Ready, Set, Enroll!

Open enrollment for the Health Insurance Marketplace begins on November 1.
By Mimi Garcia

The rain is falling, there is a cool nip in the air, and a Houston autumn is just around the corner. With the cooler weather also comes the November 1 start of the three-month open-enrollment period for the Health Insurance Marketplace at HealthCare.gov. Yes, it’s almost Obamacare time!

Over the last few months, we’ve been talking about how important it is to have health insurance, ways you can get help paying for it, and what the recent changes in marriage laws mean for LGBT couples getting covered. Well, those articles were just an appetizer to prepare you for the three-month enrollment period that is about to start.

Many in the LGBT community had previously been left out when it comes to health insurance, and their health suffered as a result. It had been too hard to find coverage that treats families fairly, that covers needed care, and that doesn’t break the bank. The LGBT community continues to face significant disparities such as higher rates of tobacco use, abuse and violence, mental- and behavioral-health issues, and HIV infection. That’s where the Affordable Care Act comes in. For the first time, there are new affordable options, protections against discrimination based on sexual orientation and gender identity, and the opportunity to get coverage even if you have a preexisting medical condition.

Let’s start with the basics: you need to have health insurance—not just to avoid paying a fine at tax time (which gets really hefty next year at $695 or more), but in order to stay healthy. Thanks to the Affordable Care Act, you can’t be denied health insurance because of any preexisting condition, and you can’t be charged more because of a health condition or for being a woman. The health insurance plans on the Marketplace have to cover the basics like annual checkups with no co-pay, preventive screenings like STI testing, colonoscopies, breast exams, doctor and emergency-room visits, prescription drugs, and more.

You can even get help paying for your Marketplace health insurance. More than 8 in 10 Texans who enrolled in coverage last year got help paying for their health insurance. You could be in a family of four making up to $97,000 a year and still be able to receive financial assistance. Wondering about how much it would cost you? Visit our handy calculator at getcoveredamerica.org/calculator to get a better idea of the kind of monthly premiums you’re looking at.

If you don’t have health insurance, or if you want to change your current plan, you have a short time to enroll: November 1, 2015, to January 31, 2016. If you don’t get enrolled by the end of January, you might have to wait almost a year to enroll for 2017. Don’t wait until the last minute—that’s what everyone does, and it means longer lines, slower website connections, and less time to figure out issues if you run into any snags. If you enroll by December 15, your health insurance will start on January 1, 2016. Happy New Year!

If you enrolled last year, good job! But you may still have some work to do, such as updating your information and looking at your new options for 2016 coverage. Although you can stay with your existing plan, each year there are new options out there, so you may be able to find a new plan with better options for you. You also want to make sure that all your information like family status, income, and address are up to date. Did you get married this summer? Move? All of those things need to be updated because they affect your premiums. Active re-enrollment by December 15 is the best way to make sure you don’t lose coverage or have any gaps. If you don’t make it by December 15, you’ll still have until January 31. But why wait?

Now is the time to get ready for enrollment. Dig out last year’s tax return, look at which doctors you want to keep on your plan, and start looking at your budget. There are some great places throughout the Gulf Coast region to get face-to-face help with the enrollment process. You can call 832.393.5423 or go to getcoveredamerica.org/connector to schedule a free appointment with an expert who can help you in person.

Mimi Garcia is the Texas state director for Enroll America.


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