But enrollment in coverage without a qualifying event , is still ongoing in the following states:. And eligible residents can enroll in the new Covered Connecticut program through the end of December Native Americans and Alaska Natives can enroll year-round in plans offered in the exchange. This is true every year, not just in This is currently in place through the end of , but is expected to be extended by Congress.
As noted above, most of the fully state-run exchanges have extended open enrollment for coverage until at least January 15, And some, like New York, have consistently extended open enrollment until the end of January. But three have specifically implemented regulations or legislation to codify an extended open enrollment period:. The market stabilization rule noted that the November 1-December 15 open enrollment period would apply in every state in the fall of However, they also noted that some state-based exchanges — there are 15 of them as of , and an anticipated 18 as of — might have experienced logistical difficulties in getting their systems ready for the new schedule on a fairly tight timeframe.
HHS had previously defined open enrollment as the window from November 1 to December 15, but state-run exchanges have had the option to offer special enrollment periods before or after that window, in order to effectively extend open enrollment. For coverage effective in and future years, HHS has changed the enrollment window for HealthCare.
As noted above, New Mexico , Maine , and Kentucky plan to have their own enrollment platforms by the fall of Fully state-run exchanges are the only ones with the ability to extend open enrollment on their own in the other states, the decision has to come from CMS, since the extension has to be issued via HealthCare. Certified Navigators are available to answer questions and help you throughout the enrollment process. You do not have to stay in this plan if it does not work for you and can enroll in a different plan on healthcare.
If you do not enroll in a different plan on healthcare. You will receive two notices: one from your current insurance company and one from CMS. You will not be automatically enrolled in a plan like a person enrolled in a Marketplace plan. Some of these state subsidies reduce the premiums that people pay for their coverage, and some reduce out-of-pocket costs. Should I let my existing ACA-compliant health plan renew for ? In most cases, yes, assuming your plan will still be available next year.
Auto-renewal is an option for nearly all exchange enrollees, although Maine, Kentucky, and New Mexico residents will need to claim their new accounts at their state-run exchanges, as those states are transitioning away from HealthCare. But relying on auto-renewal is not in your best interest.
No matter how much you like your current plan, it pays to shop around during open enrollment and see if a plan change is worth your while. Health insurance is complicated, and many people want or need personal assistance with the application process and with ongoing insurance utilization questions.
To fill this need, there are a variety of assisters nationwide who are trained to guide people through the process of researching and enrolling in health plans, and some can provide ongoing support after the plan is purchased. The health insurance Navigator role was created for the purpose of providing impartial education and outreach about the exchanges and exchange health plans, helping applicants determine whether they qualify for subsidies or Medicaid, and assisting them in the enrollment process.
Standards and regulations for the Navigator program are outlined in 45 CFR In early , HHS laid out enhanced requirements for Navigators — most of which took effect for — including targeted assistance for underserved and uninsured populations, as well as post-enrollment assistance on issues such as eligibility appeals and health insurance utilization.
The enhanced requirements are detailed in 45 CFR In the guidelines for , HHS reversed course somewhat on this, making those duties optional, rather than required, for Navigator organizations.
But HHS has pivoted once again on this, with new rules for and beyond that once again require Navigator organizations to provide assistance with post-enrollment issues like subsidy reconciliation and eligibility appeals. Navigators are not permitted to recommend one plan over another or direct consumers towards a particular policy.
Navigators are paid by state and federal grant programs, and they cannot be compensated by the insurance companies. Certified application counselors CACs can also provide assistance with the enrollment process.
They are similar to Navigators, but their role is more limited and their focus tends to be strictly on helping people enroll, without the more extensive assistance that some Navigators can provide.
Navigators are funded through the exchange, but certified application counselors are not. Funding for the CAC program can come from a variety of state and federal sources though, including existing public health appropriations. And CACs themselves are often volunteering their time to help people enroll in health coverage.
Agents and brokers continue to assist their clients after the plan is purchased, helping them sort out questions and problems regarding billing, utilization, claims, and appeals. Brokers and agents also generally carry errors and omissions insurance, and are licensed by their state department of insurance this is in addition to their certification with the exchange; Navigators and CACs are trained and certified by the exchange, but are not licensed by the state insurance department.
For health insurance purposes, independent agents and brokers are virtually the same thing, although brokers may represent more carriers or offer different types of insurance products.
ACA consumer protections apply to all individual major medical policies, regardless of whether the coverage is sold in the exchange. Special Enrollment Periods Next Steps. Why Trust Our Content? Looking for Health Insurance? Provide a Valid ZipCode. Search Now. Snippet Render Is Present — D3 cannot be loaded in editor mode. Go to preview or publish mode. Answer a few questions to get multiple personalized quotes in minutes. Start Here. Was this article helpful?
Thanks for your feedback! If you're new to health insurance, sign up for our healthcare newsletter to help you along every step of the way. Inaccurate Hard To Understand Other.
0コメント