Open enrollment for affordable health insurance under the Affordable Care Act is currently closed. However, you may qualify for a special enrollment period if you have experienced certain life events. Read below for more information.
Having health insurance means you can see a range of health care providers when you need to. It also means you can get preventative care (including birth control options) for free, without a copay. Most people who don’t have insurance will have to pay a fine, but millions of Americans can get help paying for their insurance plan.
No matter what, Planned Parenthood will still provide expert, quality care – if you have insurance or not. You can still come to us for the care you need, when you need it – with or without insurance.
Want to know which plans are available for you?
You might be eligible for NJ FamilyCare (Medicaid) if you meet certain income requirements. You can enroll in NJ FamilyCare at any time during the year, not just during the open enrollment period. For information about enrollment in NJ FamilyCare, visit www.njfamilycare.org or call 609-989-4320.
If you are not eligible for NJ FamilyCare, you can learn more about affordable health insurance through the Health Insurance Marketplace, which is a resource where people can browse for and compare health insurance plans, apply for coverage, and get answers to questions about insurance. You can access the Marketplace online at www.healthcare.gov or by calling 1-800-318-2596.
Each insurance plan has a “network” or list of health care providers where you can go with your insurance card. If you have a provider you want to see, make sure they’re on this list. If you want to come to Planned Parenthood, or have Planned Parenthood as an option for care, look for a plan that includes us. For a list of plans that include Planned Parenthood, visit www.PlannedParenthoodHealthInsuranceFacts.org.
Wondering when you can apply?
If you are eligible for NJ FamilyCare, you can apply at any time during the year. For information about enrollment in NJ FamilyCare, visit www.njfamilycare.org or call 609-989-4320.
For plans through the Health Insurance Marketplace, the next open enrollment period will be at the end of the year. However, if you have experienced certain life events, you may be eligible to enroll sooner. Some examples of life events that may qualify you for a special enrollment period are:
- Getting married
- Having a baby, adopting a child, or placing a child for adoption
- Having a change in income or household status that affects eligibility for premium tax credits or cost-sharing reductions (if already enrolled in coverage)
- Permanently moving to a new area that offers different health plan options
- Gaining citizenship
- Leaving incarceration
- Losing other health coverage (including job loss, divorce, loss of eligibility for Medicaid, expiration of COBRA coverage, aging of a parent's plan, or a health plan being decertified). Note: loss of coverage does not include voluntarily quitting other health coverage or being terminated for not paying your premiums.
- A serious medical condition, an unexpected hospitalization, or temporary cognitive disability that kept you from enrolling during the open enrollment period
If you are rejected for Medicaid, the denial may qualify you for a special enrollment period.
Questions about costs?
Most uninsured Americans will get financial help to help buy an insurance plan. This is part of the law. The amount of financial help depends of a range of factors, including your annual income and family size.
You may qualify for lower premiums on a Marketplace insurance plan if you meet certain income requirements.
If you don’t get insured, you will probably have to pay a fine of $325 (per person without insurance per household) or 2% of your income, whichever is more.
Visit www.PlannedParenthoodHealthInsuranceFacts.org for a handy calculator to find out how much financial help you can get and an estimate of how much you’ll pay for your insurance.
Ready to apply? Here’s what you’ll need.
- A government-issued identification, such as a driver’s license, passport, or non-driver ID card
- Social Security number and date of birth for everyone in your household applying for coverage
- Employer and income information for every member of your household (from documents like last year’s tax returns, paystubs, or W-2 forms, and the name and address of any employers)
- A best estimate of your annual household income
- Tax filing status (Do you file taxes? If so, do you file them alone or with a spouse? How many dependents do you claim?)
- Policy numbers for other health insurance you or other family members may have
- If applicable, immigration number for any immigrant household members (e.g. green card number, employment authorization number)
Need help signing up?
You can get free help from an enrollment specialist. Visit www.PlannedParenthoodHealthInsuranceFacts.org or localhelp.healthcare.gov for a list of organizations helping with enrollment in our area. Planned Parenthood’s website also explains what insurance terms like “premiums,” “deductibles,” and “copay” mean and can help answer questions about what you should look for in an insurance plan if you are a woman.
You can also get free help online or by phone. Call 1-800-318-2536 or visit www.healthcare.gov for assistance.