Open enrollment for obtaining or maintaining health insurance in the federal or state-based Marketplaces begins on Saturday, November 15. The National Hemophilia Foundation (NHF) recommends that all community members who obtained health insurance though their Marketplace last year submit a new application during open enrollment. While the federal Marketplace is set up to automatically renew insurance plans, we recommend you reapply because rules governing plans and changes to income and family circumstances may alter coverage under an existing plan or qualifications for financial assistance. To browse the federal Marketplace, please visit: healthcare.gov.
For those renewing coverage, the insured will receive a notice of the same plan’s availability with any changes noted. A different notice will be sent to those insured who received premium tax credits in 2014. In either case, we highly recommend that you reapply and not rely on auto-renewal. Even small plan or rule changes can affect coverage and financial assistance.
As always, remember to review plan options and changes carefully with special attention paid to each plan's provider network, drug formulary and cost-sharing requirements. Some provisions in plans purchased in 2014 will be “grandfathered” in and you will retain those benefits. Those purchasing plans through the Marketplace for the first time in 2015 may have differing coverage provisions. Expect to pay more out of pocket in 2015. The out-of-pocket maximum increases from $6,350 to $6,600 for individuals, and $12,700 to $13,200 for families.
If you live in Idaho, you will go to a new site to enroll or re-enroll in your plan as the Idaho Marketplaces has changed management this year from healthcare.gov to its own state-based Marketplace: Your Health Idaho or 1.855.944.3246.
Finally, if you require assistance enrolling or re-enrolling in a plan, please look for certified application counselors, navigators or others in your area listed on the healthcare.gov or your state-based Marketplace website. The federal government and many states have certified these individuals. Make sure you are working with someone who has met the training, privacy and other requirements necessary to serve in these roles.
Remember, for our community, making insurance coverage decisions during open enrollment is one of the most important financial decisions you will make all year. These decisions take time, but failing to make the right decision can be financially devastating. Please visit NHF’s toolkit for assistance assessing your family’s needs.
