Affordable Care Act Resources

Updated November, 2016

Dates  for open enrollment: November 1, 2016 – January 31, 2017. The Affordable Care Act (ACA), also known as “Obamacare,” is the law that requires most U.S. citizens and legal residents to have qualifying health coverage.  You will be unable to sign up for health insurance once the open enrollment period ends unless you have special circumstances (find out more about your options outside of open enrollment here).  Visit this U.S. Department of Health & Human Services webpage to read more facts about ACA implementation in Wisconsin.

 

Key Things to Know about the Health Insurance Marketplace

The Health Insurance Marketplace is for people seeking to shop for more affordable insurance or who are now uninsured.

The Marketplace simplifies your search for health coverage by gathering all of the options available in your area in one place. You can compare plans based on price, benefits, and other features important to you before you make a choice. Plans will be presented in four categories – bronze, silver, gold, and platinum – to make comparing them easier. Insurance plans in the Marketplace are offered by private companies. They cover the same core set of benefits called essential health benefits. No plan can turn you away or charge you more because you have a preexisting condition. For more information, see Healthcare.gov’s Quick Guide to the Marketplace

 

Key Dates for the Health Insurance Marketplace

  • November 1, 2016: Open Enrollment starts — first day you can enroll, re-enroll or change a 2017 insurance plan through the Health Insurance Marketplace. Coverage can start as soon as January 1, 2017.
  • December 15, 2016: Last day to enroll in or change plans for new coverage to start January 1, 2017.
  • January 1, 2017: 2017 coverage starts for those who enroll or change plans by December 15.
  • January 31, 2017: Last day to enroll in or change a 2017 health plan.  After this date, you can enroll or change plans only if you qualify for a Special Enrollment Period.

What You Will Need to Apply for Health Insurance

  • Social Security Number (or document number for legal immigrants)
  • Employer and income information for every member of your household (from pay stubs or W-2 forms – Wage and Tax Statements)
  • Your best estimate of what your household income will be in 2017
  • Policy numbers for any current health insurance plans covering members of your household
  • A completed Employer Coverage Tool for every job-based plan you or someone in your household is eligible for (get the Employer Coverage Tool form here)
  • Notices from your current plan that include your plan ID, if you have or had health coverage in 2016

Where can I get help signing up for health insurance?
There are a variety of people and organizations that are trained and certified to help you understand your health coverage options and enroll in a plan. They are known by different names, depending on who provides the service and where they are located, but they all will provide similar kinds of help. When seeking out help, look for:
• Navigators
• Application assisters
• Certified application counselors
• Licensed insurance agents and brokers

 

To find help for signing up for health insurance or other government programs, check the Wisconsin Health Insurance Marketplace Enrollment Directory. Organizations are organized by county in the directory. Please check back on this resource often, as it may be updated periodically with new resources and updated information.

 

Visit LocalHelp.HealthCare.gov to find help in your area. Search by city and state or zip code to see a list of local organizations with contact information, office hours, and types of help offered, such as non-English language support, Medicaid or CHIP, and Small Business Health Options Program (SHOP). Check back on this resource often as new organizations will be added regularly. 

 

Where can I sign up for health insurance? Healthcare.gov
Healthcare.gov is Wisconsin’s health insurance marketplace (also known as the federal exchange). This website allows you to:

  • Check your eligibility for government assistance programs, including subsidies and tax credits
  • Compare individual and small group insurance plans
  • Link to insurers to purchase the health insurance plan that best suits you

You can purchase insurance through Healthcare.gov using four methods:

  • Online – To apply through the marketplace website, you will need to sign up for a marketplace account which will require a valid email address. If you need help signing up for an email address, please visit the Brown County Library’s Technology Training page.
  • By phone – call the Healthcare.gov hotline at 1-800-318-2596 (TTY: 1-855-889-4325) to get help filling out an application.
  • By mail – You can fill out a paper application and mail it in. Once you get your eligibility results, you can either go online or contact the Marketplace Call Center to pick a plan and enroll. Download a 2017 paper application and instructions (Even if you are planning on applying for health insurance online, it may be helpful to fill out a paper application beforehand so you can gather all of the necessary information in advance.)
  • With In-Person Help – Trained people in your community – like Navigators, assisters, agents, and brokers – can help you fill out an application and enroll in coverage.  Get started: Enter your zip code to see a list of groups and people near you.

You can shop around – you do not have to purchase within the exchange (marketplace), but purchasing in the exchange is the only way to get the tax credits. Health insurance (the exact same plans) may be purchased off the exchange at the same prices.

 

You can also purchase insurance through an independent company or insurance agent of your choice. For more information about purchasing health insurance, see the Wisconsin Office of the Commissioner of Insurance Health Insurance webpage.

 

Protect Yourself from Fraud

As you research, seek help and apply for health insurance, it is important to take steps to protect yourself from fraud.

Be Informed

    • Visit HealthCare.gov, the official Marketplace website, to learn the basics.
    • Compare insurance plans carefully before making your decision.
    • Look for official government seals, logos or web addresses. Any website with the .gov domain is an official government website.
    • Know the Marketplace Open Enrollment dates — November 1, 2016 through January 31, 2017. No one can enroll you in a health plan in the Marketplace until Open Enrollment begins or after it ends unless you have special circumstances.

Protect your Private Information

    • No one should be asking for your personal health information. Don’t give it to anyone.
    • Keep personal and account numbers private. Don’t give your Social Security Number or credit card or banking information to companies you didn’t contact or in response to unsolicited advertisements.
    • Never give your personal health or financial information to someone who calls or comes to your home uninvited, even if they say they are from the Marketplace.

If anything seems confusing or suspicious, contact an official channel immediately. Visit HealthCare.gov or call their toll free hotline at 1-800-318-2596 (TTY 1-855-889-4325). For more information about protecting yourself from fraud, click here.

 

Additional Links and Resources

 

Do you have questions about how the Affordable Care Act will affect you and your family? Find additional information about the Health Care Reform at these resources:
Enroll Wisconsin

The Henry J. Kaiser Family Foundation – For Consumers: Understanding Health Reform Non-partisan information and facts about health care reform, including information about how individual states are implementing the Affordable Care Act.
See also:
Health Reform Frequently Asked Questions
Health Insurance Changes Coming Your Way informational video 

Wisconsin Department of Health Services – Consumer Guide to Health Care The DHS Consumer Guide to Healthcare provides information about finding and choosing health care providers and paying of health care, including insurance options.

Wisconsin Office of the Commissioner of Insurance – Health Care Reform Frequently Asked Questions This document compiled by the Commissioner of Insurance answers frequently asked questions for consumers in regard to the Affordable Care Act.

Consumer Reports – Health Insurance  Read updated insurance policy ratings, guides for picking health insurance policies and more in the Health Insurance section of the Consumer Reports website.

 

For information about the reforms taking effect, the following websites have comprehensive information pages:
About the Law – U.S. Department of Health & Human Services
Affordable Care Act – Medicaid.gov
Affordable Care Act – United States Department of Labor
Affordable Care Act Tax Provisions – Internal Revenue Service
Health Care Law Fact Sheets – AARP (American Association of Retired Persons)