Deadline to sign up for ACA health coverage is coming up in December
The deadline to sign up for Marketplace health insurance, available through the provisions of the Affordable Care Act (ACA), is drawing near – it’s December 15th, 2020. And like so many aspects of our lives in 2020, this one has also felt the impact of the pandemic. The WV Navigator program that assists West Virginians in choosing the best health care plan for themselves and their families has ceased in person office hours and travel to walk-in enrollment events. They have instead gone to a secure virtual platform to assist residents of the state.
Jeremy Smith Program Director for the WV Navigator program, says getting help signing up is important as many folks could easily be overwhelmed by the options and may choose the wrong plan for their family. Since in person consultations are not available, they are offering their services over the phone and through online platforms like Zoom.
“It’s hard to really understand what is a deductible, what is a copay, are my doctors in network,” said Smith. “Or somebody may not be very comfortable signing up on the computer and navigating the application online. At WV Navigator we’ve got folks that can talk to you and your family about your specific situation and make sure you understand what options are available to you and make sure that you’re signing up for a plan that’s going to the best for you and your family.”
Jessie Ice, Executive Director for West Virginians for Affordable Health Care says where you get that plan is important as well. She recommends going to healthcare.gov rather than another off-market plan.
“When you are shopping on healthcare.gov that means that you are getting one of the ACA’s approved health care plans.”
Ice says in addition to pre-existing conditions, there are other essential health services a healthcare.gov plan must cover.
“You get prescription drug coverage, pediatric services, which includes dental and vision for kids, your preventative wellness check each year,” she said. “Screenings for things like diabetes and getting your immunizations and things like that; your emergency services and hospitalization, mental health and addiction services do not have to be covered unless it’s an ACA plan. Same thing with pregnancy, maternity and new born care, ambulatory care, lab services. It also covers rehab services.”
She says some of those services, especially maternity care, may not be covered under private insurance plans.
In early November, the US Supreme Court heard a third case challenging the constitutionality of the ACA. A ruling in that case is not expected until spring or possibly summer of 2021. Ice says that ruling will not affect those who sign up for a government health care plan this year.
“If you were to sign up on the Marketplace, your coverage for 2021, you’re signing into a contract [so] they will cover you for the entire year regardless of what decision comes down from the Supreme Court and how that decision is ultimately interpreted,” said Ice. “We won’t know that for many, many months but do not let that discourage you from getting a Marketplace plan this year – they will be honored in 2021 regardless.”
Smith says at least two insurance carriers are offering plans on the Marketplace for West Virginians.
“We have Highmark Blue Cross/Blue Shield and we have another company called Care Source,” said Smith. “And for the first time ever both of those companies are going to be offering plans state-wide. One of the major things that we do in our program is not only help somebody understand what the plans are, but we also make sure they understand if they’re going to qualify for financial help that can help them pay for their plan that they pick.”
You can get more information about or make an appointment with a WV Navigator counselor at 304-356-5834 on online at wvnavigator.com. There is no charge for enrollment assistance.