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(Graphic by Matt Martinez)
The Health Insurance Marketplace for Affordable Care Act health plans has opened up a special enrollment period from Feb. 15 to May 15 because of the coronavirus pandemic.
Enrollment for 2021 originally ended on Dec. 15, 2020, but the Biden administration launched the special enrollment period to offer health insurance during COVID-19. Enrollment is open to anyone.
Those who apply may also be eligible for tax credits to lower their premiums, copays and deductibles. Eight in 10 Wisconsinites with Marketplace insurance receive help paying for their insurance, according to the Wisconsin Office of the Commissioner of Insurance.
Here’s what you need to know:
1. What do I need to do?
Those interested can visit Healthcare.gov to apply. They will have to create an account in order to apply for coverage.
2. How do I know which plan is right for me?
You can also use webpages on the site to find what plan would work best for you.
3. What materials do I need to enroll?
Healthcare.gov provides a checklist.
4. How can I calculate my income?
Marketplace premiums are calculated based on expected income for the upcoming year. Healthcare.gov provides an explanation on how to calculate this figure.
5. I need help. Who can I call?
To connect with an insurance specialist in the Milwaukee area for help during the application, call (414) 400-9489.
6. When does enrollment start?
Enrollment benefits will start on the first day of the month following successful enrollment. For instance, someone who applies in February should receive benefits starting March 1.
Those interested can also visit wiscovered.com for more information on enrollment in Marketplace plans. The site answers frequently asked questions and also offers help in enrolling for Medicare and BadgerCare plans.
7. What do the plans cover?
All plans on the marketplace cover the following services:
- Doctor visits
- Preventive or primary care
- Hospitalization
- Emergency services
- Prescription drugs
- Pregnancy and newborn care
- Pediatric dental care
- Mental health services
- Laboratory services
- Rehabilitation services and devices.
8. What happens if I miss the deadline?
If you miss this special enrollment period, you may still be able to apply due to a qualifying life event, such as getting married, having children or losing your health insurance unexpectedly.
9. What else do I need to know?
The Centers for Medicare and Medicaid Services reported that 11.4 million Americans enrolled for Marketplace health plans in the 2020 open enrollment period.
And 87% of the people enrolled in these plans received advance payment of premium tax credits, which reduced the premiums they paid on their insurance.
The average monthly premium before the credit was $595. With the credit, the average went down to $89.
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