ACA... ... Marketplace opens Nov. 1
The Affordable Care Act’s (ACA) open enrollment period opens Nov. 1 and runs through Dec. 15. Insurance for consumers with pre-existing conditions is still available through the federally-run exchange, and financial assistance to help pay premiums for people who qualify. There’s expert help, too, to assist consumers shopping for coverage. In Wyandotte County, residents can turn to the County Health Council (CHC) of Wyandotte County Kansas Assisters Network (KAN).
“We help educate people and find a plan that best fits their needs,” says Molly Moffett, the network’s project director. “It’s especially important now with new plans coming out that don’t meet ACA guidelines.”
The federal government has loosened ACA-regulated restrictions on short-term health plans to give consumers more options. The premiums are usually less than ACA-compliant plans, but coverage is limited. The plans don’t cover pre-existing conditions, or, typically, mental health, maternity care or prescription drugs, and deductibles can be very high.
“Other than employer-provided insurance and Medicaid, the (ACA) marketplace is one of the only places where folks can get coverage for their pre-existing conditions,” Moffett says.
The federal Health and Human Services Department is encouraging agencies, like KAN that help people sign up for ACA health insurance to inform consumers about non-ACA compliant plans. Unlike insurance brokers, professionals such as Moffett are unbiased, federally trained navigators and ACA-certified application counselors who don’t work on commission.
KAN is partnering with several nonprofits to assist residents seeking health insurance through the ACA marketplace. They include El Centro’s Johnson and Wyandotte County locations, Johnson County’s Department of Health and Environment and Shawnee Mission Health. Free assistance is also available at CHC of Wyandotte County’s downtown KCK location.
To schedule an appointment, call 913-735-9008 or book an appointment online at https://ksassisters.org/new-page/. Assistance is available in English or Spanish weekdays, 9 a.m. to 5 p.m., and evenings and Saturdays on demand.
“All sites are bilingual,” Moffett says.
People will be advised what to bring to the appointment. Among required documents would be birth dates and Social Security number of anyone, including children applying for coverage, a list of medications, information about current health coverage and pay stubs or W-2 forms to qualify for federal subsidies or Medicaid. Plan to spend, on average, 30 minutes to an hour.
Two insurers will sell ACA health plans to all Kansas residents – Ambetter from Sunflower Health and Medica Insurance Co. Blue Cross and Blue Shield of Kansas is offering plans this year in all Kansas counties except Johnson and Wyandotte.
People have the option of keeping their ACA plan, providing it’s offered through a carrier in the ACA marketplace, but experts recommend reviewing coverage, even if people like their current plan, and shopping for the plan that best suits their needs.
“Most plans will stay the same, but a few are changing. We recommend people come back and review to see if other plans are better for them,” Moffett says. “If they don’t do anything, they will be automatically enrolled in their old plan, or if it doesn’t exist anymore, in a similar plan.”
Last year, 5,735 Wyandotte County residents purchased ACA policies. The CHC of Wyandotte County assisted 600 people during open enrollment.
Moffett says, “It’s important that families know if they don’t have Social Security numbers, but their children do, they can buy a plan for their kids and won’t need to enter one for themselves.”
Editor’s Note: The CHC of Wyandotte County Kansas Assisters Network does not assist Medicare beneficiaries enrolling in or making changes in their Medicare plans or providers during Medicare open enrollment, which runs Oct. 15- Dec. 7. Instead, they can get one-on-one counseling at no charge through state health insurance programs — SCHICK in Kansas, CLAIM in Missouri and the Area Agency on Aging. The National Council on Aging (www.mymedicarematters.org/enrollment/medicare-open-enrollment/) has a free online guide. Trained counselors will show Medicare beneficiaries their options.
