Open enrollment starts Oct. 1 for Affordable Care Act; local help available
People with pre-existing health problems will no longer be denied health insurance once the Affordable Care Act goes into effect Jan. 1.
In fact, the only health-related question that you’ll be asked when enrolling in the program is: “Do you use tobacco?” If the answer is yes, you won’t be denied coverage but you’ll pay a higher rate. It’s the only question the federal government allows insurance providers to ask, and Colorado permits them to do so.
Open enrollment in the program is from Oct. 1 through March 31. Coverage can begin as early as Jan. 1, depending on when a person completes the enrollment process and payment is received by the insurance provider.
So, how does this program work?
Beginning Oct. 1, Colorado residents will have access to various sites where certified guides have been trained to walk individuals through the process of learning their options, comparing costs, and choosing a plan from one of the four insurance companies available in Colorado.
In Mesa County, the certified assistant for Connect for Health Colorado (the one-stop online ACA marketplace where Coloradans can shop for and compare health insurance plans) is Hilltop’s Health Access, with an office at 602 Bookcliff Ave.
“Our role is to educate community members about the Affordable Care Act,” said Jackie Sievers, director of Hilltop’s community services, the department that oversees the program. “We can walk them through it.”
Staff members can assist people in applying for subsidies that help pay for the monthly premiums; and they’ll guide consumers through the process of enrolling in a plan of their choice.
For example, a 40-year-old buying an individual plan can choose from multiple levels of coverage, ranging from $236 to $400 a month. (That’s without a premium subsidy that many will qualify for).
A family of four with an annual income of $94,200 would qualify for a subsidy.
“There will also be a major Medicaid expansion that will go in effect Jan. 1,” Sievers said. “A single person earning $15,282 a year will qualify for Medicaid.”
A family of four with an annual income of $31,322 will also qualify for Medicaid.
“If you’re not Medicaid eligible, we’ll look at subsidies,” Sievers said. “Our goal is to make it affordable to everybody.”
The federal government refers to the online choices as an “exchange,” and the trained assistants as “navigators.” Colorado chose different terminology, using the words “marketplace” and “guides.”
By the end of September, the Grand Junction office plans to begin scheduling appointments for October, when the marketplace officially opens. While Connect for Health Colorado has estimated the process will take about 45 minutes, “we plan to allow for an hour and a half,” said Rhonda Lofing of Hilltop’s Health Access.
“Some people’s situations will be clear cut; others will have more questions. It’s going to help a lot of people,” who have been unable to acquire health insurance previously, Lofing said.
Currently, 800,000 people are uninsured in Colorado. An estimated 22,000 uninsured are in Mesa County.
“The law does not allow insurance companies to deny coverage for a pre-existing condition,” Lofing said.
Once the open enrollment period is over, two guides will remain at Hilltop’s Health Access office to assist those whose circumstances have changed due to major life events such as a birth or divorce.
The Connect for Health Colorado website, connectforhealthco.com, should be up-to-date and fully functioning by October. Connect for Health Colorado also operates a call center in Colorado Springs where people can call and apply over the phone. The number is 1-855-plans4you.
Hilltop’s Health Access office is open Monday through Thursday, 9 a.m. to 7 p.m., Fridays, 9 a.m. to 5 p.m., and will be open some Saturdays. Drop-ins are welcome.
Oh, and if you smoke — and are untruthful about it — the insurance provider can cancel the policy leaving you liable for health care costs. It’s also considered fraud.
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