Get Ready for Public Exchange Healthcare Plans Enrollment

 In Affordable Care Act, Blog, Health Care, Health Insurance

When the Affordable Care Act (ACA) was introduced to Americans in the year 2010, millions of people began to benefit from what is better known as Obamacare. A form of financial protection against rising insurance policy prices and potential care restrictions, Obamacare helped over 16 million Americans obtain health insurance coverage. So much so, in fact, that even people with pre-existing health conditions were granted coverage. However, here we are six years later with insurers exiting the marketplace from all corners.

How did this happen and what is the solution, you ask? Well, the consequences of a lingering need for suitable coverage in the pre-Obamacare health care system has led to Obama administration discussions taking place and now, the government has started taking control by aiding displaced health law customers in picking plans. This new strategy has got people everywhere talking and more importantly, smiling.

Speaking about the new method, former administrator of the Centers for Medicare and Medicaid Services, Donald Berwick, said, “Would we want these people not to be getting insurance? Of course not. They’re the people who need it the most.” On that note, 2017 health insurance must be a winning idea, right? By a wide margin, yes, but it’s essential to anticipate what’s on the horizon by learning more about the strategy.

What’s Included in the New Strategy?

People who log onto Healthcare.gov during open enrollment (November 1, 2016 until January 31, 2017) will still be presented with affordable health insurance however, various plan options will be made available. This will ensure that anyone who previously had coverage from a discontinued insurance plan receives alternative choices.

Plan holders will be notified of this with “touches”. If your current plan isn’t available in 2017, an alternate plan will be displayed for you to consider, based on information provided by Centers for Medicare & Medicaid Services (CMS).

Let’s take a peek at a timeline of what to expect:

  • November 1-15 – Seven “touches” pertaining to plan options will be presented to plan holders.
  • November 16-21 – Three additional “touches” will be added. The notifications will specify comparable health plan insurers. A bill and welcome packet will follow.
  • December 15 – The CMS will spur plan holders to make a decision by this date. Around 20 attempts to encourage public plan exchanges will commence as a way of urging coverage renewal.
  • December 16-31 – Not yet made a decision? Expect to receive a further five reminders.

While the amount of people receiving notices has not yet been disclosed by the Obama administration, up to one million are predicted to be on the receiving end of exchanges for coverage. Enrolment deadlines can essentially be met thanks to this alternative healthcare choice method. Furthermore, people are more likely to take a proactive approach when shopping for coverage annually. After all, if individual circumstances change, a plan may not be suitable anymore, proving why it’s integral to have options.

Healthcare Statistics in the United States

Did you know that the United States is the only industrialized nation in the world that doesn’t have a universal healthcare system? Approximately 16.3% of Americans lacked coverage for healthcare in 2010, according to the US Census Bureau. This is equivalent to 49.9 million people. Reasons for lack of coverage varied but typically, it was because of interrupted Medicare benefits, job loss or being ineligible for a particular plan, based on findings gathered by the National Center for Health Statistics.

With the new Healthcare.gov plans for left-behind enrollees, even people ineligible for healthcare can now gain coverage. Considering the fact the U.S. spends more on healthcare than any other developed country in the world, it’s important that as much of the population is supported with health care dollars as possible. On the plus side, people in the United States have one of the highest life expectancy at birth – an estimated 78.49 years!

How Can You Prepare for 2017 Open Enrollment?

Having the freedom to switch plans if you so wish, or browse options that might not have been made available to you before, is definitely something to be jumping for joy about. Keep in mind that plans and prices can be previewed ahead of open enrollment (starting November 1, 2016).

Taking the following steps will ensure that as a consumer, you will obtain the best healthcare possible:

  • Get an Overview of the Marketplace – The Marketplace could help you get covered. It lists numerous plans from different providers, each with different features and prices. Coverage can be applied for in four different ways – paper application, by phone, in-person or online.
  • Use Your Calendar – Noting down special dates for enrolment can prevent you from missing out by January 1.
  • Healthcare Checklist – You will be required to have certain things on hand to apply successfully, such as information about the size of your household, Social Security numbers, mailing addresses, employer and income information, etc.
  • Staying Updated – The more you know about healthcare coverage, the easier it will be to make an informed decision. Sign up for email and text message reminders on the healthcare.gov website.
  • The “Metal” Categories – Calculate the estimated average plan cost by focusing on Bronze, Silver, Gold, and Platinum plans.

For a list of additional steps view our complete guide to open enrollment for 2017.

Understanding Special Enrolment Periods

Just because Healthcare.gov is making life easier for people who necessitate healthcare, this doesn’t mean that you are guaranteed acceptance for a plan. Certain qualifying life events will be taken into account, as well as proof of eligibility. Prepare to hand over documentation relating to the qualifying event if you are hoping to enroll at a time when a qualifying event is occurring.

Examples of qualifying events include:

  • Birth or adoption
  • Becoming a U.S. citizen
  • Becoming a dependent/gaining a dependent
  • Marriage
  • Moving to a new area permanently
  • Employer-sponsored benefit coverage reduction

In certain situations, you might not need a qualifying event, such as if you are an American Indian. Should you be lacking coverage towards the end of the year, a short-term policy would be the better option. Sure, there are good points and bad points associated with short-term insurance policies. Nonetheless, a temporary problem can be fixed with an affordable solution like this, therefore it shouldn’t be overlooked. When you think about how much cheaper it would be than an ACA-compliant plan, temporary is a preferred choice in comparison with having absolutely nothing in place for the last few weeks of the year!

Rachel Decena
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Rachel Decena

Racel Decena is the Co-Founder of Amazing Healthcare consultants healthcare. She is aclaims specialist with specialties in medical billing, patient accounts management and collections. She has a thorough understanding of the health insurance claims review process.
Rachel Decena
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