What every Kentuckian Needs to Know to Get Covered and Stay Covered
From November 1 to January 31, Kentuckians will have the opportunity to enroll in quality, affordable health coverage through the Health Insurance Marketplace. This year, Kentuckians will use healthcare.gov to enroll in a qualified health plan, instead of kynect like in years past. 9.6 million Americans are already getting coverage through healthcare.gov.
Kentucky’s model for streamlined eligibility and enrollment has been widely considered one of the most successful in the country. Before the expansion, in December of 2013, the State Health Access Data Assistance Center at the University of Minnesota reported that Kentucky’s uninsured rate was 20.4%. By the end of 2015, the uninsured rate was 7.5%. Around 85,000 individuals have obtained qualified health plans through kynect and another 440,000 have enrolled in Medicaid since 2014.
Here are five things every Kentuckian needs to know about the upcoming open enrollment period:
1. Open enrollment begins on November 1 & those looking for 2017 coverage will apply on healthcare.gov
Like kynect, Kentuckians will be able to go online and select a plan that meets their needs and budget from many of the same carriers they are already familiar with. On November 1, the Health Insurance Marketplace will reopen until January 31. During this time, all Kentuckians looking for 2017 coverage will be able to enter the Health Insurance Marketplace and select a plan that fits their needs and budget. All individuals previously enrolled in a health plan through kynect will need to complete a healthcare.gov application by December 15 for January 1 coverage to begin. If consumers don’t have health insurance, November 1 is their chance to find a plan they can afford. If you’re eligible for Medicaid you can enroll year-round.
Nothing changes with 2016 coverage through kynect. Plans are still valid through December 31, 2016.
2. The Medicaid program and application process have not changed
If a person is enrolled in Medicaid, they do not need to do anything until their renewal/recertification date. If someone is Medicaid eligible, he/she can apply anytime during the year. A tax household size of 4 may be eligible for Medicaid if annual household income is less than $33,534. You can apply anytime online at benefind.ky.gov, by calling 1-855-459-6328 or getting help from an Application Assister (kynector).
Medicaid and KCHIP open enrollment in a Managed Care Organization (MCO) is scheduled for October 24, 2016 through December 16, 2016. Medicaid individuals wishing to change their current MCO must do so during the open enrollment period. A MCO change made during this period will be effective January 1, 2017. After you change a MCO you will have 90 days to make another change. After 90 days, you will not be able to make another change until the next open enrollment period, unless you have an event that allows a change. To change a MCO call 1-855-446-1245 or 1-800-635-2570 between 8:00am and 5:00pm to talk with a Member Representative. If you want to stay with your current MCO, you do not have to do anything.
3. In-person help is available to help Kentuckians understand their options and enroll in a plan.
The enrollment process can be confusing for many, especially if an individual has gone a long time without coverage. Luckily, there is free, in-person enrollment help available right here in Russell Springs. Previously referred to as “kynectors,” these are unbiased experts from the communities they serve who are certified to sit down with Kentuckians to explain coverage options and help with making the best coverage decision for consumers and their families. They can also help with plan renewal for those who are already insured through the Affordable Care Act and want to keep or switch their coverage. Consumers can find a nearby in-person assistor by entering their zip code at https://localhelp.healthcare.gov/#intro
4. Kentuckians can only get the tax credit, called APTC or Advanced Premium Tax Credit or a Cost Sharing Reduction that helps cover out-of-pocket costs by enrolling through HealthCare.gov
About 85 percent of Marketplace-eligible uninsured Americans could qualify for financial help. For many Kentuckians, affordability is a real concern in their health care decision-making. In the past, high premium costs have forced many to go without health insurance simply because they couldn’t afford it. Thanks to financial help, most consumers can find a plan with a monthly premium between $50 and $100. Consumers can check out the Get Covered Calculator tool to find out what type of financial assistance they may be eligible for at www.getcoveredamerica.org/calculator
The kynect call center (855-459-6328) is still here to help direct Kentuckians where to go for coverage. The call center will help prescreen for program eligibility and can assist with Medicaid applications. The call center can also help with questions and information. To apply for 2017 coverage a health insurance application will need to be completed on healthcare.gov prior to December 15 for January 1 coverage to begin. HealthCare.gov customer service call center can be reached at 800-318-2596 and is open 24 hours a day, seven days a week
Local assisters, previously called “kynectors,” can help consumers compare their options, or they can visit healthcare.gov to see plans laid out in an apples-to-apples way.
5. Consumers may face a fine come tax time if they remain uninsured.
This enrollment period is an opportunity for Kentuckians to not only gain access to quality affordable healthcare, but to also avoid paying a fine when it is time to file taxes. If individuals do not enroll in a plan by the deadline of January 31, they could face a fine of $695 or 2.5% of their yearly income, whichever is greater. Thanks to the financial help that is available, many consumers will find purchasing coverage more affordable than paying the fine for not having insurance as well as paying for health services without coverage during the year. By contrast, purchasing an affordable plan provides families with free preventative care, prescription drug coverage, and other essentials for a healthy life.
November 1 marks an exciting opportunity for Kentuckians who need to find or renew their health insurance. With these five simple facts, consumers can prepare for open enrollment and take action to protect themselves and their families with quality, affordable health coverage.
For questions or assistance, please contact Hannah Davis at 270-858-6655 x2339 or firstname.lastname@example.org.