ACA Open Enrollment: What You Need to Know
Posted by Diana-Lee—October 1st, 2013

October 1, 2013, is the first day of open enrollment for private insurance coverage through the marketplaces established under the Affordable Care Act, also often referred to as Obamacare.

Not everyone will need or want to use a marketplace to establish health insurance coverage. So how do you know if it is for you? Here are some things to consider:

  • Private coverage: If you currently have or need an individual health insurance policy through a private insurance company, the marketplaces are for you. You fall into this category if you do not have insurance provided by an employer or other group or program.
  • Medicaid and Childrens Health Insurance Program (CHIP): The marketplaces are for you if you or members of your family are already using these programs or if you want to find out if you qualify for them.
  • Medicare: You do not use the marketplaces. You continue to make choices about coverage, including supplemental policies and dental coverage, through Medicare’s existing system.
  • Employer-based coverage: The marketplaces most likely do not apply to your situation. You will continue to learn about employer-based health insurance coverage options from your employer. Since most people in the United States receive their health insurance through an employer, chances are good many of you reading this will fall into this category. However, you can use the marketplace if you want or need to find an alternative to the coverage choices offered by your employer.

What are marketplaces?

Under the Affordable Care Act, each state had the choice to either set up its own marketplace for citizens of that state or to have its citizens use the system set up by the federal government.

These marketplaces allow people shopping for private health insurance to fill out one application and see each insurance option available and the costs associated with those options in one place. This is intended to allow consumers to make an educated choice about their private insurance options and simplify and streamline the application and comparison process.

The website HealthCare.gov is a place to learn about health insurance options regardless of where you live in the US. You can learn which marketplace you use by visiting this page on that site: https://www.healthcare.gov/marketplace/individual/.

How do you use the marketplace?

There are four steps to take if you want to use a marketplace to compare your options and purchase a private insurance policy.

1. Go to HealthCare.gov to find your marketplace and set up an account.

2. Fill out an application. This checklist will help you gather the information you’ll need to complete the application: https://www.healthcare.gov/downloads/MarketplaceApp_Checklist_Generic.pdf.

3. Compare the coverage options offered based on your application. Depending on your income, you may be eligible for savings on your health insurance costs or programs like Medicaid or CHIP.

4. Choose the right plan for your needs and budget.

I know this process is intimidating, so please ask any questions you have in the comments and I will do my best to answer them.

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About Diana-Lee

Diana Lee is a blogger, lawyer & health advocate who's been disabled by Chronic Migraine. She's passionate about educating patients & combating stigma

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