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Nine Things You Need to Know About ACA Enrollment and How to Choose a Health Insurance Plan

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Download our ACA Enrollment Flyer Here!

1. When to apply: The marketplace open enrollment begins on Nov. 1, 2019 and ends on Dec. 15, 2019.

2. Who should apply? People who do not have health care coverage through their job or through MaineCare or Medicare can purchase health insurance through the Affordable Care Act (ACA - also called ObamaCare).

3. How do I find a plan and where do I apply?
Online: The best place to start is at www.healthcare.gov. That is where the majority of Americans in the individual market will sign up for a plan.

In person: Many nonprofit and community organizations have trained individuals, known as "navigators" or “assisters”, to help you apply for coverage at no cost. Call the statewide navigator line 1-855-806-7333 to find a navigator near you.

By telephone: You can also call the Marketplace Call Center at 1-800-318-2596 and apply over the phone. It accepts calls seven days a week, 24 hours a day. Remember, you can get plan estimates and learn about your coverage options before you enroll by visiting www.healthcare.gov/see-plans/ or by calling “Consumers for Affordable Health Care” at 1-800-965-7476.

4. What do the plans cost? The cost depends on your income. Many Mainers are eligible for help paying for their premiums. During Open Enrollment, you can explore health plans that offer a variety of options to meet your health needs within your budget. Working with an assister can help you determine which plan will be best for you.

5. Will premiums increase this year? Some Mainers may see an increase in their premiums, but others will see a decrease. It is important to shop around. If you get a letter from your insurance company saying your plan will be much more expensive next year, don’t panic! The price shown in the letter is usually not accurate. You can find estimates for how much plans will cost you by visiting http://www.healthcare.gov/see-plans/ or calling 1-800-965-7476. It is important that you explore your options to make sure you get the best plan for you. The good news is that Maine has expanded MaineCare. Within a certain income bracket your plan will change from an ACA marketplace plan to a MaineCare plan. Your plan Navigator can assist you with any questions you may have.

6. How do I prove my eligibility for the subsidy? You’ll need to provide detailed information on the application, including:

• Social Security number

• Birth dates and home addresses for all individuals who will be applying for coverage under the plan

• Name of employer and income information for every member of your household, even if they aren’t all applying for coverage

• Estimated household income

7. What are the different types of plans? The marketplace plans fall into three categories:

Bronze – Lowest monthly premium, highest out-of-pocket cost, very high deductibles.

Silver – The most popular plan. Moderate premiums, moderate out-of-pocket costs, deductibles are lower than Bronze plan.

Gold – High monthly premiums, lower out-of-pocket costs, low deductibles.

There is also a catastrophic plan, which includes all the benefits required by the ACA, including free preventive care. These plans carry low monthly premiums and very high deductibles. But they are only available to individuals under the age of 30 and to those who get an exemption from the marketplace because, for example, they cannot afford coverage any other way. You can find out more about the various types of plans at healthcare.gov/choose-aplan/plans-categories.

8. What if I’m already enrolled in a marketplace plan? First of all, remember that Maine has expanded MaineCare. Within a certain income bracket your plan will change from an ACA marketplace plan to a MaineCare plan. Your plan Navigator can assist you with any questions you may have. In addition, if you don’t do anything by Dec. 15, 2019 you will most likely be automatically renewed in your current plan. If your plan is no longer available, the marketplace will enroll you in the most similar plan, unless you are eligible for Medicare. If you are eligible for Medicare, the Marketplace will not enroll you into a new plan.

9. Does it pay to shop around for a plan? Yes, because there have been many changes in the 2020 plans and there are new plans available this year. You should be sure to check if the plan you are considering covers your doctors, prescription drugs and hospitals you are likely to use. Premiums also vary from year to year. IMPORTANT: Your premium must be paid before January 1, 2020. If you don’t pay your premium by January 1st, your plan might be canceled and you may have to wait until the next open enrollment period to sign up for another plan. If you have any questions, contact the statewide Navigator hotline or Consumers for Affordable Health Care. Premiums also vary from year to year.

FREE HELP IS AVAILABLE IF YOU HAVE QUESTIONS OR CONCERNS:

- You can bo to https://localhelp.healthcare.gov/#/, plug in your zip code and a list of nearby navigators will pop up.
- In Maine, you can also call the statewide navigator line at 1-855-806-7333.
- You can also visit www.enroll207.com

Download our ACA Enrollment Flyer Here!

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