The Affordable Care Act
Open Enrollment 2017
The Latino community faces several serious health disparities that lower life expectancy and quality of life. These health outcomes may result in part from lack of timely preventive services or screenings, often associated with a lack of health insurance coverage. Expanding opportunities for coverage can improve health outcomes for Latinos. As a CFC LULAC is committed to connecting families with quality affordable healthcare.
When Can I Enroll?
Open Enrollment for 2018 is Open Now
The enrollment period for 2018 is now open. You will be able to sign up for coverage through the Marketplace during the next open enrollment period, which runs from November 1, 2017 through December 15, 2017.
States with extended deadlines are California, Colorado, Connecticut, District of Columbia, Massachusetts, Minnesota, Rhode Island, and Washington. The extended deadlines and coverage dates can be seen here.
Marketplace. How Do I Enroll for 2018?We encourage you to utlize the method for enrollment that you are most comfortable with:
- Enroll online in English at: Healthcare.gov; and in Spanish at CuidadoDeSalud.gov
- Completing and mailing a paper application form using these instructions for assistance. Speaking to a representative at call centers by calling 1-800-318-2596.
- Meeting with an in-person assister, navigator or social worker at a community health center. This page can help you find an in-person assister in your area.
I enrolled last year, What do I have to do for 2018?
If you enrolled in coverage last year, you must re-enroll or enroll into a different plan by December 15, 2017 for your new insurance to start on January 1, 2018 and avoid a gap in coverage.
If you signed up for coverage through the marketplace last year, you MUST renew your coverage for the new year. Your 2017 coverage ends on December 31, 2017 regardless of which month you enrolled in last year.
From November 1, 2017 through December 15, 2017, you can go to the Marketplace and:
- You can choose to stay in your current plan (as long as it is still being offered.) You can easily search for your plan in the marketplace with your plan number which can be found on your monthly insurance statements.
- You can look for a new plan.
If you do not take action by December 15, 2017, the Marketplace will try to auto-enroll you into the same plan as last year and you will receive the same financial assistance as last year.
Please take the time to update your information. You may be eligible for cheaper monthly premiums or higher premium tax credits. Log in and see.
Four Easy Steps to Renew your Coverage
- Review Your Plan: Make sure your plan fits your needs for 2018. Consider if you should choose a plan with a different monthly premium, deductible, or copay.
- Update your Information: Log into your marketplace account or call the marketplace 800 number and review your prefilled application. Change your information as needed.
- Compare Plans: Check to make sure there aren't more affordable options, or plans with different deductibles, premiums or copay to fit your health needs. If you are content with your current plan, and wish to simply re-enroll, you can directly search for your plan using its 14 digit ID number which can be found on your statements.
- Choose a Plan and Enroll: Make a final decision, enroll into your plan and pay your first premium. Enroll by December 15th to ensure that there is no lapse in coverage.
Understanding How Health Insurance Works
The goal of health insurance is to help you pay for your medical costs and services.
Through the marketplace, a variety of health insurance plans are offered by a variety of companies. Under the ACA, all insurance plans must cover certain key health services, but there are still differences between the plans. Below are some things to consider when picking a health insurance plan.
- The Premium: The amount taken out of your paycheck to pay for health insurance.
- Copayments/Copays: A fixed amount (ie. $15) you pay for a covered health care service like a visit to a primary care physician or the purchase of prescription medicine. You are not responsible for any additional costs for these items as they are covered by your health insurance plan.
- Deductible: How much you must pay for the services your health plan covers before your coinsurance takes effect. Your plan may have a separate deductible for medical care and prescription drugs. Typically copay's do not count toward your deductible.
Typical costs that apply to your deductible include:
- Hospitalization, surgery and other procedures
- Lab tests, MRIs, CAT scans, surgical costs, anesthesia, physical therapy, and other medical devices
- Coinsurance: A fixed percentage you pay (ie. 20%) as your share of the costs for a covered health service after you have met your deductible. Before your deductible is met, you pay 100% of costs. You continue to pay the fixed percentage until you reach your out of pocket maximum.
- Out of Pocket Maximum: The most you will have to pay during a policy period (usually a year) for health care services you receive. Once you have reached your out-of-pocket maximum, your health insurance plan begins to pay 100%of the allowed amount.
- Networks: Some insurance companies contract with facilities, providers and suppliers to provide health care services in a group called a network. You can see providers who are outside of this “network”, but you may need to pay more. Check with your provider before you see someone outside of your network so you can understand the costs. When you enroll in an insurance plan, you will get a membership card or other paperwork that will have important information such as your name, member number, plan group number, co-payment and coinsurance information and important phone numbers. Make sure to keep your insurance card in a secure place and call your company to replace it if lost.
If you don’t understand how these terms apply to your plan, be sure to address them with your insurance company before enrolling into the plan.
From Coverage to Care
From Coverage to Care is an initiative by the Centers for Medicare and Medicaid Services to help people with new health care coverage understand their benefits and connect them with primary care and the preventive services so they can live a long and healthy life.
Getting the Most out of your Coverage.
Use your coverage to stay healthy:
Even though you may not feel sick it is still important to have regular check-ups and preventative care. Preventative care a key part of addressing the health disparities the Latino community faces.
One of the most important parts to making sure you regularly visit the doctor is to make sure you find a doctor you like and trust. A long-term relationship with your primary care provider is important to ensuring you get the best care. Primary care providers include general practice, family practice, internal medicine, pediatrics and usually, obstetrics and gynecologists. This is the person you will see for your check ups instead of going to the emergency room.
Do not be afraid! Some people are afraid to see a doctor or health care professional because they are afraid of hearing bad news. If you see a doctor regularly, you have a better chance of identifying and treating any health concerns before they become an issue.
Discussions to have with your doctor:
Do not be afraid or embarrassed to approach your doctor with any of your health concerns. They are there to help you. If you hide information from your doctor, it may hinder their ability to diagnose and treat you.
Ask your doctor questions if you:
- Have questions or concerns about your health
- Are unsure how to change your routines to feel less tired, have better habits, be healthier
- What are some lifestyle changes you should make to be healthier? Are you having all of the screenings you should? Screenings are important as they check for diseases or illnesses before symptoms appear. Early detection allows for early treatment and better outcomes. Some important screenings include blood pressure and cholesterol screenings.
- Be physically active
- Make healthy food choices
- Achieve and maintain a healthy weight
- Be tobacco free
- Manage stress
Are you taking all of the preventative medicines you should? Ie. Regular aspirin to help prevent heart disease.
Do you have all of the immunizations and/or shots you need? Ie. flu shot, shingles vaccine.
Getting a regular check-up will allow you to learn how your age, gender, family history, and health behaviors can affect your chances to live a longer, healthier life.
Regularly seeing a doctor can help you: