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Congressman Gene Green

Representing the 29th District of Texas

Open Enrollment for Health Insurance Marketplaces

Open Enrollment season is upon us. On November 1, 2017, millions of Americans will have the opportunity to buy or change their health insurance plan for 2018. You can find plans with no-cost preventative care like flu shots and mammograms. Most consumers can also find options with premiums between $50 and $100 per month, thanks to financial assistance.

Free help is available. All you have to do is visit www.healthcare.gov or call 1-800-318-2596. You can also make a one-on-one appointment in the Houston-area by visiting localhelp.healthcare.gov.

*If you’re interested in Medicare Open Enrollment, please continue to scroll down the page.*

Here’s what you should know:

  1. Open Enrollment on the healthcare marketplace begins on November 1, 2017 and lasts until December 15, 2017. Sign up early on healthcare.gov to beat the rush. 
  2. Financial help is available and getting covered could be more affordable than you think. Eight in ten people qualified for financial help last year, meaning that they could find premiums between $50 and $100 per month.
  3. Whether you are returning to switch plans or this is your first time getting covered, the deadline is December 15, 2017.
  4. Trained professionals are available to provide free help. Call 1-800-318-2596 or visit localhelp.healthcare.gov.

Helpful resources:

  • healthcare.gov
  • 1-800-318-2596
  • 1-855-889-4325 (TTY users)

Five steps to staying covered: (Courtesy of Health Insurance Marketplace)

  1. Review
  • Look for a letter in the mail from your health plan describing any plan changes.
  • Read the letter and contact your health plan if you have questions.
  • Write down important dates and information.

      2. Update

  • If you don’t update your information, like changes in your income, you might not get the right premium tax credit and cost-sharing reductions. Even a small change can affect what you qualify for, so make sure your information is up-to-date.
  • After you submit your application, read your eligibility notice carefully. Even if none of your information changed, you might get different cost savings because of changes in the Marketplace.

      3. Compare

  • Are you happy with the changes to your current plan?
  • What will your benefits and costs be?
  • Are new options available? There may be plans available to you that weren’t an option last year. Plans can change each year, and some of these changes could affect what doctors, pharmacies, and prescriptions you can use.
  • When you compare plans, you’ll see if the plans you’re interested in cover specific doctors, prescription drugs and facilities, like hospitals and pharmacies. You can also filter plans based on doctors, drugs, and facilities.

     4. Choose

  • You can choose any plan available to you in your area in 2018, no matter what plan you had in 2017.
  • You can use any premium tax credits and cost-sharing reductions (if you qualify) only if you enroll in a Marketplace plan.
  • If your insurance company isn’t offering a plan through the Marketplace in your area for 2018, you may be matched with an alternate plan.

     5.Enroll

  • If you want health coverage in 2018, you must enroll in a plan by December 15, 2017, the end of the Open Enrollment Period. You won’t have a chance to change your plan after this date unless you qualify for a Special Enrollment Period.
  • If you want your health coverage to start on time, make sure you pay your first premium. You can see a summary of your coverage under “My Plans & Programs.”
  • Make sure to report any updates to your information to the Marketplace. You must report a life change (like getting married, having a baby, or losing health coverage) within 30 days to ensure your coverage is kept up-to-date.

 

Fall Medicare Open Enrollment

For 2018 Medicare coverage, open enrollment is from October 15 to December 7. During this annual enrollment period, you can make changes to various aspects of your coverage. You can switch from Original Medicare to Medicare Advantage, or vice versa, or from one Medicare Part D prescription drug plan to another. If you did not enroll in a Medicare Part D plan when you were first eligible, you can do so during the general open enrollment, although a late enrollment penalty may apply.

If you’re already enrolled in a Medicare Part D prescription plan or a Medicare Advantage Plan and you don’t want to make changes to your coverage for 2017, you don’t need to do anything during open enrollment, assuming your current plan will still be available in 2018. If your plan is being discontinued and isn’t eligible for renewal, you will receive a non-renewal notice from your carrier prior to open enrollment. If you do not, you can keep your plan without taking any action during open enrollment. However, your benefits and premium could be changing for 2018, so it is important to make sure you understand any changes that may apply, and that you check to make sure that your current plan is still the best available option.

What you need to know:

  • Fall Open Enrollment occurs from October 15 to December 7 of every year
  • In most cases, Fall Open Enrollment is the only time you can pick a new Medicare Advantage or Medicare Part D plan.

Helpful resources:

  • If you want to join a stand-alone prescription drug plan (PDP), use the Plan Finder tool on www.medicare.gov. The Plan Finder tool compares plans based on the drugs you need, the pharmacy you visit, and your drug costs.
  • If you want to join a Medicare Advantage Plan, call 1-800-MEDICARE to find out what plans are in your area. When you receive the list of plans, check the plans’ websites to see which best fits your needs.
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