Enrolling in Marketplace Coverage for 2020 – What Do You Need to Know?

(INDIANAPOLIS) – The Indiana Department of Insurance reminds Hoosiers that open enrollment for 2020 Affordable Care Act (ACA) plans will begin on Friday, November 1, 2019, until Sunday, December 15, 2019. In order to have an ACA Marketplace or Off-Marketplace plan for 2020, you must enroll in a plan and pay the first month’s premium by December 15.

Those who currently have an ACA plan or need one in 2020 should take the time to shop for plans. If you already have coverage through a Marketplace plan, review your information to make sure your application is accurate. You can update your application with any income and/or household changes. You might qualify for a different amount of help with costs, or find a different plan that costs less or better meets your needs.

What to Look for

If your plan is no longer available in 2020, you should receive a notice from your insurer and from the Marketplace. Even if your plan is continuing, it pays to shop and check whether the doctors or hospitals your family uses are in the plan networks.

If you are looking for a new plan, there are four categories of health insurance plans to choose from on the Marketplace (Bronze, Silver, Gold and Platinum). They’re broken up by how costs are shared between you and your insurer. A fifth category, Catastrophic, is available for consumers under 30 years of age or who face a hardship in accessing the other plans. To learn more about the different plans and network types, visit www.healthcare.gov/choose-a-plan/plan-types/.

What’s New for 2020

CareSource and MHS/Ambetter are the two insurance companies in Indiana offering 2020 individual ACA-compliant Marketplace plans. In 2019, MHS/Ambetter offered plans in all 92 counties, and CareSource offered plans in 79 counties. In 2020, CareSource has expanded and will now offer plans in all 92 counties and MHS/Ambetter will continue to offer plans in all 92 counties. 

There are multiple options for enrollment. You can enroll into an ACA plan via the Federal Marketplace at HealthCare.gov or by obtaining coverage through certified enrollment partner websites. Additional information on enhanced direct enrollment may be found at www.healthcare.gov/direct-enrollment/

Additional Information for 2020

There will not be a penalty for not having minimum essential coverage. Before 2019, consumers would pay a penalty if they were not enrolled in a health plan. The tax penalty for 2020 is $0.00. If you do not have ACA-compliant plan for the 2020 coverage year, you will be responsible for your major health care costs, but you will not be penalized at tax time.

Short-term, limited duration options may offer lower premiums but less comprehensive coverage. Short-term plans are not available through the Marketplaces, but you may see it offered elsewhere. They may be issued for less than 12 months and may be renewed for up to 36 months. They are required to cover certain benefits, such as ambulatory patient services, hospitalization, emergency services and laboratory services. While they are typically cheaper than ACA-compliant major medical health insurance, short-term plans typically have limited benefits, pre-existing condition exclusions, broader benefit exclusions and higher levels of consumer cost-sharing. Before signing up for a short-term plan, it is important to think through what health care services you and your family may need and check whether those services are covered.

Questions

If you have questions about the 2020 open enrollment, email compliance@idoi.IN.gov or contact a certified Indiana navigator for enrollment assistance. You can search for a Navigator in your area at www.in.gov/healthcarereform/2468.htm.

About the Indiana Department of Insurance
The Indiana Department of Insurance (IDOI) protects Indiana’s insurance consumers by monitoring and regulating the financial strengths and market conduct activities of insurance companies and agents. The IDOI monitors insurance companies and agents for compliance with state laws to protect consumers and to offer them the best array of insurance products available. The IDOI also assists Hoosiers with insurance questions and provides guidance in understanding how insurance policies work.

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