Time to Check Your Health Insurance
Why is now a good time to take a closer look at your health
care needs and options?
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2017 Open Enrollment
November 1, 2016
open enrollment begins
December 15, 2016
enroll before this date to have
coverage January 1, 2017
January 31, 2017
open enrollment ends
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If you're uninsured or looking for more affordable health
insurance, the “open enrollment” period is the time to visit healthcare.gov or
your state’s exchange. During “open enrollment”, private health
insurance options can be reviewed and coverage can be purchased. People
with low and moderate incomes may be able to get financial
help to pay for health insurance coverage. Assistance to pay for
premiums and other cost-sharing may be available for individuals and families,
depending on which plan is purchased. If you get health insurance through your
employer, Medicaid or Medicare, you are not eligible for this assistance. You
can also sign up for insurance outside of the open enrollment period,
if you lost your job, married, divorced or had a baby.
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You may enroll
in Medicaid and the Children’s Health Insurance Program (CHIP)
at any time, year round.Certain requirements must be met to
qualify for these public programs. Medicaid provides long-term services and
supports to people with disabilities.
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Do you already have health insurance through the
Marketplace?
It is also important to update your income and household
information in the Marketplace to make sure you get the assistance that is
available.
• This is a good
time to check your health insurance coverage and see if it still meets your
healthcare needs.
• You may enroll
in a different plan each year or you will be automatically
re-enrolled in your current plan or a similar one by December 15,
2016.
• If a new
plan does not cover your providers or services, seek more information about
transition rights.
• You should
carefully read all health insurance notices and updates.
Why should you check your coverage?
• Even if you
like your current health plan, new plans may be available and
premiums or cost sharing may have changed since last year.
• Even if your
income has not changed, you could be eligible for more financial assistance.
• If your income
has increased, updating your information with the Marketplace will
help avoid paying future penalties.
If you have a disability or a health condition, pay attention to
details or possible changes:
• Are a broad
range of health care providers included in the health plan’s network of
providers?
• Are there
enough medical specialists in the network to meet your needs?
• Are needed
medications included in the plan’s list of covered drugs?
• Is there
adequate access to non-clinical, disability-specific services and supports?
• Does the plan
have service limits, such as caps or limits on the number of office
visits for therapy services?
• Are mental
health services covered to the same extent that other “physical” health
benefits are covered?
Are you or your family members uninsured?
Most individuals will be able to get health insurance coverage
regardless of pre-existing health conditions or prior denial of
coverage. Interested individuals can go online, enter information and
review insurance options. Information on monthly premiums, deductible
costs, doctors, hospitals and which drugs are covered by a plan should be
available. Enrollment is limited to individuals who live in the
United States, are U.S. citizens, nationals, or non-citizens who are lawfully
present, and not currently incarcerated.
If you have not signed up for an insurance plan, it is important
to note that you may be subject to a fee for not having health care
coverage. If you or your dependents do not have insurance that
qualifies as minimum essential coverage for tax year 2016, you
may have to pay either 2.5 percent of your household income with
a maximum of what the national average premium is for a bronze plan, or a
flat fee of $695 per uncovered adult and $347.50 per child under 18, with
a maximum of $2085 -- whichever is higher.
Where to get help?
Purchasing health insurance can be complicated. If you or
your family member needs assistance with understanding the options, healthcare.govcan
help. This website has information about seeking assistance in local
communities, explanations of health insurance terms, enrollment information,
assistance with out-of-pocket cost estimation and much more. There is also
a 24-hour phone line for consumer assistance at 1-800-318-2596 to
call for help.
In addition, each state has health insurance “navigators” to
assist individuals with enrollment in health
insurance plans. Individual health plan information should
be available in late October 2016 on the website. If you would
like more information on specific topics, the National Disability Navigator Resource Collaborative(http://www.nationaldisabilitynavigator.org/) has a comprehensive set of materials available on
disability issues and the Affordable Care Act.
Phone: 1-800-318-2596 (Available
24/7 with access to 150 languages)
TTY: 1-855-889-4325
1825 K Street, NW, Suite 1200 • Washington,
DC
20036 • PH 202/783-2229 •FAX 202/534-3731 •
Info@c-c-d.org
• www.c-c-d.org
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