Transcript Ready to Enroll Power Point

Ready To Enroll
Open Enrollment 2014-2015
The second Open Enrollment Period for the Health
Insurance Marketplace starts on November 15, 2014
and lasts through February 15, 2015. Starting
November 15th you can go online to view the
available plans, apply for coverage, and enroll in
health insurance coverage.
The Marketplace
The Health Insurance Marketplace is the website
where private insurance companies sell competitively
priced health insurance policies for individuals,
families and small businesses. In Kansas we access
out Marketplace by visiting healthcare.gov or calling
1-800-318-2596
Lower Costs
Financial help is available. When you buy a plan
through the Marketplace, you may be able to use
an Advanced Premium Tax Credit (APTC) to lower
the amount you pay per month for your plan. The
amount of tax credit you qualify for will depend on
your household size and income.
Lower Costs
If your income is below a certain level, you may
qualify for Cost Sharing Reductions, which
automatically reduce your out-of-pocket costs
when you get care, like your deductible and
copayments.
Advanced Premium Tax Credits
If your income is between the amounts below, you may
qualify for an Advanced Premium Tax Credit to help lower
the amount you pay per month in premiums.
Household Size
100% FPL
400% FPL
1
$11,670
$46,680
2
$15,730
$62,920
3
$19,790
$79,160
4
$23,850
$95,400
5
$27,910
$111,640
6
$31,970
$127,880
7
$36,030
$144,120
What will you need to apply and enroll?
You will be asked basic information about your family and
household. In order to be prepared for the application and
enrollment process, you should have the following
information gathered.
• Names, birth dates, and Social Security Numbers for
everyone in your household
• Your projected household income
• Tax information, such as filing status and number of
dependents
• Immigration documentation and supporting
identification numbers
Applying Online
If you plan to submit an online application, you will need
an email address and the associated password to create an
online Marketplace account.
If you plan to apply with the help of a Navigator or assister,
and you don’t currently have an email address, it may be
helpful to create one prior to your appointment.
A Navigator or assister can help you create one if you are
not comfortable creating one on your own.
About the Plans
The plans offer certain consumer protections.
• You cannot be denied coverage because you have a
pre-existing condition
• Preventive services are covered at no cost to you
• There are limits on your out-of-pocket costs for care
• Insurance companies have to summarize your benefits
in a way that is easy to understand
About the Plans
Marketplace plans must all cover a set of Essential Health
Benefits.
• Ambulatory patient services (outpatient care you get
without being admitted to a hospital)
• Emergency services
• Hospitalization (such as surgery)
• Maternity and Newborn care (care before and after
your baby is born)
• Mental health and substance use disorder services
(includes counseling and psychotherapy)
About the Plans
Marketplace plans must all cover a set of Essential Health
Benefits.
• Prescription drugs
• Rehabilitative and habilitative services and devices
(services and devices to help people with injuries,
disabilities or chronic conditions gain or recover mental
or physical skills)
• Laboratory services
• Preventive and wellness services and chronic disease
management
• Pediatric services
Metallic Plan Levels
Health plans are available with different levels of cost-sharing,
which includes deductibles, copayments and coinsurance.
Each plan level is labeled with a metallic level.
Plan Level
Bronze
Silver
Gold
Platinum
Monthly Cost
$
$$
$$$
$$$$
Cost for Care
$$$$
$$$
$$
$
Navigators and Other Assisters
If you need help with the application or enrollment
process, or just have questions about the Marketplace, a
Navigator or other Certified Assister can help.
Navigators are trained by CMS, background checked, and
receive ongoing education and support from the Cover
Kansas Team.
To find Navigators or other assisters in your area, visit
insureks.org/assistance or LocalHelp.healthcare.gov.
You can also call the Marketplace at 1-800-318-2596.
When Can You Enroll?
The Marketplace opens on November 15, 2014. The Open
Enrollment Period will last until February 15, 2014.
If you choose your coverage by December 15, 2014, your
coverage will begin on January 1, 2015.
You can enroll outside the Open Enrollment Period with a
Special Enrollment Period if you have a major life change
or you lose your current coverage involuntarily.
Things to Remember When Choosing
Your Health Insurance
Keep your coverage needs in mind. The plans offer different
levels of cost-sharing between you and the insurance company.
It may be helpful to base your choice on how often you think
you will use health care services.
Check the plan networks and prescription drug formularies to
make sure your hospital, clinic or doctor is covered, and that
the medication you use is covered by your plan.
Think about how the plan costs will fit into your budget. You
will pay a monthly premium and also out-of-pocket costs when
you go to the doctor or have a prescription filled.
Renewing Your Current Marketplace
Health Insurance Plan
All 2014 Marketplace health plans will be up for renewal in 2014.
Prior to November 15, 2014, your insurance company will send you a
notice about your plan and any changes the company may have
made. You should review the notice to make sure the plan still fits
your needs. Be sure to check if your doctors, health care facilities, and
medications are still covered by your plan. You will need to update
your Marketplace account with household size and income
information to make sure everything is correct for the next year.
If you like your plan and you are okay with the changes, the
Marketplace will automatically renew your coverage for 2015.
Renewing Your Current Marketplace
Health Insurance Plan
Some plans won’t be offered in 2015. If your current plan
is cancelled, you will have the option to enroll in one that
is similar by going to the Marketplace.
If you want to choose a new plan for 2015, you can go to
the Marketplace starting on November 15, 2014 to choose
your new plan and enroll. If you select a plan by
December 15, 2014, your coverage will begin on January
1, 2015.
For more information, contact:
Jordan Rickabaugh
Navigator Project Coordinator
[email protected]
785.249.2657