The Affordable Care Act (ACA) created health insurance Marketplaces, or exchanges, to make it easier for people to compare and shop for insurance. It also facilitated the creation of new helpers—which may be called navigators, application assistors, or certified application counselors, depending on who provides the service and where they are located—to help people get through the process. Why? Because health insurance can be hard to understand and everyone’s situation is different.
Who can help
Navigators don’t work on commission, can’t favor any one insurance company, and can’t be paid by any insurance company. Their job is to educate consumers and help them apply for health insurance. They can provide impartial information and guidance, but cannot tell consumers which plan to choose. Navigators may be self-employed or may belong to certain groups, such as unions, church groups, tribal organizations, and chambers of commerce.
Insurance agents, as they have for many years, can still help people select the health plan that’s best for each situation. As licensed insurance professionals, they are allowed to recommend plans, setting them apart from navigators.
How to sign up
People shopping for insurance can apply for a health plan through the state Marketplace by going online, using paper forms, or picking up the phone. The Marketplace website for each state walks users through the process, step by step. Consumers can save their progress so they can quit at any point and come back later to finish.
If you have questions, you can call the Healthcare.gov call center at 1-800-318-2596 (TTY: 1-855-889-4325) anytime, 24 hours a day. The website also offers a live chat service; visit www.healthcare.gov/help-center.
When to sign up
Open enrollment began on Oct. 1, 2013, for health plans effective Jan. 1, 2014. This first enrollment period runs until March 31, 2014. After that, the annual open enrollment period will be from Oct. 15 to Dec. 7.
If you enroll in a health plan between Oct. 1, 2013, and Dec. 15, 2013, and make your first premium payment, your new health coverage starts Jan. 1, 2014.
During the rest of open enrollment, if you enroll between the 1st and 15th day of the month and pay your premium, your coverage begins the first day of the next month. So if you enroll on Feb. 10, 2014, your coverage begins March 1, 2014.
If you enroll between the 16th and the last day of the month and pay your premium, your effective date of coverage will be the first day of the second following month. So if you enroll on Feb. 16, 2013, your coverage starts on April 1, 2014.
Consumers can only purchase health insurance coverage during the annual open enrollment period unless they have a special enrollment or limited enrollment event. Those events include a marriage, birth or adoption, the loss of other coverage due to job loss, becoming newly eligible for advanced payments of the premium tax credit, and moving to a new coverage area. If the exchange navigators determine a person was incorrectly or inappropriately enrolled in some other type of coverage, then that may also trigger a special enrollment event.
In 2014, there will also be a one-time open enrollment period so that individuals with non-calendar-year plans can transition to calendar-year plans upon their renewal dates in 2014.
To find out more about coverage options and other ACA-related topics, take a look at our new Health Care Reform Information Center, our Learning Center, or check out our free brochure, 9 Things You Need to Know About the Affordable Care Act.