Open Enrollment season has arrived for the Health Insurance Marketplace. Between November 1 and January 15, eligible people can enroll in a health insurance program of their choice. Plans vary in coverage levels, covered providers and cost, which can make deciding which plan to enroll in difficult and confusing.
Take Care Utah offers enrollment assistance
Luckily, Utahns have access to Take Care Utah, a Utah Health Police Project program that offers enrollment assistance to Utah enrollees. The program “is a network of nonprofit organizations focused on helping people with health insurance,” according to information from Utah Health Policy Project. “It consists of about 50 enrollment specialists all across Utah. All services are provided free of charge.”
During 2021, 41% of enrollees paid $10 or less for their monthly premiums, and ACA consumers across the nation saw a reduction in out-of-pocket costs, with the median deductibles decreasing 83%.
Even Utahns who recently signed up for coverage should reassess their options to make sure they have the best, most affordable plan for their needs.
So if you and your family need health care coverage and don’t know where to start, Take Care Utah can help.
What you’ll need
When you’re ready to enroll, you’ll need to assemble the proper documentation. This will include:
- Names, birth dates, and Social Security numbers for each family member applying for coverage.
- Information about health insurance coverage offered through your employer (if any).
- Estimated annual household income.
- Last three months of pay stubs for all income earners in your household (if applying for Medicaid or CHIP).
You’ll also need to be ready to choose from different health care options for your family. For instance, different plans will have different in-network or preferred providers. Knowing the name of any doctors you’d like to continue seeing will help you ensure your plan will cover care offered from the right places.
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When choosing a plan it can be helpful to attempt to estimate the medical expenses you expect in the coming year. You can use the prior year’s expenses as a guide. As a general rule, paying a higher monthly premium will give you a lower out-of-pocket maximum and vice versa.
“All plans in the Health Insurance Marketplace cover essential health benefits such as emergency services, maternity and newborn care, mental health and substance abuse services, prescription drugs, laboratory services, and much more,” reports Take Care Utah. “It’s likely your plan offers additional coverage beyond the minimum requirements—you will see exactly what each plan offers when your compare them side-by-side in the Marketplace.”
Affording healthcare
Some people may worry whether they’ll be able to afford care or if they’ll even be eligible because of ongoing health conditions.
Fortunately, pre-existing conditions and gender have no influence on whether you can receive coverage or not. Take Care Utah says the only things that can affect your premium are your age, where you live and whether you’re a smoker.
Additionally, if you aren’t sure you can afford premiums or any sort of coverage, talk with one of the experts at Take Care Utah to see if you qualify for a reduced or free plan. You can see plans and prices and get an estimate on your possible discount by visiting healthcare.gov.
You can also find out more information about insurance coverage from programs like Medicaid, Medicaid expansion, Children’s Health Insurance Plan (CHIP) and Utah’s Premium Partnership. These options provide coverage for families, children and individuals up to $17,600 a year for one person or $36,000 for a family of four. Unlike coverage offered by the Health Insurance Marketplace, these programs have no limit to when you can apply for them during the year.
Sarah Leetham, Take Care Utah co-director said, “Thousands of eligible children in Utah go without coverage every year. Oftentimes, families grow tired of encountering barriers through the enrollment process and never successfully enroll. Take Care Utah has a team of advocates that help families walk through the entire enrollment process, whether that is for Medicaid, CHIP, or Marketplace.”
Interested in getting help choosing a health insurance plan this year? Take Care Utah’s assisters offer free, in-person as well as virtual help. To find your nearest enrollment assister, call 801-433-2299 or search by ZIP code on the takecareutah.org website.