Make a New Year’s Resolution To Get Your Health Needs Covered


By Rosy Mota

This month, I, like many of my fellow LGBT Houstonians, will be taking time to reflect and celebrate as 2015 comes to a close and we look forward to what 2016 holds.

Whether your New Year’s resolutions involve eating healthier, going to the gym more, or starting a meditation program to help with your emotional and mental health, I want to remind everyone of one way to ensure that you will have success in the New Year: getting health insurance coverage through the online Health Insurance Marketplace. If you enroll by December 15, your health insurance coverage will start on January 1.

Though LGBT Americans often face unique obstacles when seeking healthcare, the Affordable Care Act includes specific benefits and protections for the LGBT community that have helped to expand access to quality, affordable health coverage. In fact, according to a study by the Urban Institute, the uninsured rate for lesbian, gay, and bisexual adults has almost been cut in half since the middle of 2013. But many LGBT Texans who could benefit from the Affordable Care Act still remain unaware of their options.   

It’s important to remember that the Affordable Care Act provides historic new protections for the LGBT community, so nobody with health insurance can be denied preventive coverage because of sexual orientation, gender identity, or gender expression. Additionally, people can no longer be denied coverage due to a pre-existing condition like cancer, HIV, or diabetes.

Also, every health plan must cover 10 essential health benefits such as prescription medications, emergency-room visits, and preventive services. Lifetime and annual caps on coverage are also prohibited, which means historic new protections for HIV patients. And insurance companies cannot deny transgender Americans the free preventive services they need, regardless of the sex they were assigned at birth or their current gender identity.

Under the Affordable Care Act, legally married couples—including same-sex newlyweds who have been married in Texas—can receive financial assistance as a married couple. In fact, 85 percent of Texans who enrolled in the Marketplace now receive financial assistance to lower their monthly premiums.

Free, one-on-one enrollment assistance from culturally competent experts is available, and Houstonians can visit the Get Covered Connector at EnrollGulfCoast.com to see where free local enrollment assistance is available in your area and schedule an appointment. These enrollment assisters are trained to provide this assistance, including in matters of cultural competency.

To help you pick the plan that best meets your needs and budget, Enroll America has also launched a free plan-comparison tool called the Get Covered Plan Explorer. In addition to giving you a personalized estimate of your yearly cost based on your medical and financial situation, the Plan Explorer can help you find out if your favorite doctors are covered by the plans you are considering. The Plan Explorer provides clear, easy-to-understand information about available plans, so you can make an educated decision about how to get the best and most affordable coverage.

It’s also important to keep in mind that this is not only an opportunity to gain access to quality, affordable healthcare for you and your family, but also to avoid paying a fine when you file your taxes. If you do not enroll in a plan by the deadline of January 31, 2016, you could face a fine of $695 or 2.5 percent of your yearly income, whichever is greater. The fine will increase each year, making it more and more costly to delay complying with the law—on top of having to pay for health services throughout the year without the benefit of insurance coverage. That $695 (or more) could better serve you and your family by helping to pay for a plan with free preventative care, prescription drug coverage, and other essentials for a healthy life.

The Affordable Care Act presents an unprecedented opportunity for LGBT individuals to get affordable insurance coverage. In Houston, Get Covered America is working with local partners like LHI, Out2Enroll, and Young Invincibles to assist you in getting and staying covered for 2016. While the open enrollment period goes until January 31, in order to have insurance on January 1, you must enroll by December 15, so visit EnrollGulfCoast.com today. Get covered and stay covered!

Rosy Mota is the regional director for Enroll America.


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