Enrollment is now open for coverage under the Affordable Care Act (Obama Care), which means that it’s time to select your insurance coverage for the coming year. While this process can seem daunting, it is important to take the time to review your options and there are ways to reduce stress and hassles.

Are You Eligible to Purchase Coverage Under the ACA?

Before you complete forms or evaluate insurance coverage options, be sure that you are eligible for coverage under the Affordable Care Act. To determine if you qualify, review:

• Medicaid Eligibility. If you are eligible for Medicaid you are not eligible to enroll with tax subsidies in the ACA program. However, if you live in a family with children, they may be eligible for the Florida Children’s Health Insurance Program (CHIP).
• Insurance through Your Employer. In most instances, if your employer provides employee-only insurance through an ACA-compliant plan, you are not eligible to enroll with tax credits in the marketplace. However, in some instances you can choose Medicaid instead of your employer insurance.
• Income and Taxes. To enroll in health care plans through the ACA, you must have an income and file a tax return. If you do not have income or do not file a return, you can apply for Medicaid.

The bottom line is that you cannot participate in both the ACA program and Medicaid, and usually if you qualify for one, you do not qualify for the other.

Here Are the Next Steps

Once you are sure that you qualify for coverage under the Affordable Care Act, the next steps are:

• Gather all of the information you will need to apply. This can include information about your household, income, and current coverage. You will also need to refer to specific documents, such as pay stubs, tax returns, or W-2s. The government provides a convenient checklist to help you collect everything you need.  
• Make a list of considerations that are important to you when selecting your plan. This can include whether you can stay with your current healthcare providers or coverage of specific conditions. To make this process easier, make a list of your doctors and prescriptions before you review plan options. 
• Anticipate medical needs that are likely to arise in 2020. If you are planning to start or add to your family, are planning a surgery or medical procedure, or have other expected medical needs for the next year, identify them now so you can include these needs as you select your plan. 
• Estimate your income for 2020. You need to make the best effort to anticipate your income for next year, based on last year’s income and expected changes. 
• Set a budget. Consider how much you can spend on your plan each month. This amount should include your monthly premium payment as well as out-of-pocket costs for prescriptions or non-covered services. 
• Create a Marketplace Account and file an application or work with a qualified health insurance broker who can assist you with this process. Before you log in, you can preview the plans and pricing to help make the right decision. 
• If you already have coverage through the marketplace and plan to renew your coverage for 2020, first review your 2019 application to be sure that it is still accurate. If not, update it with appropriate changes. Do this before you start your 2020 application because that form will be pre-filled with your 2019 information. 

Due to changes in the administration of the Affordable Care Act, this year there is less support to help you review options and make selections, but you don’t have to manage this process alone. Our experienced agents can help you through every step of this process to help you select the best coverage that fits your needs and budget.