You Have One Week Left to Get Affordable Health Coverage

open enrollment ends on December 15

Guest blog author: Marina Kurakin, Legal Advocate and Health Insurance Specialist

Six years ago, the Affordable Care Act (ACA, or Obamacare) broadened access to medical care for millions of Americans. Over those years, I've helped with more than 4,000 enrollments.

I started this work before the ACA, when individuals couldn't get approved for insurance because of pre-existing conditions or outrageous costs. In those years before the ACA, the clients I worked with had to file for bankruptcies, lose homes to medical debt, or depend on emergency rooms for care. Now that has all changed.

Seeing individuals receive life-extending procedures, organ transplants, physical therapy, and connect with psychiatric or substance use treatment is brilliant. There's still much work left to be done to create a more equitable system. But with the ACA, those who are newly covered have gone from surviving to thriving.

If you are eligible for ACA Medicaid, you can apply throughout the year. But if you are Marketplace eligible, you must sign up during open enrollment, between November 1 and December 15, with new coverage starting on January 1, 2020.

With one week left to apply and renew benefits for ACA Marketplace, here are some tools and information you need to enroll in and keep your coverage.

For starters, here's what you need to know about available plans and how to apply:

  1. Who can enroll in health insurance through the Marketplace:
    • Someone who isn't eligible for Medicaid due to higher income or immigration status
    • Documented immigrants (citizen, green card holder, student visa, etc.)
    • Employee insurance is either not available; is more than 9.56% of your gross income; or doesn't meet Minimum Essential Coverage criteria (meaning it covers less than 60% of your anticipated medical costs)
  2. How to apply:
    • Create a new account or renew existing coverage on HealthCare.gov
    • Enroll or renew by calling the Marketplace at 1.800.318.2596
    • Find in-person help with this online tool
    • If you are living with HIV, you can call Legal Council's intake line for assistance at 312.427.8990
  3. What the plans cover:
    • All plans on HealthCare.gov offer true coverage. This means that you will not sign up for a plan and later discover that an essential needed medical benefit is not available to you. You could sign up for a plan outside of the marketplace and unknowingly purchase a policy that doesn't meet your needs and is more costly.
    • No health questions are asked during open enrollment, so pre-existing conditions will not be a barrier for health insurance.
  4. What the plans cost:
    • Your monthly premiums and use costs are based on the following:
      • Your age
      • Your projected income for 2020
      • Your Zip code
      • Your tobacco use: Using tobacco more than four times a week will result in higher premium costs.
      • Your tax-filing: If you file as a single adult, only your income influences your plan's costs. If you are married, you must file jointly and both incomes count. If you claim a dependent or someone else claims you as a dependent, then your total tax family income will determine your eligibility for assistance.
    • The lower your income, the more assistance you will get to help pay for monthly premiums and copays when you start using your insurance. Get a preview of what the prices will look like for you at https://www.healthcare.gov/see-plans.

I've helped many clients with enrolling in a Marketplace plan. Here are some of their frequently asked questions:

If you live in Illinois and need assistance in enrolling in a Marketplace plan, visit getcovered.illinois.gov for available resources. If you have HIV and need assistance in enrolling, call Legal Council's intake line at 312.427.8990.

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