Health Insurance Marketplace

November 11, 2019

November 1 marked the beginning of open enrollment for 2020 health insurance coverage through the Health Insurance Marketplace. Since debuting in 2013, the Health Insurance Marketplace has provided access to low-cost healthcare coverage for millions who would otherwise be without health insurance or who are interested in taking advantage of more cost-effective alternatives to their current coverage.

“Having health insurance is an important part of your health journey, and the Health Insurance Marketplace has made comprehensive coverage more possible for many people,” says Roy Finch, chief executive officer (CEO) at Palestine Regional Medical Center. “Health insurance allows you to be proactive when it comes to your health by taking advantage of preventive care services and other resources that can help detect disease earlier and help manage chronic conditions. And by staying on top of your health and the health of your family, you’re contributing significantly to making our community healthier, too.”

This year’s open enrollment period runs from November 1 through December 15, 2019. During this time, you can enroll in a plan if you do not currently have coverage; make changes to your current coverage; or renew your current plan as it stands today. It’s also a good idea to update your Marketplace application with your expected income and household information for 2020, to take advantage of the best plan, features and savings for you for the new year. Additionally, if you have experienced a major life event, such as health coverage loss, marriage, adoption or having a baby, you may qualify for an extended special enrollment period after December 15.

What’s covered?
All Marketplace plans cover the following health benefits:

• Ambulatory patient services (outpatient care you get without hospital admission)
• Emergency services
• Hospitalization (surgery and overnight stays)
• Pregnancy, maternity and newborn care (both before and after birth)
• Mental health and substance use disorder services, including behavioral health treatment (including counseling and psychotherapy)
• Prescription drugs
• Rehabilitative and habilitative services and devices (to help those with injury, disability or chronic conditions gain or recover mental and physical skills)
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services (including oral and vision care for children)
• Birth control coverage
• Breastfeeding coverage

Some plans may offer other additional benefits, like dental and vision coverage for adults, and medical management programs (weight management, diabetes, etc.). It’s important to compare plans to find what’s best for you.

Getting ready to enroll
Before you enroll, there are a few simple steps you can take to ensure that you’re ready to choose the right plan for you and your family:

• Gather what you’ll need to apply or re-enroll, including information about your household, income, tax information and more. A handy checklist can be found at www.HealthCare.gov
• Update your Marketplace application with your expected income and household information for 2020
• Explore the coverage options available at www.HealthCare.gov
• Refresh your knowledge of how insurance works, including deductibles, out-of-pocket payments, copayments, etc.
• Make a list of important questions that will help you make the right decision, like “Can I stay with my current doctor?” and “Can I use my local hospital?” As you compare plans, consider whether the plan includes any physicians or providers you or your family regularly see, including primary care providers, pediatricians, OB/GYNs, ENTs, dermatologists and other specialists.
• Set your budget so that you can choose a plan with financial requirements that best meet what you are able to afford.

There are several ways you can enroll, including online, by phone, through an agent or broker, or by mail. For more information on how to enroll via the method of your choice, as well as other resources that can assist in ensuring that you and your family are covered for 2019, visit www.HealthCare.gov.