Obamacare Open Enrollment Guide for Families

Some people find Obamacare complicated and even intimidating.

Our goal here is to help you make sense of open enrollment and simplify the process. In 2015 we published an Obamacare Guide for Families. While there is some company- or plan-specific information, the introductory overview to Obamacare should be helpful.

Get the Obamacare Guide for Families Here

Answers to Common Questions about Obamacare

When is Obamacare open enrollment?

The open enrollment period for 2019 begins November 1, 2018, and ends on December 15.

These dates are important because, unless you have special circumstances, you will be unable to get an individual health insurance plan outside of this window.

Who needs to enroll during open enrollment?

Everyone who needs individual health insurance needs to enroll. If you are covered through an employer or through a government sponsored plan like Medicaid, Tricare, or the VA, you don’t need to bother with open enrollment.

If you already enrolled in an Obamacare-compliant plan for this year, you will need to go through the process again for 2018. Plans and prices change, and it’s usually best to re-certify your eligibility for subsidy help.

Do I have to enroll on healthcare.gov?

No. The only people who need to move through the federal health insurance marketplace are those who think they will qualify for premium tax credits (subsidies) to help them pay premiums. If you make between 100-400% of the federal poverty level (many, many people do), you may be eligible.

If you are subsidy-eligible, we provide a private, secure third-party enrollment platform that will streamline the process and make it much simpler than using the government site!

Will healthcare .gov work?

While the government website has improved, we’ve found a much more efficient and user-friendly way to handle enrollments. We utilize a third-party enrollment platform that will seamlessly interface with the government Marketplace behind the scenes to process your enrollment. This approach will make the whole process dramatically faster and easier. 

How long does it take to enroll in Obamacare?

During the initial rollout of Obamacare, enrollments sometimes took hours to complete. With the streamlined process available on our marketplace, you could finish in a few minutes.  

What kinds of health insurance plans are available in Obamacare?

All plans must cover the 10 essential health benefits as laid out in the Affordable Care Act. So the coverage will be comprehensive.

You’ll find plans labeled by metallic categories: Bronze, Silver, and Gold.

Bronze plans will have the lowest cost but the lowest level of coverage (i.e. you’ll have higher out-of-pocket costs), and the plans progress upward from there. Most people typically select silver plans, but you should look at your options. (In South Carolina this year, as an example, there are bronze plans that are zero premium for a lot of subsidy-eligible people).

Will pre-existing conditions be covered?

Yes. Under the affordable care act, nobody can be declined health insurance coverage and the price you pay cannot be influenced by pre-existing conditions or medical history. The only factors that impact your basic premium are age, location, and tobacco use.

Do I need an agent? How does that affect my price?

Your premium will be the same whether you sign up by yourself or with the help of an agent or broker. A licensed and experienced broker (like us!) can guide you through the process and understand the different plan options so you’ll know what you’re buying. Since it’s free, there’s no reason not to utilize a broker’s help.

(Brokers are paid a fee or commission by the insurance company when they help you purchase that company’s plan. This doesn’t impact your price for a plan at all. If you want to know what we make from a particular insurance company, just ask.)

What happens if I don't sign up for Obamacare?

If you don’t sign up during open enrollment, you won’t be able to sign up later (unless you have a qualifying life event). You’ll still be able to apply for a short-term health insurance plan to provide major medical protection, but this will not satisfy the requirements of the “individual mandate” because they don’t meet all of the requirements of Obamacare.

That said, the individual mandate of the Affordable Care Act will not be enforced in 2019. If you’re healthy and not eligible for a subsidy, short-term health insurance is definitely worth a look.

(If you choose to opt out of Obamacare for some reason, consider the alternatives described in our “Nobamacare plan.“)

Are there qualified plans outside the government Marketplace?

Yes, in many states – including South Carolina – there are plans that are not available on the Marketplace. While they meet all of the Obamacare guidelines, if you bought these plans you would not be eligible to receive subsidies.

This year, if you don’t qualify for subsidies, you will definitely want to avoid the Marketplace because you will find much better value for your money outside of it. Contact us to see the difference.

Can I change my plan after I sign up?

You can change your plan during Open Enrollment. You will not be able to change your plan in the middle of the year, however, unless you have a qualifying life event.

How to Enroll in Obamacare

We promise to make this process as simple as possible. That’s why we’ve invested in a web-based platform to help our clients view plans, apply for subsidy eligibility, and enroll in one streamlined, seamless process.

You can access our certified Obamacare Open Enrollment Marketplace platform here:

Open Enrollment for South Carolina MarketplaceOpen Enrollment for Georgia Marketplace

 

If you have other questions, please let us know. Insurance is personal, and you may have other questions that are more specific to your particular needs and situation. We will do our best to help answer those questions so you can make decisions with confidence.

Contact AC Forrest today