Nevada Health Link and Healthcare.gov will be back in the spotlight this week.
Saturday marks the first day of open enrollment for consumers to buy subsidized health insurance plans offered via the Affordable Care Act.
Consumers who qualify for federal subsidies can choose plans offered by five insurance carriers on the state’s Silver State Health Insurance Exchange. They can enroll in-person, on the phone or online. Consumers with existing, federally subsidized plans must re-enroll or jeopardize losing their subsidy.
Last year’s open enrollment was the nation’s first since the passage of the Affordable Care Act.
Nevada learned that the insurance business is a complicated one. Consumers who enrolled for plans experienced flaws triggered by faulty billing, payment and enrollment software on the Silver State Exchange.
But state officials say the majority of problems are behind them. Nevada Health Link is now plugged into Healthcare.gov, the federal system, and has revamped its outreach efforts to the community.
“If it doesn’t go well it won’t be because we didn’t do the right things,” said Bruce Gilbert, the exchange’s executive director.
There’s a lot to know about the health care law and how it works in Nevada. Instead of reading the long-winded, now-infamous federal bill, here are five tips for consumers who want a federally subsidized plan or need to re-enroll in one.
Already have a plan? Re-enroll or pay the price
The state has one piece of advice for consumers who signed up for subsidized plans last year: Re-enroll.
Consumers won’t be grandfathered into a plan for the upcoming year. If they are currently enrolled in subsidized plans, they have from Nov. 15 to Dec. 15 to sign up for a plan that will start Jan 1. The Affordable Care Act says that patients who don’t re-enroll will be placed into a nonsubsidized plan. Consumers who qualify for tax credits could end up paying a lot more for plans if they don’t act. Consumers who qualify for Medicaid do not need to re-enroll with Nevada Health Link.
The greatest danger is if those at the lower income levels lose the federal subsidy, Gilbert said.
He didn’t offer cost estimates on the penalties. But he said not re-enrolling “could make insurance unaffordable” for lower-income consumers.
Do I qualify?
There are a lot of factors used to determine eligibility. The paramount components are household incomes and whether employers offer plans. If a company offers a plan that’s not eligible with the ACA, consumers can apply. If plans exceed 9.5 percent of income, consumers can apply. The state has developed a guide for consumers about the open enrollment period.
A single person making between $11,670 and $46,680 may be eligible for subsidies. For a family of four, the range is $23,850 and $95,400.
Here is a list of all incomes that qualify for subsidies
Where do I go to sign up or re-enroll?
There are a lot of options. Consumers can sign up for insurance without leaving the house. They can have face-to-face interactions.
Online: Visit Nevada Health Link’s website.
Call Nevada Health Link: 1-855-7NVLINK (855-768-5465)
Go to a brick-and-mortar location: Las Vegas: Boulevard mall, 3528 S. Maryland Pkwy.
Consumers who want to keep their current plans can re-enroll by calling their insurance carrier.
Navigators, brokers and assistors
There are differences among all three. None will cost you money. All will be at the exchange’s brick-and-mortar locations. Consumers will also be able to contact them at other locations.
Brokers are certified by the state to talk about out-of-pocket costs, deductibles and compare plans. They can analyze consumers’ health care needs and can work with consumers after they enroll in plans, said Kirstine Sorenson, a Las Vegas health insurance broker.
“They offer the highest form of consumer protection under the law,” she said.
Unlike brokers, navigators and assistors are funded with government grants. They are federally trained to assist consumers through the enrollment process online or in person.
Before enrollment, Consumers should double check their annual incomes. Don’t fudge, miscalculate or do anything else that could inaccurately portray annual income, Sorenson said.
Consumers who list the incorrect income may have to pay penalties, she said.