Opinion

Progressive Voice: Open Enrollment 101 – Getting Covered for 2018

Progressive Voice is a weekly opinion column. The views and opinions expressed in the column are those of the individual authors and do not necessarily reflect the views of their organizations or ARLnow.com.

By Emma Goodacre

Since 2010, hundreds of thousands of Virginians have gained access to health insurance through the Affordable Care Act (ACA). Virginia’s uninsured rate is now down to 8.7 percent — a 33 percent drop since enactment of the ACA.

Nationally, the Affordable Care Act has helped over 20 million people access quality care at an affordable price that, for many, was previously inaccessible.

But with so many “repeal and replace” attempts in Congress, an open enrollment period only 45 days long and huge cuts to advertising and navigator funding by President Trump’s Administration, many Virginians are confused about their ability to access affordable coverage going into the health insurance enrollment season.

Fortunately, the Affordable Care Act is still in effect and affordable coverage options ARE available for Virginians shopping on the Marketplace.

Young Invincibles, a national nonprofit organization dedicated to expanding economic opportunity for the Millennial generation, is helping Virginians get coverage at an affordable price, understand their plan options, and access high quality care.

We do year-round health insurance literacy education to ensure that Virginians know how to use their insurance, and to provide culturally competent health care options to some of the Northern Virginia’s most underserved communities.

This year, we will be at the forefront of Virginia’s open enrollment outreach to support consumers looking for affordable coverage options, particularly in light of the significant cuts to Virginia’s enrollment assistance programs such as Enroll Virginia, the Navigator consortium dedicated to helping people get coverage.

The Marketplace open enrollment season runs only from November 1 until December 15. Below, you’ll find some of the most frequently asked questions about open enrollment and affordability options so you’ll be ready to enroll on November 1st.

Has “Obamacare” been repealed?

No. The ACA — commonly known as “Obamacare” — has not been repealed.  Comprehensive coverage remains available and income-based tax credits are currently available to make plans more affordable.

What is the Marketplace? Who should buy insurance there?

The Health Insurance Marketplace provides information about health insurance, how to compare and purchase plans, and help for enrolling in a plan. To get a tax credit to lower the cost of buying a plan, you must purchase insurance through the Marketplace. You can access the Marketplace by visiting HealthCare.Gov.

If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying health coverage, then the Marketplace is for you.

How do I get covered?

Open Enrollment runs from Wednesday, November 1 to Friday, December 15, 2017. You must enroll during these six weeks to have insurance coverage starting January 1, 2018.  You can enroll:

What is the difference between a bronze, silver, gold or platinum plan?

Marketplace plans must include comprehensive coverage known as “essential health benefits.” Lower level plans such as a bronze plan will generally have lower monthly premiums, but higher out of pocket costs for health care services. Silver or gold plans will have higher monthly premiums, but will cover more out of pocket costs.

Certain income levels can qualify for extra discounts to cover out of pocket costs, but you MUST enroll in a silver plan to become eligible.

I got Marketplace insurance last year. Do I need to do this again?

New plans are available on the Marketplace every year and you may be able to find a plan that’s a better fit for you. To get the best bang for your buck, make sure you log in and “actively renew.”

If your current plan or provider is no longer offered in this year’s marketplace and you want to make sure you can visit your current doctor, bring a list of doctors and prescriptions with you to your enrollment appointment. This will help you understand your options for keeping your doctor and getting the care you need.

Insurance is expensive! Is financial assistance available?

Discounts that lower your monthly costs, and in some cases, lower your out of pocket costs are available to low and middle income Marketplace shoppers.

Anyone making up to four times the federal poverty level, about $48,000 a year for an individual, may be eligible for a discount to help afford their health plan. Over 80 percent of people who apply for coverage through the Marketplace qualify for these credits. Additionally, 80 percent applicants could get a plan for $100/month or less.

Emma Goodacre is the Northern Virginia Training and Outreach Coordinator at Young Invincibles. She is a Certified Application Counselor (CAC) available to help assist Virginians enroll for affordable health insurance.