Health Insurance Marketplace Information You Want To Know

November 5, 2014

Do you or someone you know plan to use the Health Insurance Marketplace to purchase health care coverage in 2015? Are you prepared to navigate the Marketplace to find the health insurance plan that best fits you and your family needs?

Health Insurance 2015

Here is a short guide to changes and improvements at Healthcare.gov and the Health Insurance Marketplace to help you successfully navigate the Health Insurance Marketplace and find your best-fit health insurance.

Healthcare.gov – A New & Improved Website

The Healthcare.gov website has gone through a complete makeover just in time for the 2015 Enrollment period. The website has been updated and revised, making it much simpler for first-time users to navigate the site and complete the enrollment process.

One vital improvement? Most first-time applicants will be able to use a shorter, simpler online enrollment application, with fewer pages, mouse clicks and questions to navigate. This not only streamlines the application process, but should result in less applicant frustration.

Check out the new and improved Healthcare.gov website for yourself.

Marketplace Insurance

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New Insurance Providers To Choose From

The Health Insurance Marketplace will have several new health insurance providers selling plans for the 2015 coverage year. To date, there has been a 25% increase in available health insurance providers, giving Marketplace applicants more options to find a health insurance plan that best fits their health care needs.

More health insurance providers is a win-win for everyone! Not only will consumers have more options and more choices for 2015, additional health insurance providers also means more competition. More competition can lead to potentially better pricing options for consumers and possibly saving them money on their 2015 plan purchases.

Most People Can Find an Affordable Plan

The Marketplace provides health care plan options at a variety of price levels, allowing most customers to find an affordable plan to match their needs. Last year, most adults with low-to-moderate incomes (less than $28,725) who applied for insurancee were able to find a plan with a premium less than $125 a month for individual coverage.

The same results are expected this year. Using the Marketplace is a good way to ensure you and your family will have 2015 health care insurance, at prices you can afford.

Are You Ready for the 2015 Marketplace Insurance Enrollment?

The Healthcare Insurance Marketplace is only open for a limited time, so mark your calendars. You don’t want to miss those key enrollment dates if you plan to purchase 2015 health insurance through the Marketplace.

Other information to help you better prepare for the 2015 Marketplace insurance enrollment include:

And, if you plan to use the Marketplace for your 2015 health insurance, consider signing up to receive important Open Enrollment news and updates. By registering for either email or text notifications, you can keep on top of key enrollment dates, pricing and plan information.

Health Insurance Marketplace

With this information, you are now ready to complete your 2015 Health Insurance Marketplace enrollment.

We Are Here To Help

Delaware Family Voices is here to help answer your questions before, during and after the Open Enrollment period. Please contact us and let us know how we can help you.

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Images from Healthcare.gov.

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Health Insurance Marketplace Dates You Don’t Want To Miss

October 22, 2014

Are you or someone you know planning to apply for health insurance through the Health Insurance Marketplace? Then you might want to take note of the following important dates for the upcoming enrollment period.

Health Insurance Marketplace

Key Dates for 2015 Marketplace Enrollment

The 2015 Health Insurance Marketplace Open Enrollment period is fast approaching! This open enrollment period is when you can apply for 2015 health insurance coverage through the marketplace. If you are considering a marketplace insurance plan, or want change an existing marketplace insurance plan, you need to know these important dates.

These four key dates are crucial to ensuring you receive the marketplace health insurance benefits you want for 2015:

November 15, 2014 – The 2015 calendar year Open Enrollment period begins. You can apply for insurance coverage, choose to keep existing coverage, or change your coverage.

December 15, 2014 – This is the enrollment cut off date for coverage to begin on January 1st, 2015. If you want new coverage to begin on January 1st, your application must be completed by December 15. If you are changing plan coverage, you need to enroll by this date to prevent a lapse in coverage.

December 31, 2014 – Coverage ends for 2014. New coverage can begin as early as January 1st, 2015, so long as the application has been submitted by December 15th.

February 15, 2015 – Open enrollment ends. This is the last day you can apply for a 2015 Health Insurance Marketplace plan.

Mark your calendar now to ensure you don’t miss these important health insurance enrollment dates!

