Ask The Expert: How Healthcare Navigators Can Help You

Under the Affordable Care Act, millions of Americans are now eligible for affordable and quality health insurance. The Health Insurance Marketplace Open Enrollment period began on November 1 and runs through January 31, 2016. You should understand what to look for and what questions to ask when choosing the best option for you and your family.

The federal government’s marketplace is a new way to find health coverage that fits your budget and meets your needs. With one application, you can see all your options and enroll.

Every health insurance plan in the federal government’s marketplace will offer essential health benefits, including doctor visits, preventive care, hospitalizations, and prescriptions. You can compare plans based on price, benefits, quality, and other features that are important to you before you make a choice.

Jackson Health System currently has “Health Navigators” at all of its hospitals and clinics to assist people during enrollment. The navigators are committed to educating the public on their eligibility for insurance affordability programs and the full range of Qualified Health Plan (QHP) options.

Individuals without health insurance are required by law to sign up.  Those who fail to sign up for insurance under ACA may be penalized.

Here are some frequently asked questions about the Affordable Care Act and the government’s Health Insurance Marketplace:

How long does it take for my plan to take effect?
Depending on the date of enrollment, plans may begin on February 1 or March 1, but typically take effect on January 1, 2016.

Can I buy or change health plans outside of the open enrollment period?
If you experience a qualifying life event, such as a death, birth, or divorce, you can enroll outside of the open enrollment period. You have 60 days from the date of the event to enroll in a plan. Qualifications for this special enrollment opportunity vary. Visit Marketplace.cms.gov for more details.

What are the penalties and exemptions under the Affordable Care Act?

• Exemptions from the penalty:
  • You’re uninsured for less than three months of the year.
  • The lowest-priced coverage available to you would cost more than 8 percent of your household income.
  • You don’t have to file a tax return because your income is too low.

• Hardship penalties exemptions:
  • You were homeless.
  • You were evicted in the last six months or were facing eviction or foreclosure.
  • You received a shut-off notice from a utility company.
  • You experienced a fire, flood, or other natural or human-caused disaster that caused substantial damage to your property.
  • You filed for bankruptcy in the last six months.
  • You had medical expenses you couldn’t pay in the last 24 months.

If I am not satisfied with the plan I selected, can I sign up for another plan?
Yes, you can switch your plan at any time during the open enrollment period.

What do I need to bring to my appointment to apply for health coverage?
Make sure to have the following information for every individual who is applying for coverage: home and mailing address, social security number, document information for legal immigrants, and employer and income information.

For more information about the federal government’s Health Insurance Marketplace, visit HealthCare.gov or jacksonhealth.org.

LaQuanna Scott-Lightfoot is the associate administrator of uncompensated care at Jackson Health System.