The Open Enrollment Period started November 15, 2014, which means it’s time to shop for the healthcare insurance you will have for 2015. Last year, Nevada had a rough rollout of its first Health Insurance Marketplace (also known as the healthcare exchange). But with Healthcare.gov now backing the Nevada’s healthcare exchange, officials promise this year will run a lot smoother.
To help people get ready to buy insurance for 2015, we have created this Frequently Asked Questions guide. This Q and A will tell you where to get started to shop for health insurance, the important dates you need to keep track of, and where to go to get help if you are having trouble figuring the process out.
Here are the questions we answer in the order they appear:
What is the Affordable Care Act?
What is the Open Enrollment Period?
Why should I sign up for insurance during the Open Enrollment Period?
What is Healthcare.gov?
What is Nevada Health Link?
Where do I start to buy health insurance?
What are the important dates and deadlines?
Is the Open Enrollment Period the only time I can get insurance?
What are Enrollment Assisters and how are they different from Insurance Brokers?
I already have insurance, do I still need to enroll?
If I have insurance through my employer do I still need to enroll through the healthcare exchange?
What if I can’t afford health insurance?
What is Medicaid? How do I know if I qualify for it?
What are the fines for not getting insurance?
I’m confused, is there anywhere I can get help?
What is the Affordable Care Act?
The Patient Protection and Affordable Care Act was legislation passed in 2010 aimed at increasing the affordability and quality of health insurance and lowering the number of uninsured people. The law now prohibits insurance companies from denying new applicants medical coverage plans due to pre-existing conditions, so now everyone can get insurance even if they are already sick or have other medical issues.
A big part of the law is the “individual mandate” which requires all U.S. citizens to have health insurance or pay a fine. Though health insurance can be expensive, if you sign up for insurance during the Open Enrollment Period, you may qualify for subsidies or tax credits from the government.
What is the Open Enrollment Period?
The Open Enrollment Period is from November 15, 2014 through February 15, 2015. It is a time where you can go to Healthcare.gov, compare prices for health insurance and pick the plan that is right for you.
Why should I sign up for insurance during the Open Enrollment Period?
Buying insurance during the enrollment period guarantees that you receive a Qualified Health Plan with Essential Health Benefits such as coverage for emergency services, prescription drugs, lab tests and other medical services.
Signing up during open enrollment will also allow you to qualify for subsidies from the government for your health insurance. That means you’ll pay less for insurance, as the government will foot part of the bill.
Signing up during the Open Enrollment Period will also make sure you avoid fines for not having insurance.
What is Healthcare.gov?
This is where you will actually shop for your health insurance. It’s like a mall where you can check out different insurance plans, compare prices, and pick the right one for you. But remember, there are hundreds of plans available from the exchange and everyone will be offered many different plans and it will not be the same for everyone. Click here to visit Healthcare.gov.
What is Nevada Health Link?
Nevada Health Link is a website with informational resources for the Open Enrollment Period and insurance for Nevadans. It’s a place to learn about the subsidies you may qualify for, as well as learn about where to get help if you are confused along with many other informational resources. Click here to visit Nevadahealthlink.com.
Where do I start to buy health insurance?
Healthcare.gov is the healthcare exchange where you can go to shop for health insurance online, starting November 15. Nevadahealthlink.com is also a good starting place for Nevadans to get information about shopping for insurance. You can also start at Nevadahealthlink.com to get insurance through the exchange, but it will eventually send you to Healthcare.gov to actually buy insurance.
Once you go to Healthcare.gov, you will click ‘Get Coverage,’ put in your zip code and answer questions about your expected income for the year 2015, your family size and a few other questions. After that the system will estimate any tax credits or subsidies you may receive and then show you the different plans you can choose from.
Additionally, you can call 1-800-318-2596 to shop for individual and family plans on the phone.
You can also come to Northern Nevada HOPES and talk to our certified Enrollment Assisters, or go to the Nevada enrollment store at 3937 South McCarran Blvd (corner of Longley and South McCarran behind the Wet Hen Café) from 10 am to 7 pm (extended hours on the 15th of each month are from 9 am to 9 pm). Each location offers FREE assistance when signing up for health insurance and will walk you through the entire process to get you insured.