Health Care Insurance

Key Marketplace Enrollment Information

Here is additional information you want to take note of to keep your 2015 Marketplace health insurance coverage on track.

During Open Enrollment:

If you enroll between the 1st and 15th of the month, your coverage starts the 1st day of the next month.

If you enroll between the 16th and last day of the month, your coverage begins the first day of the 2nd following month. In other words, if you enroll on December 16, your coverage will not start until February 1st.

Those With Current 2014 Marketplace Coverage:

Your 2014 coverage will end on December 31st.

Those enrolled through the federal Marketplace will be automatically re-enrolled in their existing plan. Note that those enrolled in Medicaid will need to re-enroll.

If you want to change coverage, you will need to do so between November 15 and December 15 to ensure your coverage begins on January 1.

Outside The Open Enrollment Period:

If you miss the February 15th, 2015 final enrollment date, you may not be able to purchase Marketplace health coverage for 2015.

You may buy Marketplace insurance only if you qualify for a Special Enrollment Period due to a qualifying life event. Learn more about how to qualify for a Special Enrollment Period.

You can enroll in Medicaid or CHIP at any time.

Family Health Insurance

Connect With Health Insurance Marketplace

Enrolling for health insurance through the Health Insurance Marketplace can raise a lot of questions. Don’t feel you have to “go it alone.” There are several resources available for you to reach out and get answers to your Health Insurance Marketplace questions.

Got Questions? Call the Marketplace directly at (800) 318-2596 or TTY (855) 889-4325. The lines are open 24 hours, 7 days a week, except certain holidays.

Keep Up-to-Date – Subscribe to receive email or text message updates about new health insurance options and benefits.

Read the Healthcare.gov Blog – The Blog is full of helpful information and resources that can help you through the enrollment period.

Get Answers – Check the Marketplace Get Answers page for more more information about health coverage.

You can also follow what’s happening at the Health Insurance Marketplace via their Social Media venues: Facebook, Twitter, Google+ and YouTube.

How Can We Help?

Delaware Family Voices is here to help answer your questions before, during and after the Open Enrollment period. Please contact us and let us know how we can help you.

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Images from Healthcare.Gov.


The Affordable Care Act – What Does It Mean For Families?

October 9, 2012

On March 23, 2010, President Obama signed into law the Affordable Care Act (ACA), putting into place comprehensive health care changes that were scheduled for implementation over the next four years. Almost immediately, ACA provisions began phasing in, despite court challenges to the ACA.

In June 2012, the U.S. Supreme Court upheld nearly all of these ACA changes, allowing existing provisions to remain in effect, and the remaining provisions to continue to be phased in through 2014. For a complete list of Key Features of the Affordable Care Act, By Year, click on this link.

The ACA and Families of Children with Special Health Care Needs:

Many ACA-required changes affect families of children with special health care needs. Listed below are key ACA provisions that directly affect families with children, as well as when these provisions became, or will become, effective.

ACA Provisions Already In Effect:

Pre-existing Conditions The ACA prohibits insurers from denying coverage to children under age 19 because of a pre-existing condition. (Effective since September 2010)

Maintaining Coverage for Young Adults This ACA provision allows parents to keep their adult children on a parent’s insurance plan until the child reaches age 26, unless the young adult is offered insurance at his/her employment. (Effective since September 2010)

Denying Coverage Based on a Technicality Insurance companies can no longer rescind coverage due to errors or other technical mistakes on a customer’s application. Some insurers have used such technicalities to deny coverage to individuals who had become ill. This practice is now illegal. (Effective since September 2010)

Providing Free Preventative Care All new plans must cover certain preventative services without charging a deductible, co-pay or coinsurance. Covered services for children include screenings for autism, blood pressure, cervical dysplasia and hearing, as well as behavioral assessments.  Click on this link for a complete list of covered services. (Effective since September 2010)

Eliminating Dollar Limits on Lifetime Essential Benefits The ACA prohibits insurance companies from imposing lifetime dollar limits on essential benefits such as hospital stays. Insurers have also been restricted from putting annual dollar limits on coverage of essential benefits in all new plans. (Effective September 2010)

Increased Access to Home Care Since October 1, 2011, the new Community First Choice Option has allowed states to offer home and community based services to people with disabilities through Medicaid rather than only offering institutional care in nursing homes. (Effective since October 2011)

ACA Provisions Scheduled for Implementation in 2013 and 2014:

Two Additional Years of Funding for the Children’s Health Insurance Program (CHIP) Effective October 1, 2013, states will receive two additional years of funding under CHIP for the express purpose of continuing insurance coverage for children ineligible for Medicaid due to their parents’ income.

