Having health insurance is as vital for your financial health as it is for your physical health. Without coverage, you could find yourself in a cycle of debt as you try to pay off medical bills. That’s why it’s important to pay attention to enrollment windows, so you don’t miss your opportunity to get covered.
For people who are younger or healthier, the thought of paying monthly premiums may not be appealing. However, it’s much better than paying the full price for a minor procedure or doctor’s appointment.
Not only that, but you can receive free or affordable preventative services that could potentially catch health conditions early on, helping you save money in the long-term. And because ACA is a public health option, everyone’s monthly premiums will fall when more people in better health sign up for this program.
This year, the enrollment period to sign up or renew your health insurance policy under the Affordable Care Act (ACA) is November 1 to December 15. ThePennyHoarder.com explains how to sign up and get covered.
When you sign up for health insurance through the ACA, you pay a deductible. You also pay for coinsurance, which is a portion of the qualifying service or treatment you received. How much you pay for each depends on the plan you enroll in. Both have caps on out-of-pocket costs and no yearly or lifetime limits.
According to HealthCare.gov, the uninsured typically pay double for the same treatment and services as those with insurance. That means having health insurance can help you save a significant amount of money.
How To Enroll In The ACA
There are several ways to apply. You can complete the process over the phone or with assistance from an in-person navigator, a professional trained to guide people through the procedure. In addition, you can apply through a broker or mail your application. Some nonprofit groups may even have certified Marketplace volunteers who can assist you at local health clinics or hospitals.
If you apply online, visit HealthCare.gov. First-time applicants can select “take the first step to apply,” but if you already have coverage through the ACA, click “login to review/change plans.”
Several states run their own health insurance marketplace, which means you can only enroll through the state. These states include:
- New Jersey
- New York
- Rhode Island
- Washington, D.C.
Massachusetts, Minnesota, Nevada, New Jersey, New York, Pennsylvania, Rhode Island, and D.C. have later enrollment deadlines, so make sure you contact your state’s marketplace to make sure. Generally speaking, coverage goes into effect on the first of the year.
When you register, you will need to submit an estimate of your earnings for next year. Additionally, you will also need to provide information such as:
- The number of people in your household
- Your family members’ Social Security numbers and dates of birth
- W-2s or paystubs
- Policy numbers from your existing health insurance
You cannot enroll in the ACA if you already have insurance through Medicare, Tricare, or the Children’s Health Insurance Plan (CHIP).
The ACA provides coverage for patients with pre-existing conditions and services classified as “essential,” such as:
- Outpatient treatment
- Emergency services
- Pregnancy, maternity, and newborn care
- Mental health and substance abuse services
- Psychological and physical rehabilitation services for those with chronic conditions, injuries, or disabilities
- Lab work
- Preventative and wellness services for chronic disease management
- Pediatric care, dental, and vision services
If the income you earn is 100% and 400% of the federal poverty level, you may qualify for federal subsidies. Typically, the lower your income, the more assistance you will be eligible for.
What Options Does The ACA Offer
Health insurance plans are categorized as Bronze, Silver, Gold, and Platinum. Bronze has the most affordable premiums but the least coverage, while Silver, Gold, and Platinum offer incrementally better coverage at a higher premium. Depending on your state, you may have a wider variety of plans for each tier.
When you pick a plan, choose one where your current doctor is in-network and covers your medications. Common plans include:
- Exclusive provider organizations (EPOs): These only cover the cost of care if the services are administered by in-network physicians and hospitals, except in emergencies. You do not need to pick a primary care provider.
- Health maintenance organizations (HMOs): Under this plan, you can only receive care from doctors employed by or contracted by the HMO, except in emergencies. Additionally, some HMOs require that you reside or are employed in the service area.
- Point of service plans (POSs): You pay less for services from in-network health care providers. If you need to see a specialist, you must first receive a referral from your primary care provider.
- Preferred provider organizations (PPOs): Services from in-network providers are more affordable. Plus, for an extra cost, you can also receive care from out-of-network providers. You do not need referrals for specialists.
Health insurance coverage is crucial for your financial and physical well-being. If you don’t already have insurance, make sure you mark your calendar and enroll before the deadline!
- Jacobson, Susan. “Need Health Insurance? How to Sign Up for ACA Coverage by Dec. 15 Deadline.” The Penny Hoarder, The Penny Hoarder, 11 Nov. 2020, www.thepennyhoarder.com/save-money/how-to-sign-up-for-affordable-care-act/?aff_sub2=homepage.