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Are You Ready for 2019 Open Enrollment?

10/28/2019

 
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It is time for open enrollment for the Affordable Care Act (also known as Obamacare). Each year during this time, individuals are given the chance to enroll or re-enroll in health insurance coverage. Although this topic is very controversial, the Affordable Care Act is near and dear to the hearts of many.   
 
The Affordable Care Act (ACA) was enacted on March 23, 2010. The primary goal of the ACA is to improve access to health care, reduce the overall costs of health care, and expand health plan benefits. The ACA helps individuals and families obtain affordable health insurance coverage, if coverage is not offered through an employer. Based on income and household size, the ACA provides tax credits to lower monthly premiums and other cost-sharing reductions (such as deductible and co-insurance).
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The ACA has expanded the benefits that are included in health plans. One benefit expansion stipulates that insurance carriers must eliminate declining individuals or increasing premiums due to pre-existing conditions (during open enrollment dates). Another benefit expansion stipulates that individuals must be covered by a "qualified" health plan. For a health plan to be "qualified," it must include the following essential benefits:
  • Prescription Drugs
  • Rehabilitative and Habilitative Services and Devices
  • Laboratory Services
  • Preventive and Wellness Services and Chronic Disease Management
  • Pediatric coverage includes oral and vision care
  • Ambulatory Services
  • Emergency Services
  • Hospitalization
  • Maternity and Newborn Care
  • Mental Health and Substance Use Disorder Services, including Behavioral Health Treatment
 
The open enrollment date for this year starts on November 1, 2019 and ends December 15, 2019.  The plans purchased during that time will be effective starting on January 1, 2020.  To purchase a health plan, the following is needed to complete the process:
  • Household projected income for the year 2020 (proof of income may be requested by the Marketplace)
  • Be a U. S. Citizen or lawfully present
  • Names, SSNs and DOBs of individuals needing coverage
  • No qualified employer coverage available
  • Complete application to determine eligibility for tax credit and other cost reductions
  • Select a health plan
  • Pay 1st month's premium by the specified deadline
 
As mentioned, open enrollment is starting this Friday, November 1 through Sunday, December 15. Do not wait and risk missing the open enrollment period.  If you have a 2019 health plan, please contact me to ensure your information is updated so that you receive the appropriate tax credit for the upcoming plan year.  If you do not have health coverage, please call 704-626-7484 for enrollment help to get you and your family covered for 2020.
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