i'm covered

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Nov
1
open enrollment begins
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Dec
15
deadline for Jan 1 coverage
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Jan
31
open enrollment ends

YOU WILL NEED TO RE-ENROLL IF:

Remember, as your life and family change, your health insurance needs change, too. are you covered? recommends that every Ohioan take time to explore their health care options every year during open enrollment, or when they experience a major life change. Factors to consider include:

• New health insurance plans that will better fit the needs of you and your budget

• Life changes, such as a change in employment, a birth or death in the family or retirement

• Your currently policy can not be automatically renewed

Although you can automatically re-enroll with your current health insurance plan, you may still have questions. The counselors and navigators at are you covered? are always available to help you find the health insurance plan that best meets your needs and budget.

IF YOU CHOOSE TO KEEP YOUR CURRENT PLAN:

If you enrolled in a health marketplace plan last year, you will receive two notifications in the mail:

• One mailing from your current health insurance company will tell you how to keep your current plan automatically, if possible.

• One mailing from the Health Insurance Marketplace will let you know more information about re-enrollment.

Even if you are eligible for automatic re-enrollment, the counselors at are you covered? can help you make an informed decision about keeping your current plan or moving to one that better fits the needs of you and your budget.

If you enroll automatically, one of two things will happen:

• You’ll pay the same premium and receive the same tax credit and other savings you had previously.

• Or you’ll re-enroll without any premium tax credit or savings.

what it covers

No one plans to get sick or hurt, but most people need medical care at one time or another. Health coverage helps pay for these costs and protects you from very high expenses. When you buy a health insurance plan, the company agrees to cover part of your medical costs when you get sick or hurt.

Did you know the average cost of a three-day hospital stay is $30,000? Or that fixing a broken leg can cost up to $7,500? Having health coverage can help protect you from unexpected high costs like these.

Your health insurance plan will show what types of care, treatments, and services your plan covers, including how much the insurance company will pay for different treatments.

In general, your health insurance will cover the most important benefits you need:

  • Doctor visits
  • Hospitalization
  • Prescriptions, including birth control
  • Maternity and Infant Care
  • Pediatricians
  • Mental Health
  • Emergency Services

Health insurance covers preventive services, too, and many of them are at no additional cost to you. These preventive services include:

  • Vaccinations
  • Cholesterol screening
  • Blood pressure screening
  • Colorectal cancer screening
  • Mammograms
  • Pap smears

how we can help

are you covered? connects Ohioans to free information and assistance to sign up for health insurance through a company or through Medicaid. Our services are free, and we are a trusted network of local non-profit and health care organizations with a sole focus of making sure you have the health coverage that meets your needs.

f.a.q.

  • What is are you covered?
    are you covered? provides the only statewide network of trained counselors and navigators, working in all 88 Ohio counties. We coordinate the work of 250 organizations who want to make sure all Ohioans have access to affordable health insurance.

    Our services are completely confidential and you will leave with the peace of mind that we found our personalized approach will make sure you have the right coverage for you and your budget.

    Through our local partners, we reach out to communities and neighborhoods throughout Ohio. Our counselors arrange times and locations to meet that are convenient for busy families. We take all the time you need to walk through the process of selecting a health insurance plan make sure it meets your health and financial needs, help you make changes and answer any questions you have about your coverage.

    are you covered? is funded by:
    AARP Ohio
    The Columbus Foundation
    Interact for Health
    Ohio Association of Foodbanks
    Voices for Ohio’s Children
  • Are there any fees for services? Does the organization make commissions or profits?
    There are no fees, commissions or profits for the counseling services of are you covered?, and the organization does not favor one health insurance plan over another. We work with you to explore your health insurance options and develop a customized plan to connect you with coverage that meets the needs of you and your budget.
  • How will I find out if I am automatically re-enrolled or not?
    The notice you get from your insurance company will tell you if:

    * You’ll be automatically enrolled in your 2016 plan or a plan similar to it
    * You won’t be automatically enrolled and need to enroll in a plan in order to have health coverage in 2016

    Tip: Be sure to keep your Marketplace and insurance company notices in a safe place. If you want to renew your current plan or a similar plan offered by your insurance company, you’ll need the plan identification number that appears on your insurance company notice.
  • How do I find out about changes in my health insurance plan if I'm automatically re-enrolled?
    There are frequently changes in health insurance plans, and the counselors from are you covered? can help you figure them out.

