You still have time to choose your plan in the Health Insurance Marketplace at healthcare.gov. In order to have coverage by January 1, you will need to enroll by Dec. 15. You can still get coverage starting on Feb. 1 as long as you enroll by Jan. 15. After that you will need a special event (marriage, childbirth, move, etc.) to enroll in a Marketplace plan.
Ensure you will remain eligible for Medicaid if you are currently enrolled. Also make sure your contact information is current. You can go to fssabenefits.in.gov to check. If you are no longer eligible for Medicaid, you will want to know that before the Marketplace deadlines pass.
For anyone confused by all the options in the Marketplace, remember that there is a great deal of overlap between plans, including coverage of emergency services, hospitalization, certain types of preventative care, services for both mental health and substance use disorder, pregnancy care, pre-existing condition coverage, etc. For more details, visit this site: healthcare.gov/coverage/what-marketplace-plans-cover.
That said, determining the best insurance selection for yourself and your family will depend on the types of services you regularly need, your budget and your likely future needs. One helpful practice is to look over the health care costs you paid last year since they weren’t covered by insurance (including deductibles). What was the total amount? Do you and your family go to the doctor frequently or rarely? Do you foresee any health care procedures needed this year? Those types of questions will help you narrow your choices.
It also helps to talk to those more familiar with the insurance options rather than relying on the online descriptions. Marketplace representatives can answer your questions. Just call 1-800-318-2596. You can also check out the Marketplace tips on what to consider before making selections at www.healthcare.gov/choose-a-plan/comparing-plans.
As you look through healthcare.gov, you may be confused by the sheer number of unfamiliar terms used in health care. You can go to this page for helpful definitions or even have the page pulled up during your call with a Marketplace representative: healthcare.gov/glossary.
If you are a DACA (Deferred Action for Childhood Arrivals) recipient, this might be your first year of eligibility for the Marketplace. Starting this year, those DACA recipients who meet requirements for Marketplace enrollment have access to a Qualified Health Plan (QHP) and Basic Health Program (BHP).
Eskenazi Health Financial Counseling can also offer you in-person guidance on Marketplace choices as well as on Medicaid and other government programs. They also can discuss whether you might qualify for cost reductions for your insurance. The three biggest Eskenazi Health Center locations are particularly helpful with Marketplace assistance: Eskenazi Health Center West 38th St., Eskenazi Health Thomas & Arlene Grande Campus and the downtown campus at 720 Eskenazi Ave. Your financial counselor can customize the talk based on your individual needs as well as the needs of your family members.
To schedule an appointment with a financial counselor at one of these Eskenazi Health Center locations, please pick a time where you see an opening Monday – Friday, 9 a.m. – 5 p.m. on Eskenazi Health MyChart or call 1-855-202-1053.
Financial Counseling has been offering expanded hours on Saturdays during the enrollment period. The final Saturday for Marketplace help is Dec. 14 on the downtown campus (720 Eskenazi Ave.) between 10 a.m. and 2 p.m.
Keep in mind that the counselors will try to fit in walk-ins during regular and expanded hours, but having an appointment is always preferable to ensure you get in.
While it is certainly a hassle to take the time in this busy season to wade through health insurance options, you will be glad you did once you find a plan that makes sense for your budget and health care needs. Just don’t feel like you ever must make those decisions alone.
Nydia Nunez-Estrada, M.D., family medicine specialist with Eskenazi Health Center Grande