Since the Health Insurance Marketplace went online, much work has been devoted to getting people without insurance enrolled in a plan. But once you have new health insurance, it is equally important to make sure you stay insured and are considering your full range of options. If you enrolled in Marketplace coverage for 2015, keep the following questions in mind throughout the year:
Has my household’s income changed since I filled out my Marketplace application?
If you have Marketplace health insurance and are receiving tax credits to help pay your monthly premium, remember that the amount you are receiving is based on your estimate of your 2015 yearly income. This is the amount that you reported on your Marketplace application.
It is important to log on to healthcare.gov and report changes whenever you experience an income or household change. Changes that need to be reported include an increase or decrease in how much you get paid or how many dependents you have, as well as a change in marital status. Updating your information on healthcare.gov will allow any financial assistance you receive to be corrected for your next month’s premium, which can help prevent you from having to pay back tax credits when you file your taxes next spring.
Is my current plan helping me meet my health needs affordably?
Keep in mind that the Marketplace, as well as many employers, offers a variety of insurance options each year. If you suspect that your current coverage may not be the best fit for you, reach out to a navigator or other in-person assister about exploring other options. Unless you have an income or household change, you usually cannot switch your insurance plan mid-year, but most insurance providers (including Marketplace, Medicare, and many employer options) WILL allow you to switch plans each fall.
How long will my current insurance plan continue?
If you have Marketplace insurance, your current plan will continue until the end of the year (December 31, 2015). At that point, the insurance company may decide to change your plan’s costs or benefits, or your plan may stay the same. Your insurance company will send you a letter this fall about any changes that will go into effect on January 1st.
Keep in mind that other plans may change as well, and entirely new plans may be offered. It benefits you to re-examine options in the Marketplace each year. If you have employer coverage and think it may be unaffordable, the Marketplace may be an option for you as well. Beginning on November 1st, you can check out the Marketplace options for the coming year. If you decide to switch, make sure to enroll by December 15th for your new coverage to begin on January 1st. You will have the entire open enrollment period (November 1, 2015 – January 31, 2016) to change plans, though.
I know someone who still does not have any health insurance. When can they apply?
The best time of year to apply is in the fall, when most insurance options have open enrollment periods. But someone who needs insurance now may have other options. People who experience a qualifying life change may qualify for a Special Enrollment Period, and if your income makes you eligible for BadgerCare Plus, you can sign up at any time through the state website. See below for a summary of when to apply through the Marketplace.
**Apply for BadgerCare Plus at any time**
If you have any questions about your eligibility, reporting changes, or making sure you are considering all your options, call one of the Navigator agencies below to get free, local help:
Madison: Covering Kids & Families – 608-261-1455
Milwaukee: Covering Kids & Families – 414-270-4677 and Gerald Ignace Tribal Health Center – 414-383-9526
Racine & Kenosha: Racine Kenosha Community Action Agency – 262-637-8377
Janesville: First Choice Women’s Health Center – 262-902-8572
Dial 2-1-1 anywhere in Wisconsin to find in-person enrollment help in your area.