It will be easy for you to keep your Marketplace coverage next year
By Amira Wazeer
I have been sitting in on conference calls and attending classes for the fall open enrollment season. Basically everything stays the same, the focus this year is on fixing what went wrong, since so much went wrong last year the fix has priorities, there will probably still be some glitches.
I can assure you however the Federal Marketplace is working hard to make it easy for you to keep your current Marketplace coverage when your health plan comes up for renewal.
Here are seven things to know about renewal and auto-enrollment:
All 2014 Marketplace health plans will come up for renewal in 2015. Open Enrollment for 2015 health coverage through the Marketplace begins November 15, 2014.
Your insurance company will send you information this fall about updated premiums and benefits.
Review your plan’s 2015 changes to see if it still meets your needs. Call or visit the plan’s website to make sure your doctor and other health care providers will be in the plan network next year. Also make sure any prescriptions you take will be covered.
If you’re happy with your current plan and want to keep it--and your income or household size haven’t changed - you don’t need to do anything. The Marketplace will auto-enroll you in the same plan for 2015.
If your income or household size have changed, you’ll need to report that to the Marketplace so you get the right premium tax credit. If you don’t update this information, you’ll get the same premium tax credit you got in 2014. If your income has gone up or your household size changes and you don’t report these changes to the Marketplace, you may owe money at the end of 2015 when you file your tax return.
If you want to change plans, you can:
Choose any other Marketplace health plan your company offers in your service area if you want to stay with your current insurance company.
Choose a new health plan from a different insurance company through the Marketplace.
Buy a new private health plan outside of the Marketplace. If you do this, you won’t be eligible for premium tax credits and cost-sharing reductions offered through the Marketplace.
In some cases, your current Marketplace plan won’t be offered in 2015. If that’s the case, you will be automatically enrolled in a similar plan so you don’t have a gap in health coverage, unless you choose another plan and enroll. Because your plan is ending, you’ll qualify for a Special Enrollment Period that lets you enroll in an individual plan outside the Open Enrollment period.
Special Enrollment Periods are also available if you lose your job and are no longer covered through your employer; you may be able to find affordable health coverage in the Marketplace.
If you lose your job-based insurance for any reason, you can buy a private health insurance plan in the Marketplace. This is true even if you leave your job outside of Open Enrollment. When you apply for Marketplace coverage, you’ll also learn if you qualify for Medicaid or the Children’s Health Insurance Program (CHIP).
If you have COBRA coverage you can keep it. In some cases, you can buy Marketplace coverage instead. If COBRA ends outside of Open Enrollment, you qualify for a Special Enrollment Period.
According to healthcare.gov the following is a list of events that qualify you for a special enrollment period (voluntarily giving up coverage does not qualify you for a special enrollment period):
- Lost coverage due to divorce
- Did you or anyone in your household lose health coverage in the last 60 days OR do you expect to lose it in the next 60 days?
- Policy or plan year ended for policy you bought yourself
- Turned 26 and aged off a parents health plan
- Lost eligibility for Medicaid or CHIP
- Changes in household size
- Did anyone in your household get married or have a baby
- Got divorced and lost health insurance
- Adopted a child or had a child placed with you for foster care
- Did you have any changes in circumstance such as:
- Moved outside your health plan’s coverage area
- Had a change in income
- Gained citizenship or lawful presence in the U.S.
- Released from incarceration (prison or detention)
- Are you a member of a federally recognized tribe, or an Alaska Native corporation shareholder?
(Amira Wazeer is a state licensed and federally certified insurance agent with over 14 years experience. She specializes in Medicare plans, Affordable healthcare plans, dental and vision plans, Life insurance for diabetics and Janazza (final expense) insurance. Consultations are free. Need a speaker at your upcoming events or have Questions and comments contact a.d.wazeer@Comcast.net or call 404-202-1926.)