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ACA Marketplace Open Enrollment Starts Today! Here’s What Pennsylvanians Need to Know

November 01, 2018

The six-week Open Enrollment period for the Affordable Care Act's (ACA) insurance marketplace, HealthCare.gov, runs today through December 15, 2018. Pennsylvanians who get their insurance through the marketplace, or who are uninsured, should take advantage of this opportunity to get covered and stay covered.

In a statement yesterday, Pennsylvania Insurance Commissioner Jessica Altman urged Pennsylvanians who rely on the marketplace for coverage to “explore their options this and every year.” New insurance plans are available that may be better fits for individual needs or that could change the amount of financial assistance available.

This HAP blog post outlines key benefits for Pennsylvanians using the marketplace this year:

  • Financial help for covering the cost of insurance is available as always
  • Many premiums will increase only slightly, while some will go down
  • Many Pennsylvanians will have more coverage choices
  • Plans on the Pennsylvania marketplace provide the same consumer protections as always

The Insurance Department also cautioned consumers to be careful about where they shop for insurance. HealthCare.gov is the official website for Pennsylvanians seeking to enroll or re-enroll in marketplace plans. Some companies and agents are offering plans they say are compliant with the ACA, but in fact, they do not have all the consumer protections and wellness benefits that the ACA requires.

Help Navigating the Marketplace

HAP and Pennsylvania hospitals have joined with state government, the insurance community, navigators and assisters, and health care organizations to help Pennsylvanians during Open Enrollment. Key resources include:

  • From the Pennsylvania Insurance Department:  An Open Enrollment webpage that contains links to 10 new consumer education videos. With Consumers’ Checkbook, shoppers can view plan options, estimate monthly premiums and total annual out-of-pocket costs, and learn how to buy a plan.
  • At HealthCare.gov:  Consumers can use local help lookup to find nearby enrollment assistance. The call center is staffed at the same level as last year and ready to help consumers compare plan options and enroll. 

Other resources include your local hospital or health system or neighborhood health clinic.

About Automatic Re-enrollment

As in years past, Pennsylvanians who are currently enrolled in a marketplace plan will:

  • Receive notices about Open Enrollment from the marketplace and from their current insurer. The insurer will provide information about premiums, coverage and benefit changes, and plan availability for 2019.   
  • Be automatically re-enrolled if they don’t actively re-enroll by December 15. If the same or similar plan is not available, consumers will be automatically re-enrolled into a plan from a different issuer to avoid a gap in coverage. 

HealthCare.gov Maintenance Downtimes

The maintenance schedule this year is similar to last year:  HealthCare.gov is scheduled to be offline for maintenance from 12 a.m. to 12 p.m. each Sunday during the sign-up period, except for the final Sunday. 

According to the latest U.S. Census data, Pennsylvania’s uninsured rate is at a record low 5.5 percent. Let’s work to maintain or improve on that during 2019 Open Enrollment.

For more information about HAP’s open enrollment advocacy, please contact Jolene Calla, HAP’s vice president, health care finance & insurance.

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