    If you’ll be automatically enrolled in the same health plan or in a similar plan, your insurance company notice will tell you:

    * The plan you’ll be enrolled in
    * Your 2016 monthly premium and estimated savings
    * Any changes to your plan for 2016
    * Your other coverage options, deadlines, and important information about your coverage
  • How can I find out about whether I can keep my free or discounted coverage?
    If you’ll be automatically enrolled in the same or a similar plan, you will receive a Health Insurance Marketplace notice which will tell you which one of the following applies to you:

    * You’ll get the same premium tax credit and other savings you had in 2016
    * You’ll lose your premium tax credit and other savings unless you update your Marketplace application and the new information shows that you qualify for savings
  • Can I choose a different health insurance plan, even if I'm automatically re-enrolled?
    Yes, no matter what, you can choose a different plan.

    Even if your insurance company notice says you’ll be enrolled automatically in the same or similar plan, you can switch to a different plan for 2016 during Open Enrollment.

    Our counselors or navigators offer free assistance to help you through the process on a step-by-step basis.

    If you want to change plans, you must do this by December 15, 2015 for your new coverage to start January 1, 2016 or by the end of open enrollment, January 31, 2016.
  • How can I learn more if I am not eligible for automatic re-enrollment?
    If you won’t be automatically enrolled in your 2016 plan, your notice will explain:

    * Your coverage options
    * Enrollment deadlines
    * Next steps to take

    Please remember that the counselors and navigators from are you covered? can walk through this process with you, one step at a time.
  • What are my choices if I want to choose a different plan from my 2016 plan?
    You will have several options:

    * You can choose any other Health Insurance Marketplace health plan your 2016 company offers in your service area if you want to stay with your current insurance company.
    * You can choose a new health plan from a different insurance company through the Health Insurance Marketplace.
    * You can buy a new private health plan outside of the Marketplace. If you do this, you won’t be eligible for premium tax credits and cost-sharing reductions offered through the Marketplace.
  • If my insurance company decides not to offer the same health insurance plan I have this year, what are my options?
    In some cases, your current Health Insurance Marketplace plan won’t be offered in 2016. If that’s the case, we’ll automatically enroll you in a similar plan so you don’t have a gap in health coverage, unless you choose another plan and enroll. Because your plan is ending, you’ll qualify for a special enrollment period that lets you enroll (more information is available on the i’m not covered page) in an individual plan outside the open enrollment period.
  • What information and documents do I need to enroll in a new plan or re-enroll in my current plan?
    We can help you gather key facts about automatic enrollment to help your shopping:

    * Did you have family changes – new children, marriage, divorce – that might affect your coverage and costs?
    * Did the cost of your current health plan increase for 2016?
    * Will your plan offer the same coverage for hospitals, doctors and prescriptions?
    * Will there be any changes in deductibles, co-pays or other out-of-pocket costs?
    * Are there any changes in the health plan that will affect your health plan subsidy and total costs?
    * Counselors and navigators will help you understand how these factors might affect your health plan costs, discounts and subsidies.
  • Will my health insurance cover my doctor?
    Counselors and navigators from are you covered? will work with you to make sure your plan will meet your needs. We understand how important it is to maintain relationships with your doctors. are you covered? can help you if you want to check which plans cover your current health care professionals -- before you decide which plan to buy.
  • Can I go to my regular pharmacy? Will my prescription be covered?
    Not all health plans offer prescription coverage the same way. Since some health plans partner with certain pharmacies to provide you with prescription coverage, we'll help you check to see if your pharmacy is covered in the health insurance plan's network. For some drugs that you take every day, you may need to fill prescriptions by mail.
  • Will I have to pay some the costs myself?
    Your share of your health care costs (in addition to your monthly insurance bill) is called out-of-pocket costs. There are three kinds of out-of-pocket costs:

    Deductible. You must pay this amount each policy period (which usually lasts one year) for covered services before your insurance kicks in. For example, if your deductible is $1,500, you will pay 100 percent of your health care expenses until you have spent $1,500. Preventive care (such as annual checkups) is free, and does not count toward your deductible.

    Co-pay, or co-payment. A co-pay is a set amount that you pay for health care services. For example, you might have a $25 co-pay for visits to your doctor, or $75 for emergency room visits.

    Coinsurance. Coinsurance is the portion of health care costs that you are responsible for once you’ve met your deductible (see above). It’s usually a percentage, such as 20 percent. So if a doctor’s visit cost $500 and your coinsurance is 20 percent, your share is $100.

    Out-of-pocket maximum. This is the maximum annual out-of-pocket cost to you, including deductibles, co-pays and coinsurance.
  • Can I get financial help?
    More than half of all uninsured Americans can get covered for under $100 a month. And four out of five people who have already signed up received help paying for their insurance.

    The amount of financial assistance works on a sliding scale based on an individual’s or family’s income. Some people will qualify for free or low-cost health insurance through Medicaid or the Children’s Health Insurance Program (CHIP).
The project described was supported by Funding Opportunity Number CA-NAV-15-001 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services.
The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.