Prohibiting Discrimination Due to Pre-Existing Conditions or Gender Effective January 1, 2014, insurers will be prohibited from denying coverage for anyone with a pre-existing condition or because of gender, regardless of age. They will also no longer be able to charge customers additional fees due to a pre-existing condition.

Eliminating Dollar Limits on Annual Essential Benefits Effective January 1, 2014, the law will expand from no lifetime limits (implemented in Sept. 2010) to include no annual limits to the amount of coverage for essential benefits an individual may receive, and will be effective for both new and existing plans.

Preserving Insurance for Those Enrolled in Clinical Trials Effective January 1, 2014, insurers will not be allowed to drop or limit coverage because an individual chooses to participate in a clinical trial to treat any life threatening disease including, but not limited to, cancer.

Summary: The ACA provisions guarantee that no child can be denied coverage due to a pre-existing condition, either temporary or permanent, and that similar protection will apply to adults by 2014. All children, regardless of health status, can remain on their parents’ insurance plans until age 26 unless the child can obtain coverage through his/her own employer. Dollar limits on annual and lifetime essential benefits coverage cannot be put into new policies and will be removed from existing policies. Rates cannot be raised based on an individual’s gender or health status.

If you have additional questions about the ACA and it’s impact on your family, or want more information, contact Delaware Family Voices at 302-221-5362.

For a full timeline of the ACA’s provisions, visit HealthCare.gov’s What’s Changing and When Timeline for ACA Changes.


Delaware Essential Health Benefits Public Forum And Open Comment Period

July 2, 2012

Calling All Delawareans –

The state of Delaware is currently defining it’s benchmark health care plan in compliance with the Patient Protection and Affordable Care Act. You are invited to provide feedback during this timeframe – your feedback can affect the future of Delaware health insurance plans.

Background:

The Patient Protection and Affordable Care Act requires that every health insurance plan offered to an individual or small business must cover a minimum level of benefits in each of the ten areas of services listed below. This minimum coverage standard is referred to as Essential Health Benefits (EHB).

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care

Delaware’s Essential Health Benefits (EHB) Plan:

Each state, including Delaware, is responsible to define a benchmark plan as the standard for it’s own EHB benefits package. Once Delaware’s benchmark plan is established, all other health insurance plans offered in Delaware will be required to be “substantially equal” to the State’s benchmark plan. Plans will have flexibility to adjust included services as well as quantitative limits on certain services, so long as the coverage has the same value as the State’s EHB benchmark plan.

Detailed Information:

The Delaware Department of Health and Social Services (DHSS) and the Delaware Health Care Commission (DHCC) have prepared detailed materials on the State’s EHB benchmark plan, including a Stakeholder Packet, a Benefits Grid, a Benchmark Plan Comparison, and an Evaluative Tool for Chronic Disease Patients.

This material is now available for public review and feedback, and can be found at the Delaware Health Care Commission website, under What’s New.

Get Your Written Comments In By August 2nd!

Your feedback is very important. Comments on the proposed EHB benchmark plan may be submitted to the DHCC by either email or mail. Comments will be accepted through August 2nd, 2012.

E-mail to HBE_Delaware@state.de.us
Mail to: Delaware Health Care Commission, Margaret O’Neill Building, Third Floor, 410 Federal Street – Suite 7, Dover, DE 19901

Speak Your Voice! Open Forum on July 17th.

Additionally, DHSS and DHCC is hosting a public forum on July 17th, 2012, from 6:00pm to 8:00pm. All Delawareans are invited to attend the forum, review EHB material, and submit comments at that time.

The forum will be held at the Delaware Technical and Community College (DelTech), Terry Campus, 100 Campus Drive, Dover, DE 19904. Go to Rooms 400 A&B in the Corporate Training Center.

For additional information about these events, contact the Delaware Health Commission at (302) 739-2730.