By Wendy Holdren
Open enrollment starts today for the Affordable Care Act, which will help an estimated 170,000 uninsured West Virginians receive health insurance coverage over the next three years.
West Virginians for Affordable Health Care Southern Regional Coordinator Doris Selko said although today is the first day to enroll, it’s certainly not the only day.
Those who are uninsured can enroll through March 31, but Selko says the sooner someone enrolls, the better.
“If you enroll by Dec. 15, your coverage date will start Jan. 1.”
Many uninsured West Virginians will qualify for the expanded Medicaid program, and others will qualify for subsidized private insurance policies through the Health Insurance Marketplace.
To enroll, go to www.healthcare.gov and follow a few simple steps or call a live representative at 1-800-318-2596, which will be operational 24/7.
After family size and income level has been determined, the applicant will find out if he or she qualifies for Medicaid. If the applicant does qualify, he or she will automatically be enrolled and Selko said they will receive more information in mid-December.
Auto-enrollment letters have already been sent to those who already qualify for SNAP (Supplemental Nutrition Assistance Program), Medicare or Medicaid. Those individuals and families simply need to mail back the letter to enroll.
If the applicant does not qualify for Medicaid, they will be directed to select one of 11 Marketplace options from Highmark West Virginia Blue Cross Blue Shield, either for an individual or family plan. These plans all have various options, subsidies, co-pays, deductibles and out-of-pocket expenses.
Selko said premiums will largely depend on what type of coverage you want, your age, where you live and whether or not you smoke. Smokers will have a 1.5 percent higher premium, which has been implemented to encourage people to quit smoking.
Even if you do already have insurance, Selko said you may want shop to see what the Marketplace has to offer.
“People with insurance live longer, healthier lives,” Selko said. “People without insurance can have huge medical bills from treatment in the most expensive places — emergency rooms.”
The open enrollment period will close March 31, and afterwards, someone can only enroll if they have a qualifying event, such as getting married or having a baby.
Without a qualifying event, an applicant will have to wait until the next open enrollment period, which Selko said will be a six-week window of time next November/December.
Fines are being implemented starting in 2014 for those who do not have health insurance coverage, Selko said, but for large businesses, regulations are being postponed until 2015.
Selko also noted that even if the government does shut down, open enrollment for the Affordable Care Act will continue.
Many resources are available if you need help getting enrolled or need more information.
Beckley Health Right, Raleigh County Community Action, Nicholas County Starting Point and Greenbrier County Health Department were a few of the organizations that received a mini-grant to become community assistors, meaning they can either answer questions or point applicants in the right direction to get the help they need.
Selko said public libraries are also an excellent resource, as many librarians have attended training seminars on the Affordable Care Act.
For more information, visit www.wvahc.org or www. healthcare.gov.
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