After Open Enrollment under the ACA– What Can You Do Now?

The dust has mostly settled form the first open enrollment period for individual/family plans under the Affordable Care Act (ACA). Thank you for your recent visit to our health insurance website. If you find yourself without insurance or with a deductible that would be very hard to come up with, here are some ideas for three typical situations:

1.)  You experienced a life change event qualifying you for a special enrollment period

You may be eligible for a special enrollment period to get 2014 coverage if any of these apply to you:

  • You lost a plan that provided minimum essential coverage (MEC), including a loss of Medicaid coverage due to an increase in your income.
  • You lose employer-sponsored coverage or it becomes unaffordable as defined by the law.
  • You turn 27 and are no longer eligible to be on your parents’ insurance plan
  • You gain Citizenship or Immigration status
  • You move to Colorado, or out of your plan’s service area
  • Your family situation changes (marriage, divorce, birth or adoption, death)
  • You have a gain or loss of eligibility for the tax credit or cost sharing reduction

2.) You missed the deadline to get insurance, but don’t qualify for a special enrollment period.
If you do not qualify for a special enrollment period, there are some things you can do to lessen your risks:

  • Accident Insurance to cover out of pocket medical costs arising from some accidental injury
  • Critical Illness insurance to provide cash for expenses if you are diagnosed with a critical illness
  • Disability Insurance to provide cash in case you cannot work.
  • Dental or Vision insurance
  • Fixed Benefit plans that provide a flat amount for various types of medical services.

Colorado Health Brokers can help you navigate any of these situations. Please email or call if you would like to see whether you can benefit from any of these options, or have any questions about health and related insurance.

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CAN I RENEW MY 2014 COLORADO MARKETPLACE PLAN? SHOULD I?

What’s different about your Connect for Health Colorado Marketplace (Connect) account this year?  Renewal options.  Most people who purchased plans from Connect for 2014 will be able to renew those plans for the 2015 plan year (with the Affordable Care Act, individual and family plans are all on a calendar year cycle).

You should renew your 2014 policy for 2015 if you are generally happy with:

  • The amount of the monthly premium you will pay in 2015
  • The amount of deductible and coinsurance, as well as other terms of coverage
  • The network of doctors, hospitals and facilities that accept this insurance.

You will not be offered a renewal of your policy if you are no longer eligible for your 2014 arrangement:

  • Children on family plans turning 26 must get their own plans
  • Persons with Marketplace Catastrophic plans turning 30 must get standard plans
  • Persons who turned 65 who begin receiving Medicare benefits are no longer eligible

What about Subsidies?

If you received Marketplace subsidies (help with premiums, lower out of pocket costs) during 2014, your 2015 subsidy will automatically be calculated so long as Connect has enough information to do so.   If there is no 2015 determination shown in your personal Connect account, you must reapply.   This year, applying for a subsidy is easier.   The new Connect system incorporates the relevant information screens of the PEAK Medicaid system.  This means you do not have to create a PEAK account and go through that separate system any more.

How do you Renew?

You will receive notice of your renewal option from Connect and from your insurance company.  In almost all cases, you can renew your plan by doing nothing.  If your plan is through the Connect Marketplace, you may renew by:

  • Doing nothing.  In this case, Connect will renew you for 2015
  • Selecting “I want to continue with my current plan” in your Connect account.

 What if you don’t want to Renew or Need Help Deciding?

Renewing may not be the best option for you, or you may need help navigating the new eligibility process for financial assistance.  It costs you nothing in fees or extra premiums to get the advice and perspective of a professional broker.

Colorado Health Brokers are certified by Connect for Health Colorado and work extensively with Connect staff and clients purchasing plans on the Connect Marketplace.  We also handle client purchases directly from insurance companies and offer a range of supplementary coverages (accident, critical illness, travel, foreign medical, disability, life) to help each client find the best mix of coverage.   Contact us at: info@cohealthbrokers.com

NEXT:  What about renewing plans purchased directly from the insurance companies (off-Marketplace)?

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