We Answer Your Questions about Enrolling in the Affordable Care Act

10 questions and answers about the Open Enrollment 2018 period for the Affordable Care Act that ends on December 15.

2018 Open Enrollment

Q: Has the Affordable Care Act (ACA) been repealed?

A:  No. The ACA remains the law of the land. As in previous years, financial help to lower the cost of health coverage and care for those purchasing an ACA marketplace plan is available for those who qualify.

Q: What is the deadline to enroll in health coverage under the Affordable Care Act?

A:  For most people, Open Enrollment for health coverage under the ACA began on November 1 and continues through December 15. It is important to enroll in a plan by December 15, and pay your first month’s premium, to make sure that you and your loved ones have health coverage starting January 1, 2018.

If you live in a state with its own state-based marketplace, like California or New York, your Open Enrollment period may be longer. For information on your state’s Open Enrollment period and how-to sign-up, click here.

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Q: How can people enroll in coverage during Open Enrollment?

A: There are three ways to enroll: 1) online at healthcare.gov or cuidadodesalud.gov; 2) over the phone at (800) 318-2596; or 3) in-person. Find free, in-person enrollment help in your area at localhelp.healthcare.gov.

Q:  Much has been said about the rising cost of purchasing health coverage through the ACA marketplace. Does this mean everyone will pay more for coverage in 2018?

No. Financial help to significantly lower premiums for marketplace plans is still available for those who qualify. In fact, some people will find the cost of coverage to be more affordable than in previous years, so it is important to shop around for coverage and choose the plan that best fits your needs.

According to the U.S. Department of Health and Human Services, most consumers will be able to enroll in health coverage for less than $75 per month. In addition, financial help to reduce out-of-pocket costs for health care services like doctor’s visits and prescription drugs is also available for those who qualify.

Health Care - Open Enrollment

Q: There has been a lot of news coverage about changes the Trump administration is making to the ACA. Will these changes affect my 2018 health coverage?

A:  No. While the administration has made some significant changes to the way it will implement the ACA, none of these changes will impact people’s ability to get covered or receive financial help during this year’s Open Enrollment period.

Q:  Is there still a tax penalty for individuals and families who do not enroll in health coverage?

A:  Yes. The tax penalty for not having health insurance in 2018 is $695 per individual ($347.50 per child), or 2.5% of household income, whichever amount is greater. Those who are eligible and can afford coverage, yet remain uninsured, may have to pay a fine at tax time. In order to have health coverage beginning January 1, 2018, you must enroll in coverage and pay your first month’s premium by December 15, 2017.

Q: What should small businesses and entrepreneurs know about enrolling for coverage under the ACA?

A:  If you are a self-employed entrepreneur or have employees who do not have another source of insurance, you must enroll in ACA marketplace coverage by December 15, 2017, unless you live in a state with an extended Open Enrollment period.

For small businesses using the federal Small Business Health Options Program (SHOP) to purchase insurance, enrollment is year-round and not limited to the Open Enrollment deadline. However, small businesses can no longer shop online for a group plan through healthcare.gov. They can still use the site to compare plans and verify eligibility for tax credits, but as of November 15, small businesses must purchase coverage through a SHOP-certified insurance agent or broker.

Q:  What should immigrants and those in mixed-status families know about enrolling under    the ACA?

A.  Federal eligibility guidelines have not changed. Citizens, lawful permanent residents, and other qualified immigrants can enroll in coverage through the marketplace. In addition, federal privacy protections are still in place and only those enrolling in coverage need to provide their personal information and immigration status when they sign-up. For example, a parent who is ineligible can enroll a dependent child who is eligible for coverage, and is only required to provide the child’s information, not their own.

Family

Q: What should Puerto Ricans who have newly arrived on the mainland know about health coverage?

A:  It is critical to understand your health coverage options during this Open Enrollment period. An in-person navigator or application assister can help you better understand the health care system and work with you to enroll in a health plan that is best for you and your family. To find in-person assistance in your area, go online to localhelp.healthcare.gov or call 1-800-318-2596 to speak to an assister.

Individuals and families who have temporarily relocated from the island to the mainland may be eligible for a Special Enrollment Period (SEP) to enroll in ACA marketplace coverage through December 31, 2017, so it’s important  to understand if you qualify.

It is essential to note that Medicaid and Medicare eligibility varies by state, and those who were enrolled in these programs in Puerto Rico will need to, at minimum, re-enroll in the  appropriate program in their new state. In addition to helping you understand the health plans available in the ACA marketplace, an in-person or by phone assister can determine your eligibility for these programs and instruct you how to enroll or re-enroll in the right program.

Q: When can individuals eligible for Medicaid or the Children’s Health Insurance Program (CHIP) sign up for health coverage?

A: Anytime. You can apply and enroll yourself or an eligible dependent in Medicaid or the Children’s Health Insurance Program (CHIP) anytime throughout the year.

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