The Affordable Care Act, also known as ACA or “Obamacare” — requires all Americans to have health insurance.
The 2016 healthcare law enrollment period gives people without health insurance an opportunity to sign up for an approved health insurance plan through the Health Insurance Marketplace.
The open enrollment period also gives people already covered by a marketplace plan the chance to switch to a different plan for 2016. If you and your family already have healthcare coverage, you don’t have to worry about 2016 healthcare enrollment. But if you don’t have coverage, there are important facts to know about enrolling for healthcare through the Health Insurance Marketplace for 2016.
Open Enrollment Period and Eligibility
The 2016 open enrollment period for healthcare coverage through the Health Insurance Marketplace begins on Nov. 1, 2015, and runs through Jan. 31, 2016. If you don’t have healthcare coverage through a private insurance plan, Medicare or Medicaid, you are eligible to sign up for coverage through the marketplace if:
- You are a United States citizen or U.S. national
- You are currently living in the U.S.
- You are not serving time in jail or prison
If you already have a Health Insurance Marketplace plan, you can switch to a new plan for 2016 during the open enrollment period. Such changes are usually not allowed outside of the open enrollment period unless you meet special criteria. If you’re happy with your current plan, you don’t need to enroll again because your 2015 coverage will automatically renew for 2016.
How to Enroll
You can enroll for healthcare through the marketplace online at HealthCare.gov. After clicking on “Get Coverage,” you will be prompted to select the state you live in. You will automatically be redirected to your state’s marketplace site if you live in a state that operates its own Health Insurance Marketplace. The federal and state marketplace sites allow you to apply for health insurance online and select the plan that best suits your needs. When you apply online, you’ll know right away if you’re eligible for financial assistance, such as:
- Reduced monthly health insurance premiums
- Income tax credits to help offset the cost of your plan
- Free or low-cost coverage through your state’s Medicaid or Children’s Health Insurance Program
If you prefer, you can download the application from the marketplace site, print it and mail it in. You’ll receive mailed notification about your eligibility for financial assistance in about two weeks.
For help with the healthcare enrollment application, contact the Marketplace Call Center at 800-318-2596. Free personal assistance is also available in many locations to help you with the application and selecting a healthcare plan.
Benefits of Enrollment
The most important benefit of enrolling for health insurance is protecting the health of you and your family with regular medical care. All marketplace plans also include a number of free preventive services to keep you and your family healthy, including:
- Immunizations for children and adults, such as flu shots and shingles vaccines
- Cholesterol, blood pressure and diabetes screening
- Breast, cervical, colon and lung cancer screening
- Autism, hearing and vision screening for children
Since health insurance is required under the healthcare law, enrolling for a healthcare plan means you will not be subject to penalties for lack of coverage. The penalties for 2016 are $695 for every adult and $347.50 for each child in your household, or 2.5 percent of your yearly household income — whichever amount is higher.
Enrollment Tips
Healthcare enrollment can seem a little tricky at first. But a few tips can help you get through the process more easily.
- Sign up early during the open enrollment period to avoid high-traffic slowdowns on the marketplace website.
- If you use an insurance agent or broker to help you select a healthcare plan and enroll, be sure the agent signs you up through the marketplace website so you receive any financial assistance you might be eligible for.
- The enrollment application includes questions about the employment, income and healthcare coverage of everyone in your household. A checklist tells you what documents you’ll need. Gather them ahead of time to make completing the application easier.
- Check the prescription drug coverage offered by any plan you are considering to find out what co-payments and out-of-pocket expenses you would be responsible for.
- Life changes that affect your healthcare coverage qualify you for a 60-day special enrollment window outside the normal open enrollment period. Events that entitle you to special enrollment include having a baby, adopting a child, getting married, moving to another state, or losing your health insurance because of divorce or loss of employment. Your special enrollment period begins on the date of the qualifying event and lasts for 60 days.
Is your healthcare plan helping you meet your wellness goals?
By Dr. Tina M. St. John, Demand Media
About the Author: Tina M. St. John runs a health communications and consulting firm. She is also an author and editor, and was formerly a senior medical officer with the U.S. Centers for Disease Control and Prevention. St. John holds an M.D. from Emory University School of Medicine.
Sources
The Henry J. Kaiser Family Foundation: Summary of the Affordable Care Act
HealthCare.gov: Health Insurance Marketplace Basics
HealthCare.gov: Open Enrollment Period
HealthCare.gov: Who’s Eligible to Use the Marketplace
HealthCare.gov: We’re Making It Easy for You to Keep Your Marketplace Coverage Next Year
HealthCare.gov: Changing, Updating or Canceling Your Marketplace Plan
HealthCare.gov: Apply for Health Coverage
HealthCare.gov: Income Levels That Qualify for Lower Health Coverage Costs
HealthCare.gov: Get Help Applying for Health Coverage
HealthCare.gov: Preventive Health Services for Adults
Photo Credit: Getty Images
Clinical Review By/Date: Amy Magill, MA, RD, LDN on Aug 21, 2015.
