Surprise! Life Changes and the ACA

Life is always full of surprises and changes. Job loss, marriage, child birth, moving. Any of these things could trigger the kind of life change that makes you eligible for a Special Enrollment Period (SEP).

 

 

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Marriage – or divorce- could trigger eligibility for a “Special Enrollment Period.”

 

 

If you qualify for a SEP, you may still be able to get health insurance in 2017, outside the open enrollment period that ended earlier in the year.

But you have to hurry. The marketplace usually gives you just 60 days after the life-changing event to enroll in a plan. Miss the deadline and you have to wait for the next Open Enrollment Period, which begins Nov 1, 2017 for 2018 healthcare coverage.

Not sure you qualify? The health marketplace makes it easy to find out by answering a few questions. You can go here to find out if you qualify: https://www.healthcare.gov/screener/

Some healthcare programs have year-round enrollment, including Medicaid and CHIP, also known in Florida as Kidcare, the children’s insurance program. These are not tied to SEPs.

 

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EFOF healthcare navigators work year-round to enroll consumers in federal marketplace plans.

 

The federally licensed healthcare navigators with the Epilepsy Foundation of Florida enroll consumers through healthcare.gov all year long and can help answer your SEP questions. Call 877-553-7453 to speak to a navigator or make an appointment for in-person assistance. More information is also available at http://www.efof.org/acanavigation

To find out more about Special Enrollment Periods, go to https://www.healthcare.gov/blog/special-enrollment-period-facts/

 

 

 

The Affordable Care Act (ACA) gets the job done

 

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As Congress begins its debate on changing the Affordable Care Act (ACA), it’s good to review the success the federal health care law has had in reducing the uninsured rate in the U.S.

Today, more than 30 million people are currently insured as a result of the ACA’s insurance subsidies, expanded Medicaid eligibility, state and federal outreach efforts, and market regulations.

Before the ACA, more than one-third of people who tried to buy health insurance in the individual market were either turned down, charged more or were told a condition excluded them from their health plan.

How has the ACA succeeded in increasing the insured rate? The ACA has made purchasing easier and more affordable. Consumer protections that ban discrimination for pre-existing conditions have also allowed more people to get covered.

The ACA’s primary goal is to allow anyone without employer coverage to have affordable health coverage – no matter what their current health status is.  Under the ACA, insurers must:

  • Offer a plan to everyone who applies
  • Can’t charge more based on gender or health
  • Are limited in how much more to charge older vs. younger persons
  • Can’t impose lifetime or annual benefit limits or cancel coverage.
  • Include Essential Health Benefits
  • Provide premium tax credits that reduce share of costs for incomes between $24,000 and $97,000 for a family of four.

Why is having health insurance important? Having health insurance coverage allows people to have  regular doctor visits and get timely medical care.  Americans without health insurance are less likely to go to the doctor when they need to or get preventive care and cancer screenings. Even a gap in coverage increases the likelihood someone will not get timely health care.

The Commonwealth Fund report breaks down the success of the ACA by the numbers:

Near the end of the ACA’s fourth open-enrollment period, nearly 9 million people had signed up for a plan through HealthCare.gov.  Millions of other consumers in 11 states and the District of Columbia have enrolled through states’ marketplaces. In addition, 7 million have purchased health insurance in the individual market. Expansions to Medicaid and the Children’s Health Insurance Program have allowed an additional 16 million people.

If you need assistance enrolling in health insurance, including Medicaid and Florida Kidcare,  licensed navigators from the Epilepsy Foundation of Florida can help. Call 877-553-7453 to make an appointment. Or go to efof.org/acanavigation for information on navigation sites and upcoming events.

 

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EFOF’s federally licensed healthcare navigators provide in-person assistance throughout Florida.

 

Read more: http://www.commonwealthfund.org/publications/issue-briefs/2017/feb/how-the-aca-has-improved-ability-to-buy-insurance

 

Medicaid: Largest Public Health Insurance Program Covers 1 in 5 Americans

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Medicaid and the Children’s Health Insurance Program (CHIP) – known as Kidcare in Florida – provide free or low-cost health coverage to millions of Americans, including some low-income people, families and children, pregnant women, the elderly, and people with disabilities.

Even though Florida hasn’t expanded Medicaid to cover all people below certain income levels and you may not qualify based on income alone, you should apply for Medicaid because Florida still has coverage options for children, pregnant women and those with disabilities.

 If you qualify, coverage begins right away as there’s no limited enrollment period for Medicaid or Kidcare.

EFOF’s licensed healthcare navigators can help you  apply for Medicaid or Kidcare  through the Health Insurance Marketplace. Call our toll-free number 877-553-7453 to make an appointment.

Medicaid is the country’s public health insurance for low-income children, adults, seniors, and people with disabilities. The program covers 1 in 5 Americans, including many with complex and costly needs for medical care and long-term services, including seniors in nursing homes. Most people covered by Medicaid would be uninsured or underinsured without it.

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Cuts to Medicaid would hurt rural Floridians – and children in particular, because 57 percent of Florida’s rural and small-town have Medicaid. Under reforms to the Affordable Care Act being considered, there could be a more than $900 million cut to Medicaid funding over the next decade, according to a recent report by the Urban Institute.

Learn more about applying for Medicaid here: https://www.healthcare.gov/medicaid-chip/getting-medicaid-chip/