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Your health in 2015: Get covered, stay covered!

The time has come to make sure your health insurance is covered for 2015—here's what you need to know, and what you need to do.

UPDATE: 2020 open enrollment for the Affordable Care Act plans runs from November 1, 2019 to December 18, 2019 (at 3 a.m.). Some states have longer open enrollment periods. Check to see if your state does here. Also, you can get more information about how to get insurance here and learn what kinds of plans to watch out for here.

Having health insurance is more important than ever. Paying out-of-pocket for medical care can be crazy expensive and new provisions of the Affordable Care Act (ACA) mean more affordable options for coverage, higher standards for what insurance plans have to cover, and coverage of certain preventive services (like birth control—yay!) with no co-pays or other out-of-pocket costs. Plus, for most people there’s now a penalty for not having health insurance.

Fortunately, open enrollment time is here again. From November 15, 2014, to February 15, 2015, anyone can shop for health insurance plans through their state health insurance marketplace. (You can get to any state marketplace from healthcare.gov.) After this open enrollment period ends, there won’t be another one until 2016—so if you’re uninsured, now would be a good time to get to your marketplace and choose a plan. (Like, right now. Go, go!) If you have insurance, you still need to make sure your ducks are in a row for the coming year.

Getting covered

If you’re buying health insurance through the marketplace for the first time, first of all congratulations! Health care rocks. Second, here are a few things you can think about before you start shopping to make the process easier.

How much health care do you need?

Depending on how often you go to see a health care provider or whether you have medications you need covered, you might consider a plan that has higher premiums (monthly payments) but covers more of your health care costs versus a low-premium plan where you have to pay more out-of-pocket costs for care. Here are some more questions you can think about when choosing a plan.

What’s you budget?

Remember that health insurance will protect you from financial risk if you get sick or need care, so it’s an important investment. And thanks to the ACA, if your income is below a certain level you might qualify for Medicaid or for financial help—lots of people do. Here’s more about how the ACA makes health care affordable. (BTW, remember you’ll have to pay your first month’s premium before your coverage starts.)

Would it help to talk to an actual person about your options?

Choosing between health insurance plans can be a little overwhelming, especially if it’s your first time. Fortunately, you don’t have to go it alone. You can get help from real live people at local organizations, by phone or online. These kind folks (sometimes called “navigators” or “assistors”) can help you consider your options and even help with your application.

Do you have all your documents together?

You’ll need some documents and information about yourself and any family members you’re signing up with before you can apply. Specifically, you’ll need:

  • Social Security cards (or numbers if you can’t find the card)

  • Income documents, such as tax returns or W2s

  • Citizenship and immigration documents

  • Names of health care providers or medicines

Staying covered

If you’re already covered through the marketplace, there are still a couple things you need to do for 2015.

Watch that mailbox.

If you signed up for insurance through the marketplace last year, look out for two letters, one from your insurance company and one from the Marketplace. These letters will let you know if there have been changes to your plan and say how your income is calculated for any financial help you receive. If you do nothing, you’ll be automatically enrolled in the same plan or another plan offered by the same insurance company. That doesn’t mean it’s the exact same plan, though—if, for example, your insurance company cancels your plan, you could find yourself with different premium costs, out-of-pocket costs, or provider networks than the plan you originally signed up for.

Visit the marketplace.

You should visit the marketplace website even if you’re happy with your plan and don’t want anything to change. It’s important to make sure your personal information is up to date, since if you’ve had a change in income, family size, address, or immigration status, it could affect your eligibility for financial help.

It’s also a good idea to think about whether your current plan is still working for you. In many states, there are more plans offered on the Marketplace than last year, and even if you don’t change plans, the premium you pay for it could change, so it might be worth taking some time to shop around. As you decide whether to renew your plan or change to a different one, here are a few questions to ask yourself.

  • How well did your health plan work for you this year?
    Think about how much you paid out of pocket for health care, how affordable the premium payments were, and whether you were happy with the network of providers who were covered by your plan.

  • Will your health care needs change at all this year?
    Think about whether anything related to your health care will be different in the coming year. Are you thinking about getting pregnant? Are you dealing with a new medical condition? If for whatever reason you think you might be visiting a health care provider more often in the coming year, you might for example want to consider paying a higher premium for a plan with lower out-of-pocket costs.

  • Have you or your spouse been offered health insurance coverage?
    If you and your family are now eligible for coverage through an employer, you might not be eligible for financial help through the marketplace.

We love that you’re taking control of your health. If you need support as you’re exploring your options, there are people in your area trained to help. And if you have insurance but your plan isn’t covering your birth control, you can get help with that by going to CoverHer.org or calling 1-866-745-5487.

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