Starting November 15, the open enrollment period for the health insurance Marketplace will begin for Hoosiers that wish to compare and purchase health coverage. As part of the Affordable Care Act, the Marketplace aims to offer health insurance to Hoosiers without employer-provided coverage and will offer financial assistance to help many people afford coverage. A number of plans will be offered in varying levels of coverage, however all plans will cover essential benefits like preventative care, prescription drugs and other care.
Log on to HEALTHCARE.GOV or call toll-free (800) 318-2596 and get started today.
To utilize the Marketplace, Hoosiers must meet certain requirements. To be eligible, a person must reside in Indiana, be a U.S. citizen, national or non-citizen who is lawfully present for the entire enrollment period, and not be incarcerated.
What kind of coverage?
The coverage options available to Hoosiers will vary depending on benefits and the amount an enrollee pays towards a plan but must all cover a number of key benefits. Those essential benefits include:
- Ambulatory patient services
- Emergency services
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventative and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Hoosiers purchasing insurance cannot be denied coverage as the result of a preexisting condition. Plans will be offered in four levels – bronze, silver, gold and platinum and vary in the average amount enrollees will pay toward coverage.
Young adults under 30 years old are eligible for catastrophic coverage, a lower cost alternative for those seeking health insurance. Catastrophic plans have higher deductibles but lower premiums and cover primary care visits and preventative services with no out-of-pocket costs.
Can I afford health insurance?
Covering more Hoosiers means less use of the emergency room as a primary care provider and a reduction in uncompensated care, a practice that cost Indiana hospitals nearly $3 billion in 2011. To make coverage affordable for more Hoosiers, premium tax credits will be widely available to help offset the cost of insurance.
Tax credit eligibility is dependent on income; those making between 100 percent and 400 percent of the federal poverty line are eligible for assistance on a sliding scale. Hoosiers making lower incomes are eligible for a higher offset.
Beginning in early November, you will be able to preview 2015 Marketplace plans and estimated prices before you fill out an application.
Hoosiers can begin shopping for and purchasing coverage on November 15. The open enrollment period for health insurance purchased on the marketplace runs from November 15 through February 15, 2015. December 15 is the last date to enroll for coverage to begin on January 1, 2015. December 31 marks the day that 2014 Marketplace coverage ends, no matter when you enrolled.
If you had Marketplace coverage in 2014, you will need to renew your Marketplace plan or change plans starting on November 15.
Where can I get assistance navigating the Marketplace?
Online, over-the-phone and in-person assistance is available for Hoosiers with questions while shopping for coverage on the marketplace.
Hoosiers will be connected with experts who can help guide the decision-making process and answer questions. Toll-free over-the-phone assistance is also available 24 hours, seven days a week at (800) 318-2596. Call to start or finish an application, compare plans, enroll or ask a question.
To simplify the application process and provide guidance for those applying for coverage, Hoosiers can turn to a number of in-person assistance options. Federally, four organizations have been awarded grants to assist Hoosiers through the application process.
The state will also certify individuals or ‘navigators’ to assist Hoosiers with applications and Marketplace enrollment at no cost. Both federal and state navigators can help with enrollment, search both lists for assistance close to your community.
Covering small businesses:
The Small Business Health Options Program (SHOP) is a parallel online marketplace where small business owners can compare and purchase plans for their companies. Eligible small businesses will have access to tax credits to help make coverage affordable. The state’s actuary estimates nearly 50,000 Hoosiers could be enrolled through SHOP by 2017. Find application information at HEALTHCARE.GOV or call (800) 706-7893. Over-the-phone SHOP assistance is available Monday through Friday, 9 a.m. to 7 p.m. EST.