Deadline to apply for ‘Obamacare’ is near. Here’s how to get your ACA needs covered.
Have you enrolled for the 2021 Affordable Care Act — best known as Obamacare — yet? Do you want to?
Know this: The deadline to join that healthcare market in 2021 is Tuesday, Dec. 15. The biggest mistake people make is missing the deadline, said Charlene Zein, senior vice president of Ambetter from Sunshine Health. Ambetter is headquartered in South Florida and is one of many insurance companies selling ACA plans in the marketplace. So are Florida Blue, Medica and others.
“Take the time today to research your options, because health insurance may be more affordable than you think,” she said. “The deadline is almost here, but you still have time to make a decision that could benefit you and your family.”
That’s a message many in the industry are trumpeting given some nine months of a COVID-19 pandemic that is surging again.
Florida and COVID-19
Florida was the third state to surpass a million coronavirus cases after California and Texas in November and the numbers have picked up at a troubling pace since.
Thursday, Florida added more than 11,000 new confirmed cases, its highest figure since the summer peak in July, to bring its confirmed count to nearly 1.1 million cases, along with nearly 20,000 deaths. Miami-Dade leads the state in cases and deaths at more than 251,000 and nearly 20,000 deaths in the state counting residents and non-residents.
“Health insurance is more important than ever during the pandemic to ensure people are covered and to take away the stress and anxiety that people without health insurance often experience,” Zein said. “Many people qualify for subsidies.”
How Florida ranks in number of ACA enrolled
Florida was the top state in 2020 for the number of people enrolled in Obamacare, according to Kaiser Health News and a Tampa Bay Times report. The Sunshine State had 1.9 million enrolled. California (1.5 million) and Texas (1.1 million) rounded out the Top 3.
South Florida counties, including Miami-Dade and Broward, led the state, accounting for 37% of those enrolled, according to the Centers for Medicare and Medicaid Services.
Currently, from Nov. 1 to Nov. 28, more than 870,000 Floridians signed up for the Affordable Care Act on the federal marketplace, leading the country among the 36 states with exchanges on HealthCare.gov. That outpaces the record year Florida had last year, when nearly 797,000 people signed up in November 2019, before the Dec. 15 deadline.
Steven Ullmann, a healthcare policy expert with the University of Miami, told the Miami Herald earlier this month he was not surprised to see that increase in enrollments, given the pandemic and Florida’s heavy concentration of workers in the service industries, which have been battered by the novel coronavirus.
“Now you add to that the services that are being so impacted by COVID, and that impact is even larger,” Ullmann said. “A lot of people who had jobs in the service sector where they had some employer-based health insurance have lost that as well.”
Ullmann said there is added incentive in South Florida to sign up for any health insurance plan, even the ones with high deductibles — up to $6,000 until a plan’s coverage kicks in — that are most popular on the federal health exchange. That’s because Miami-Dade County has some of the most expensive healthcare in the country, he said.
“People have a realization that to offset some of those costs, if they ever needed any healthcare, that the insurance is something that they want to have,” he said.
According to Zein, there are about 125,000 people in Miami-Dade and 85,000 people in Broward who are uninsured and could qualify for health insurance at no monthly cost.
How do you enroll?
A main way to enroll in the ACA/Obamacare marketplace is via the nationwide HealthCare.gov website.
That primary sign-up site will let you see the various plans and costs and also lets you click on links to find local help — such as hundreds of South Florida agents who can walk you through the sign-up process and help you tailor coverage to your specific needs and budget.
You can also call 800-318-2596 for questions on enrolling in the Marketplace from HealthCare.gov representatives.
I lost, or may lose, my job and COBRA is too expensive. Can I sign up after Dec. 15?
“Health Insurance Marketplace coverage often is more affordable than COBRA for those who have lost jobs because of the COVID-19 pandemic or other reasons,” Zein, of Ambetter, said. She adds that people who have lost their jobs can sign up for coverage even after the Dec. 15 deadline. People have 60 days to sign up for coverage after qualifying life events like job loss, marriage, child birth and adoption through what is called a special enrollment period.
These are individuals who could receive free yearly checkups, preventive screenings such as mammograms, and comprehensive blood work along with the security of knowing they are covered should an unexpected health issue arise — but they are missing out on this potentially lifesaving benefit.
Does Obamacare cover medically necessary COVID-19 diagnostic testing?
Ambetter’s Zein said her company covers COVID-19 testing and screening services as well as treatment costs under all its plans. Make sure to ask a local agent if COVID-19 testing and treatment costs are covered by their companies, too, and it’s a point to ask when using the main HealthCare.gov sign-up site, too.
Zein said Ambetter’s “member plans’ co-payment, coinsurance and/or deductible cost-sharing requirements are waived for medically necessary COVID-19 diagnostic testing and/or medical screening services. Members do not need to obtain prior authorization before requesting a test.”
Hasn’t politics killed Obamacare?
True, the Trump administration has tried to do away with Obamacare since taking office in 2016. “But the Affordable Care Act is still the law of the land and you can still buy plans on the Marketplace,” said Jorge Martinez, a senior regional spokesman for Florida Blue (formerly Blue Cross and Blue Shield and also one of the companies enrolling people in the market).
Can I still get financial assistance (subsidies)?
Yes, financial assistance to lower monthly payments for health insurance is still available for those who qualify. Local agents or the national website can offer direction to the 970,000 or so uninsured Floridians, according to Martinez.
I couldn’t afford health insurance when I checked in past years. Has that changed?
Prices vary. But according to Florida Blue’s Martinez, there have been several adjustments to the Affordable Care Act and pricing on plans changes every year. Contact a local insurance agent or the HealthCare.gov navigator to see what you may qualify for in the 2021 plan.
Just remember, Dec. 15 is Tuesday.
This story was originally published December 11, 2020 at 2:30 PM with the headline "Deadline to apply for ‘Obamacare’ is near. Here’s how to get your ACA needs covered.."
