Navigating the Health Insurance Marketplace

The Health Insurance Marketplace is an online tool to investigate and select the best medical health insurance plan for your situation. All the options available in the Health Insurance Marketplace are ACA compliant. “ACA compliant” means that the insurance plan follows the rules of the Affordable Care Act, which was passed by Congress and the Obama Administration in 2010. These rules were in part meant to protect individuals and families from being taken advantage of by insurance companies. ACA-compliant plans can NOT discriminate against individuals with preexisting medical conditions, and MUST cover both minor and major medical issues. You are not required to get your health insurance from the Health Insurance Marketplace, it is just a tool to help you get the best insurance for your situation.

 

This year’s deadline to get health insurance that is compliant with the Affordable Care Act (ACA) is Saturday, January 15th, 2022. Every year there is a period of time set aside for individuals and families to either renew or sign up for ACA-compliant health insurance. This period of time is called “open enrollment”. Open enrollment this year is from November 1st 2021 until January 15th 2022 (actually, the deadline is December 15th if you need your health insurance to be active on the 1st of the new year). If you miss the deadline and do not qualify for an exception, then you will either have to wait until November 2022 to get health insurance, or get a non-ACA compliant heath insurance plan until then. Exceptions are granted if you’ve had certain life events, including losing your job’s health coverage, moving, getting married or divorced, having a baby or adopting a child, or a death in the family. You are typically allowed to enroll for a new ACA compliant health plan up to 60 after such an event.

 

You can get help navigating the Health Insurance Marketplace, selecting plans and completing the application/online paperwork, by finding a licensed agent or broker near you. Agents may work for a single health insurance company and may therefor be limited in their knowledge about the plans offered by other agencies; brokers are often familiar with plans offered by multiple health providers. You should not have to pay for an agent or broker to help you as these professionals are typically paid in commissions from the Health Insurance agencies to which they connect you. Additionally, you may qualify for a premium tax credit and other savings if you enroll with an agent or broker. However, to get the savings, the agent or broker MUST enroll you through the Health Insurance Marketplace. Healthcare.gov provides an online portal to help you find professionals in your area licensed to provide this help. Simply enter your zip code in this portal to find agents and brokers near you.

 

Agents and brokers must be licensed in their states and have signed agreements to sell Marketplace health plans. In many states, brokers are required to act in a consumer’s best interest. Ohio law gives you the right to file a complaint against insurance companies, health maintenance organizations (HMOs), insurance agents and adjusters. You can view more information about filing a complaint, and the Ohio agency in charge of protecting consumers from unlawful health insurance practices at https://insurance.ohio.gov

 

Ohio Medicaid Recipients. Please note that if you are an Ohio Medicaid recipient the deadlines listed in this article do not directly apply to you. While you must fill out a new Medicaid application every year to stay in the Medicaid program, the timing of this does not correspond to the open enrollment period of private insurance marketplace.