How Do I Apply for Health Insurance Through the Marketplace?
So, you’ve heard about the new Affordable Care Act law—otherwise known as “Obamacare”—and you know that you will get penalized in your 2016 tax returns if you do not have health insurance.
You might have never purchased health insurance before; thus, you don’t know the first thing about getting covered in 2016. This article does not cover how to choose a health insurance plan. Rather, this article points you, the consumer, to the right channels in order to fill out an application.
Before you pick a health insurance plan, you have to fill out an application. Below, you will find the appropriate channels and resources to complete an application correctly, effectively, and efficiently.
Step One: Fill Out the Paper Application
A person must submit an application to the Health Insurance Marketplace in order to enroll in coverage. This is the first step. The application asks tax questions pertaining to household income, tax dependents, family size, citizenship status, and many others.
The application can be found here or on the healthcare.gov website. I found the application by entering “can you buy Obamacare insurance through the mail?” on Google’s search bar. I found the application under the fourth link down on the resulting page. The application is 7 pages long, and will not take long to complete.
If you get confused, don’t worry. You will notice that HealthCare.gov plainly lists their telephone number and website information. Call or access the website for any help you might need. If you do not speak English, representatives at HealthCare.gov can assist you in another language. Just ask!
Make sure you sign the application!
Step 2: Mail the Completed Application
Here’s the Address:
Health Insurance Marketplace
Dept. of Health and Human Services
465 Industrial Blvd.
London, KY 40750-0001
Step 3: Look for an Eligibility Notice in your Mailbox
The Health Insurance Marketplace will process your paper application once they have received it. Once the application is processed, the HIM will send you an Eligibility Notice. This document is long, but it shows you how much you will receive in tax credits.
The amount you receive in Tax Credits is the dollar amount price reduction that the government guarantees to the insurance company every month on your behalf. For example, an insurance company’s normal rate for a family of four might be $803/month. If the Eligibility Notice stated that the family received tax credits of $500/month, then the family would only pay the insurance company $303/month (called the Subsidized Premium).
$803 (Base Premium) – $500 (Tax Credit) = $303/month
The Eligibility Notice also gives information on the next steps. I will summarize below.
Step 4: Call the Health Insurance Marketplace:
If you DO NOT have access to the Internet: Call the Health Insurance Marketplace!
The HIM has agents that are standing by 24/7 over the phone. Usually, these customer service representatives are helpful, but these agents cannot make a decision for you. It is part of their job description to remain impartial. If you are one of those people who need a final push, contact an agent at American Exchange.
All Eligibility Notices contain an Application Number. If you filled out a paper application, notify the healthcare.gov agent of your paper application, and give the agent the Application Number. The agent will have access to your completed application, and you can move on to health plan selection.
If you DO have access to the Internet:
- 1.Visit Healthcare.gov
- 2.Click the login button at the top right
- 3.Create an account by clicking the “Create Account” link; Valid email is required
- 4.Answer questions
- 5.Check email to complete your application. Click on the message from healthcare.gov.
- 6.Click on the link to complete your registration
- 7.Verify your identity by answering the questions.
- 8.Look for the link to find your application. Enter in your Application ID.
- 9.Go through Application noting any changes in income, family size, etc.
- 10.Enroll in coverage when prompted
2.Over the Telephone
As I stated before, HealthCare.gov has representatives that are helpful. These individuals go through all of the steps of the application with the caller. They will go through the application in a step-by-step manner asking all of the necessary questions, and they will serve as a resource to help when a caller is confused.
What you are getting here is expertise. During the Open Enrollment seasons, these folks complete volumes of applications, so they are well trained—and well-practiced—in completing applications effectively and correctly. They can also help you understand how to correctly answer questions if you are unsure.
**A word to the wise: The best times to call are closer at the beginning of the month and after the 15th of the month. The 15th of each month is the deadline to enroll for coverage for the 1st of the next month. Call volumes are high closer to the 15th, so if you want to avoid wait times of over an hour at times, then call way in advance of the 15th.
3. Enroll through an Agent or Navigator
I work for an Agency. I am an agent. Essentially, we perform the same service as HealthCare.gov representative. Clients call us, we take down all the necessary information required to fill out a healthcare.gov application. The client informs us about family size, household income, etc., and we complete the application for the client. The end result is that we enroll the client in coverage.
There are two main differences between agents and HealthCare.gov representatives. The main difference is that we can be partial when consulting our clients. For example, I am a United Healthcare customer this year, and I am quite satisfied with the health plan. I can express my satisfaction of the plan to a potential client in an effort to persuade him to buy the same plan.
Another important difference to note is that we remain your agent all year. What does this mean to you? Well, if you have a problem with an insurance carrier, or if you have an issue with the Health Insurance Marketplace, you call us first. We can help you track payments to insurance carriers, we can resolve price discrepancies between healthcare.gov and the insurance carrier. If you don’t like a plan, we can help you change plans. If you have an issue, we can help you solve it!
A Navigator’s job description mirrors the job description of agents as well as HealthCare.gov representatives. All of the aforementioned groups all assist clients with applications, all groups have prior training in order to assist, and all groups provide free application consulting. Finally, all help individuals enroll in coverage.
Navigators, like HealthCare.gov representatives, must remain impartial when helping consumers choose a plan. The main difference between Navigators versus HealthCare.gov representatives and agents is that Navigators are limited in their powers to conduct business over the telephone. If you call a Navigator, then they can tell you what they can and can’t do for you. Your best bet is to go see a Navigator in person for the best assistance possible.
How to Find Agents and Navigators:
The Internet is a great place to start for this. I simply typed “how to find obamacare navigator,” and I clicked on the first link in the Google search. This redirected me to a page where I entered in my zip code and clicked the button that matched my situation (Coverage for Me and My Dependents).
I found out that there are over 20 Navigators in 25 miles of my home, and there are even more agents in my area!
If you do not have access to the Internet, then I would just start calling around to find a Navigator. I suggest calling local hospitals, local health departments, and even local Health and Human Services branches.
Last but not least, here is the easiest step of all. Visit HealthCare.gov and click the login button to create an account. Repeat the steps seen in Part 1, Step 4. The application will take 20 or so minutes to complete, but make sure you have all your social security information and tax information handy.
Some states have State-based Health Insurance Marketplaces. For instance, if you live in Kentucky, California or Colorado, then you would access your state’s Health Insurance Marketplace to apply for health insurance coverage. Find out if your state has its own marketplace here.
This article is intended for those who do not know where to start when applying for health insurance coverage. You can apply through the mail, over the telephone, through an agent or Navigator, or through the internet. Stay tuned for information on choosing a plan!
Philip Strang is a Certified Agent/Broker with American Exchange. Contact him by telephone at 1-888-995-1674 or by email at firstname.lastname@example.org.