Applying for Insurance Through the Marketplace
The Health Insurance Marketplace is a way to find health coverage that fits your budget and meets your needs. With one application, you can see all of your options and enroll. You can apply for private insurance, Medicaid or the Children’s Health Insurance Program (CHIP).
Every health plan in the Marketplace offers the same set of essential health benefits, including doctor visits, preventative care, hospitalization, prescriptions and more. You can compare plans based on price, benefits, quality, and other features important to you before you make a choice.
Insurance Plans Run By Private Companies
Insurance plans offered through the marketplace are run by private companies. No matter where you live, you’ll be able to compare your health coverage options in the Marketplace and see what your premium, deductibles, and out-of-pocket costs will be before you make a decision to enroll.
There are protections for you and your family. Insurance plans can’t deny you coverage because of pre-existing or chronic conditions like cancer or diabetes, and they can’t charge women and men different premiums.
Get a Break on Costs
When you use the Marketplace you may be able to get lower costs on your monthly premiums and out-of-pocket costs. When you apply, you’ll find out how much you can save. Most people who apply will qualify for some kind of savings.
Visit Healthcare.gov to get answers to your questions and sign up for e-mail updates about the Marketplace. You can also call the Health Insurance Marketplace Call Center at 1-800-318-2596. TTY users should call 1-855-889-4325.
When open enrollment starts, you can go to the Marketplace and apply for health coverage, compare all your options and enroll in a plan. Remember there are penalties for not obtaining coverage or an exemption. Contact a local navigator who can explain in full detail.
Open enrollment for 2017 coverage is November 1, 2016, through January 31, 2017.
Life Changes That Allow you to Sign-up Now
Need Assistance? Burke Can Help.
Burke Navigators are available to help you navigate the enrollment process. This is a free service, but an appointment is required. To make an appointment, call 936-639-1141 and ask for a Burke Navigator.
Alejandra Chavez can be reached at 936-633-5603. She covers Polk, Angelina, Trinity, and Houston counties.
April Weeks can be reached at 936-558-6200. She covers San Augustine, Shelby, Nacogdoches, and Sabine counties.
Tiffany Mijares can be reached at 936-633-5611. She covers Tyler, San Jacinto, Jasper, and Newton counties.
Navigator Spanish Assistance Line: 936-633-5603
Five Things You Can Do To Get Ready To Enroll:
- Explore the Marketplace.
Visit Healthcare.gov to learn more about the Health Insurance Marketplace and programs you may qualify for, including Medicaid and CHIP.
- Ask your employer if they plan to offer health insurance.
Some employers will take advantage of the Small Business Health Options Program (SHOP) to provide health coverage to employees. If not, you may need to get coverage through the Marketplace or other sources.
- Make a list of questions you have before its time to choose your health plan.
For example, “Can I stay with my current doctor?” or “Will this plan cover my health costs when I’m traveling?” This will help you as you compare different health plans.
- Gather basic information about your household income.
Most people using the Marketplace will qualify to save money. To find out how much you’re eligible for, you’ll need income information like the kind you get on your W-2, pay stubs, or tax return.
- Set your budget.
There are different types of health plans to meet a variety of needs and budgets. You’ll need to figure out how much you’re able to spend on premiums each month. Think about your health care needs when choosing a plan. If you expect a lot of doctor visits or need regular prescriptions, you might want to select a plan that has higher monthly premiums, but pays more of the costs when you need care. You could pay lower out-of-pocket costs for each visit, prescription or other medical services.