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What to Expect: Enrolling in the Health Insurance Marketplaces

July 19, 2013

HealthCare.gov website

The deadline for full implementation of the Patient Protection and Affordable Care Act (ACA) is quickly approaching (January 1, 2013), which means it is almost time for those without health insurance to begin enrolling in the new health insurance marketplaces! On October 1, 2013, open enrollment in the marketplaces begins; on January 1, 2014, health insurance coverage begins; and on March 31, 2014, open enrollment ends.

What does all this mean for YOU? HealthCare.gov is the new website designed to help individuals and families understand and navigate health care reform and the new insurance marketplaces. It is a great tool that can help you and your family learn the basics of enrollment before it begins on October 1, 2013. Here are some of the most important things you should know from HealthCare.gov about enrolling in the new health insurance marketplaces:

Health insurance marketplaces are run by either individual states, the federal government, or a partnership between the two. For a list of states and their decisions regarding marketplaces, click here. Regardless of who is running the marketplace, the health insurance plan options provided must meet the minimum requirements for qualified health plans, which includes offering the same set of essential health benefits. These include at least:

  • Ambulatory patient services (outpatient care you get without being admitted to a hospital)
  • Emergency services
  • Hospitalization
  • Maternity and newborn care (care before and after your baby is born)
  • Mental health and substance use disorder services, including behavioral health treatment (this includes counseling and psychotherapy)
  • Prescription drugs
  • Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions to gain or recover mental and physical skills)
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services

When you use the health insurance marketplaces, you may be eligible for lower costs on monthly premiums or out-of-pocket costs, or even free or low-cost care. These kinds of subsidies or deductions will depend on your income and family size. On October 1, 2013, you can fill out your health insurance marketplace application and find out how much money you can save (and most people who apply will qualify for lower costs of some kind).

Click here for a four-step chart from the Centers for Medicare and Medicaid Services that highlights the step-by-step process you can expect when it comes to enrolling in the health insurance marketplaces, then click here for more detailed information about this process.

If you visit the HealthCare.gov website, you can answer a couple of questions to find out what kind of insurance plans you might be eligible for come October 1, 2013. Once you reach the HealthCare.gov homepage, you'll see a green "START NOW" button that will take you through some questions about your current health insurance status and possible coverage options for you. The website is also equipped with a 24/7 1-800 number and online chat feature, we encourage you to utilize these tools if you have any questions during the process. AIDS United encourages you to visit this extremely user-friendly site and begin exploring your health insurance options. We will continue updating you as more information becomes available.



  
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This article was provided by AIDS United. It is a part of the publication AIDS United Policy Update. Visit AIDS United's website to find out more about their activities and publications.
 
See Also
U.S. Health Care Reform

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