ACA Open Enrollment Begins Nov 1~

From KFF:

What is the health insurance Marketplace?

Health Insurance Marketplaces (also known as Exchanges) are organizations set up to create more organized and competitive markets for buying health insurance. They offer a choice of different health plans, certify plans that participate, and provide information and in-person assistance to help consumers understand their options and apply for coverage. Through the Marketplace, individuals and families can shop for coverage if they need to buy health insurance on their own. Premium and cost sharing subsidies based on income are available through the Marketplace to make coverage affordable for individuals and families. People with very low incomes can also find out at the Marketplace if they are eligible for coverage through Medicaid and CHIP. Finally, small businesses can buy coverage for their employees through Small Business Health Options Program (SHOP) Marketplace plans.

There is a health insurance Marketplace in every state for individuals and families and for small businesses. Some are operated by the State and have a special state name (such as CoveredCalifornia or The Maryland Health Benefit Exchange.) In other states where the federal government runs the Marketplace, it is called HealthCare.gov.

How do I find my state Marketplace?

Links to all state Marketplaces can be found at www.healthcare.gov

Who can buy coverage in the Marketplace?

Most people can shop for coverage in the Marketplace. To be eligible you must live in the state where your Marketplace is, you must be a citizen of the U.S. or be lawfully present in the U.S., and you must not currently be incarcerated.

Not everybody who is eligible to purchase coverage in the Marketplace will be eligible for subsidies, however. To qualify for subsidies (also called premium tax credits) people will have to meet additional requirements having to do with their income and their eligibility for other coverage.

When can I enroll in private health plan coverage through the Marketplace?

In general, you can only enroll in non-group health plan coverage during the Open Enrollment period.

For 2019 coverage, the Open Enrollment period in HealthCare.gov states begins November 1, 2018 and extends through December 15, 2018. Importantly, this Open Enrollment period is much shorter than in prior years.  If you plan to sign up, be sure to complete your application and select your plan before 11:59 pm on December 15, 2018.

Once the Open Enrollment period is over, individuals and families will not be able to enroll in Marketplace health plans until the next Open Enrollment period. However, if you experience certain changes in circumstances during the year, you will have a special 60-day opportunity to enroll in Marketplace health plans, outside of the Open Enrollment period.

For individuals and families buying non-group coverage on their own, outside of the Marketplace, you can only enroll in coverage during Open Enrollment periods and special enrollment opportunities, as well.

American Indians and Alaska Natives can enroll in Marketplace coverage throughout the year, not just during Open Enrollment.

Several state-run Marketplaces have announced they will hold longer Open Enrollment periods to sign up for 2019 coverage.  These include California (where Open Enrollment begins October 15, 2018), Colorado, District of Columbia, Massachusetts, Minnesota, and Rhode Island.  Check with your state-run Marketplace for more information.

Can I get help with my Marketplace application?

All state Marketplaces are required to offer Navigator programs to help consumers complete their application for  financial help, including help applying for Medicaid or CHIP.  Navigators also help people review their plan choices and appeal Marketplace decisions.  Navigators are paid by the Marketplace, not by health plans, and they must complete Marketplace training and be free from conflicts of interest.

However, in HealthCare.gov states this year, the federal government substantially reduced Navigator funding so it might be harder to find help from a Navigator, depending on where you live.  In Iowa, Montana, and New Hampshire the federal government did not fund any Navigator programs for 2018-2019. In some other HealthCare.gov states the federal government will not offer Navigator programs in many of the counties

You may be able to find in-person help from other sources.  In addition to Navigators, other Marketplace-certified, volunteer assister programs are run by community health centers, hospitals, and other non-profit organizations.  These certified assister programs also complete Marketplace training but do not receive funding from the Marketplace.

Finally, some consumers work with private insurance brokers to apply for private health insurance plans through the Marketplace.  Brokers also must complete Marketplace training.  They are paid commissions by health insurance companies for each policy they sell.

You can find a directory of certified Navigators, assisters, and brokers on your state Marketplace website.  In HealthCare.gov states, the Find Local Help tool is here.