What are the important dates and deadlines?
The Open Enrollment Period is between November 15, 2014 and February 15, 2015. You will need to sign up for insurance before February 15.
Everyone’s current insurance plans will expire January 1, 2015. If you sign up for insurance before or on the 15 of each month, it will start by the first of the following month.
To make sure there are no gaps in your coverage, you should sign up for insurance by December 15, so your new insurance will kick in on January 1.
Is the Open Enrollment Period the only time I can get insurance?
No, you can sign up for insurance outside of the Open Enrollment Period anytime during the year, but you won’t be able to qualify for any subsidies or tax credits the exchange offers.
There are also Qualified Health Events that allow you to buy insurance through the exchange outside of the enrollment period, but still get subsidies and tax credits. These events include marriage, divorce, birth or adoption of a child, a move to a new service area, or loss of other coverage.
What are Enrollment Assisters and how are they different from Insurance Brokers?
Enrollment Assisters are people trained to help others navigate the process of getting insurance. This help is completely free and the assisters are impartial helpers who can answer questions about health insurance and the process of getting insurance. They can’t tell you what they think is best for you, but they can answer questions about different insurance plans and help make the process less difficult and confusing.
Click here for an in-person assistance finder.
Insurance Brokers are licensed agents who can help you get insurance and answer questions. They are different from assisters in that they get a commission when they sell you insurance. Insurance Brokers are best if you are looking for additional benefits beyond health care, such as vision and dental insurance. They can help set up an insurance package for you.
I already have insurance, do I still need to enroll?
Yes, if you have insurance you will still need to enroll since everyone’s insurance will expire January 1, unless renewed. But if you already have insurance and are happy with it, in most cases you should simply be able to renew your existing plan or shop for another plan.
If I have insurance through my employer do I still need to enroll through the healthcare exchange?
No, your employer should take care of reenrollment in that case. You might get an insurance broker visiting your workplace who will guide you through the reenrollment process.
What if I can’t afford health insurance?
If you feel like you can’t afford health insurance, you should still go to Healthcare.gov and input your information, you won’t be forced to get insurance if you don’t want it. By putting in your information, you may qualify for subsidies and tax credits to reduce your premiums, drug costs or other savings. If you are concerned about making sure you get all your savings, an Enrollment Assister can make sure you get all the subsidies you are entitled to. Assisters can’t make you buy any insurance you don’t want if you still feel it is too expensive.
If you still can’t afford medical insurance you may qualify for Medicaid.
The government won’t fine anyone who faces too many financial hardships to afford health insurance. Click here to find out the qualifications for exemptions so you don’t get fined for not having health insurance.
What is Medicaid? How do I know if I qualify for it?
Medicaid is a joint federal and state program that helps low-income individuals and families cover medical costs with little or no cost for the Medicaid recipient. If you are on Medicaid, you don’t have to get health insurance.
You can find out if you qualify for Medicaid and apply for coverage at https://dwss.nv.gov.
What are the fines for not getting insurance?
In 2014, the IRS will enforce tax penalties of $95 or 1% of your yearly income (whichever is greater) for not having insurance.
In the 2015 calendar year, that will increase to either $325 or 2% of your income (whichever is greater).
After that, the penalty will increase to $669 or 2.5% of your income (whichever is greater).
I’m confused, is there anywhere I can get help?
Yes, one of the best places to get help is from a certified Enrollment Assister. These are people who are trained to help you navigate the process of enrolling for insurance and will do it for free.
We have certified Enrollment Assisters here at Northern Nevada HOPES that can help you through the process, and you don’t have to be a HOPES patient or pay anything to get their help. We even take walk ins, so you don’t even need an appointment to see an Enrollment Assister here at HOPES.
Additionally, you can go to the Nevada Health Link insurance store at 3937 S. McCarren Blvd. There is also an assister locator tool if you click here.
For additional information on the healthcare exchange, go to the Nevadahealthlink.com FAQ section by clicking here.
