Updated: May 19
Open Letter to our Friends and Family on the Importance of Health Insurance
On December 6, 2020 I joined my friends at Dakotans for Health, a group of former public officials, caregivers, health care advocates, and citizens to remind North and South Dakotans that the deadline for enrollment on the health exchanges for 2021 closes on December 15th.
Dakotans for Health is working to highlight some of the ins and outs of the Affordable Care Act (ACA) Health Marketplace to help drive enrollment, in light of President Trump's cuts to marketing and enrollment assistance budgets and COVID 19. We strongly encourage everyone to share this page far and wide with family and friends. It is so important that we do everything we can to make sure people have health insurance.
What Americans Need to Know
Who Should Apply?
The Affordable Care Act (ACA) Health Insurance Marketplace is the place where people who do not have healthcare coverage through their job or a government program, such as Medicare or Medicaid, can purchase health insurance.
Where to apply?
The best place to start is HEALTHCARE.GOV. That’s where the majority of Americans in the individual market will shop for a plan. But 11 states and the District of Columbia have their own marketplaces. Those states are: California, Colorado, Connecticut, District of Columbia, Idaho, Maryland, Massachusetts, Minnesota, New York, Rhode Island, Vermont and Washington.
Here is how you can generally get started:
To access your Marketplace, go to HEALTHCARE.GOV, click on “Get Coverage” and you will be asked to select your state. You will then be directed to click on your state marketplace or to click on “continue” to access the federal site.
You can also call the Marketplace Call Center at 1-800-318-2596 and apply over the phone. It accepts calls seven days a week, 24 hours a day.
Or you can apply in person. Many non-profit and community organizations have trained people, known as navigators, to help you apply for coverage. Go to LOCAL HELP , plug in your zip code and a list of nearby navigators will pop up.
When to apply?
The Marketplace open-enrollment began on Nov. 1, 2020, and for most Americans will end on Dec. 15, 2020.
How expensive is it?
The COST DEPENDS ON YOUR INCOME. About 83 percent of the more than 10 million people who already have insurance through the Marketplace receive a federal subsidy to help them pay the monthly premiums.
You can choose to use the subsidy to lower your premium or you can pay the full premium and deduct the subsidy from your federal income taxes.
In addition, about 51 percent of Marketplace enrollees qualify for assistance that defrays the cost of deductibles and copays.
To determine whether you will qualify, use the subsidy calculator. You can access it HERE.
I’ve heard premiums are going to be lower than last year. Is that true?
Maybe. Premium changes will vary widely across the country.
If you qualify for a subsidy, you likely won’t be affected by premium increases. Under the ACA, the subsidy increases in proportion to the rate increases.
But if you earn too much to qualify for federal financial assistance, you may find your premium has increased. The amount of premium change will vary widely by state and by plan.
You can find out what your 2020 is going to be by going to HEALTHCARE.GOV
You can also check for your state below using the Kaiser Health Premium Calculator:
How do I prove my eligibility for the subsidy?
You’ll need to provide some detailed information on the application, including:
• Birth dates and home addresses for all individuals who will be applying for coverage under the plan
• Social Security numbers, name of employer and income information for every member of your household, even if they aren’t all applying for coverage
• Estimated household income for 2021
• Policy number and plan ID of your current insurance plan
• Any letter or document your current plan has provided regarding renewal
Does it pay to shop around for a plan?
Yes, insurance plans come in and out of the market all the time. In addition, if you are currently enrolled, your doctor may leave the plan’s network in 2021 or join another network you are interested in. Premiums also vary from year to year.
What happens if I don’t buy insurance?
The ACA still requires that nearly all Americans have health insurance. There are some exceptions: You can apply for a hardship exemption if, for example, you have filed for bankruptcy, cannot find affordable coverage or had a death in the family. But, Congress repealed the tax penalty that individuals without insurance had to pay. However, while the penalty has been removed, health care experts emphasize that even if you are healthy it’s important to have health insurance, because you never know when an accident or severe illness will occur.
About Dakotans for Health
A growing network of public health officials, healthcare professionals, patient advocates, elected officials and concerned citizens dedicated to improving healthcare in the Dakotas. Dakotans for Health is leading the charge to EXTEND MEDICAID to 42,500 South Dakotans who need help via a Constitutional Amendment in 2022. PETITION CIRCULATION and FUNDRAISING are already underway.