5 Facts About the Affordable Care Act

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By Jennifer Simmons, Director of the NC Navigator Consortium

November 1, 2017 – Get ready for the world’s biggest understatement: the Affordable Care Act is a hot topic. Of course, you probably know that. What you might not know, given the frenzy surrounding the law, is the real story. Here, on the first day of the law’s fifth – and shortest – open-enrollment period, are the top five facts that you need to know about the ACA.

Fact 1: The Affordable Care Act is still the law.

Neither the president, nor Congress, nor anyone else has repealed or substantially changed the law. In short: Except for the shortened enrollment period (see fact 2) nothing much has changed for North Carolina consumers. Consumers can still buy coverage on the Health Insurance Marketplace. All plans must still cover comprehensive care (see fact 3), financial help for consumers is still available (see fact 4) and a fully funded corps of navigators is still available to help North Carolinians enroll in coverage (see fact 5). Another thing that hasn’t changed: Consumers must still have health insurance in 2018 or pay a penalty during tax time.

Fact 2: This year’s open-enrollment period is the shortest ever.
The open-enrollment period for 2018 coverage starts today, Nov. 1, and runs through Dec. 15. This 45-day open-enrollment period is the shortest in history. Also, the Health Insurance Marketplace is likely to be offline for several hours on most Sundays during open enrollment. This means that time is of the essence! If you want to enroll in Marketplace coverage for 2018, do not delay. Not sure where to start? A great first step is to schedule a free, local, in-person appointment with a certified Marketplace navigator near you (see fact 5).

Fact 3: ACA plans still cover comprehensive care.

All health insurance plans offered on the Health Insurance Marketplace must cover a set of “essential health benefits,” which include doctor’s visits, prescription drugs, emergency services, hospitalization, preventive and rehabilitative care, mental health, pregnancy-related care, birth control coverage and more. Other well-known parts of the law are still in place: Children can stay on their parents’ insurance until they are 26, coverage cannot be denied for pre-existing conditions, women cannot be charged more than men for the same coverage, and more.

Fact 4: Financial help for consumers is still available.

This one bears repeating: Financial help for consumers is still available! Nothing has happened that will affect the amount of financial help available to consumers for 2018 coverage. There are two types of financial help for consumers: premium subsidies and cost-sharing reductions. Premium subsidies help people afford their monthly premiums. About 90 percent of North Carolinians enrolled in Marketplace coverage get premium subsidies. Most subsidized plans cost less than $100 a month. Subsidies are tied to premium rates, so subsidies go up when premiums do, resulting in no cost increase to the consumer. The second type of financial help is known as cost-sharing reductions, which help consumers afford out-of-pocket costs like co-pays and deductibles. Insurance companies are still required to provide this help to consumers.

Fact 5: Free, inperson help is still available!

Navigators are trained and certified enrollment experts who provide free guidance and enrollment assistance to consumers. The NC Navigator Consortium is our state’s largest and only statewide navigator group. The consortium received the same amount of funding from the federal government for this open-enrollment period as it did last year, so help from navigators is just as available as it has always been, and it’s only a call or click away. Consumers can call 1-855-733-3711 (toll-free) or visit ncnavigator.net to schedule a free, in-person navigator meeting in their area.

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About the NC Navigator Consortium

The NC Navigator Consortium is a group of 12 health care, social service and legal aid organizations that helps North Carolina consumers enroll in affordable health insurance plans under the Affordable Care Act. Members of the consortium are Access East, Capital Care Collaborative, Care Ring, Charlotte Center for Legal Advocacy, Council on Aging of Buncombe County, Cumberland HealthNet, HealthCare Access, HealthNet Gaston, MDC, Partnership for Community Care, Pisgah Legal Services. The consortium is led by Legal Aid of North Carolina. Learn more at ncnavigator.net.

 




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