health. Getting them to go see a doctor however, is a whole other story. If more young men came in to see the doctor, we could prevent a lot of tragedies.” I couldn’t agree more.
Steven Avila currently lives in Washington D.C. and is a political appointee at the Department of the Interior.
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