2016 Open Enrollment: Tips for Consumers to Get Covered and Stay Covered

Content From: Mira Levinson, Project Director, In It Together projectPublished: October 29, 20153 min read


Mira Levinson
Mira Levinson, ACE TA Center

Editor's Note: From HRSA's ACE TA Center, here are tips and resources for the Affordable Care Act's Open Enrollment period starting Nov 1.

The third Open Enrollment period for Marketplace health coverage begins on November 1, 2015 and runs through January 31, 2016. What do consumers need to do to get covered and stay covered? The HRSA-supported Affordable Care Enrollment Technical Assistance Center (ACE TA CenterExit Disclaimer) shares key Open Enrollment messages and resources for consumers below.

The ACE TA Center works with Ryan White HIV/AIDS Program grantees and service providers to help diverse clients get enrolled in health coverage.

1.Open Enrollment dates are different than last year.

Consumers still have three months to renew their coverage or choose a new plan.

Key dates to share with consumers:

  • Open Enrollment begins November 1, 2015 and ends January 31, 2016
  • Apply before December 15, 2015 for coverage that begins January 1, 2016
  • Apply before January 1 for coverage that begins February 1, 2016
  • Apply before January 31 for coverage that begins March 1, 2016

If eligible consumers don’t enroll by January 31, 2016, they will not be able to enroll in 2016 Marketplace coverage unless they qualify for a Special Enrollment PeriodExit Disclaimer (SEP).

RESOURCE: Case managers and enrollment assisters can use the Marketplace Plan Renewal FlowchartExit Disclaimer to help guide consumers through the renewal process.

2. Consumers who had a qualified health plan (QHP) this year should log onto the Marketplace, regardless of whether they plan to change their plan or not.

Consumers who were enrolled in a 2015 QHP will be automatically renewed for 2016 coverage if their plan is still available. But all enrolled consumers should still update their applications and compare plans because:

  • They may find a plan that better meets their health needs or budget.
  • They may be eligible for higher amounts of financial assistance.

RESOURCE: Use the Health Care Plan Selection WorksheetExit Disclaimer to help consumers find the best plan for their needs.

3. Consumers who got financial assistance for 2014 plans must file and reconcile their 2014 taxes. If not, they will lose financial assistance on December 31, 2015.

This tip applies to consumers who were enrolled in a 2014 QHP and received financial assistance in the form of advance premium tax credits (APTCs) or cost-sharing reductions (CSRs). For these consumers to continue receiving financial assistance in 2016, make sure they have:

  1. Filed and reconciled their 2014 taxes and APTCs. Reconciling 2014 taxes means filing Form 8962 with their federal income tax return.
  2. Authorized the health insurance marketplace to review their tax data.

RESOURCE: Use the FAQ about PTCs and CSRsExit Disclaimer to learn more about financial assistance.

ACA - Mira Levinson blog image - My Health Insurance Works for Me_0

Millions of Americans have enrolled in new coverage options, but many others still remain uninsured, especially low-income adults. Your organization can help! For those consumers who are eligible for Marketplace coverage but are still reluctant to enroll:

RegisterExit Disclaimer for the ACE TA Center webinar on November 18 to learn more about engagement and enrollment in diverse communities.

Visit targethiv.org/aceExit Disclaimer for more tools and resources to help your clients get covered, stay covered, and use their health insurance benefits.