As Final Enrollment Deadline Approaches, Assistance Becomes More Critical

We are entering the homestretch of the 2015 open enrollment period for the Health Insurance Marketplace under the Affordable Care Act, and it’s time for that final kick to get us over the finish line. Last year’s open enrollment in Texas saw a huge spike in enrollment in the final month, so there is still time for Texans to sign up for health insurance. To guarantee uninsured Texans have the information and support they need to get coverage, organizations across Texas are hosting events to help people apply and enroll. Research on the 2014 open enrollment period showed that 3 out of 4 people want in-person assistance. People who got in-person assistance were twice as likely to successfully enroll as people who tried to sign up on their own.

Marketplace Assistance

For enrollment in coverage through the Marketplace there are three types of helpers: Navigators, Certified Application Counselors (CACs), and health insurance agents/brokers.

  • Navigator organizations have been provided federal funding to train staff and volunteers to help individuals apply for Marketplace coverage, Medicaid, or the Children’s Health Insurance Program (CHIP) through Healthcare.gov. These organizations can also assist small businesses in navigating options available to them through the Marketplace.
  • CAC organizations also have staff and volunteers trained to help individuals apply for Marketplace coverage, Medicaid, or CHIP through Healthcare.gov. CAC organizations include Community Health Centers, local governments, hospitals/health districts, and community organizations.
  • Health insurance agents and brokers are licensed insurance professionals who can often help people and businesses enroll in the Marketplace or obtain insurance outside of the Marketplace.

To find local Navigator and CAC organizations go to LocalHelp.Healthcare.gov or toll-free 1-800-318-2596.

To find local licensed insurance agents and brokers visit the National Association of Health Underwriters website.  Always confirm an agent’s license, which can be done using the Texas Department of Insurance Agent Lookup tool.

Local Enrollment Events

Throughout the open enrollment period, Texas enrollment coalitions are hosting events at shopping malls, churches, community centers, local clinics, and public libraries. Texans can find out about enrollment events in their area on the following websites:

  • Get Covered America – Texas (statewide list)
  • Enroll ATX
  • Enroll El Paso
  • Enroll Gulf Coast
  • Enroll SA

Assistance with Medicaid, Medicare, and the Children Health Insurance Program (CHIP)

People over age 60, people with disabilities, or low-income Texans may be eligible for coverage in Medicaid, Medicare, or CHIP. Individuals can also apply for these programs directly with the administering state agency.

The Texas Health and Human Service Commission (HHSC) has built a statewide network of trained community-based organizations that can help people apply for benefits including Medicaid, CHIP, Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF). The Community Partner Program website includes a tool that can be used to find local Community Partner organizations. Application assistance is also available in HHSC offices. A list of local HHSC offices is available on YourTexasBenefits.com under “Find an Office.”

The Texas Department of Aging and Disability Services (DADS) contracts with28 local area agencies on aging (AAA) to help people 60 and older and their caregivers find the information they need to locate and access community services. Each local AAA hosts a Benefits Counseling program that provides certified Medicare Benefits Counselors to answer questions about Medicare health care coverage, issues, and public benefits. Most local AAAs include information about their Benefits Counseling programs on their websites; a list of local AAAs can be accessed on the DADS website.

Remember the final deadline for the 2015 Marketplace open enrollment is February 15, 2015. Application assistance can make the difference between an individual having affordable health coverage in 2015. So let’s make this year even better than the last; take action and spread the word!

Written by Melissa McChesney, Center for Public Policy Priorities.