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Navigators fill slots to help enroll in healthcare

The Fredericksburg ENROLL Virginia office has filled all of its slots between now and March 31–the last day of open enrollment to buy health insurance plans in the marketplace.

The office offers these tips for enrolling online or by phone:

1) Create an email account with a known password if one does not already exist and be prepared to receive emails from healthcare.gov at your computer or cell phone.

2) Go to www.healthcare.gov and apply online by creating an account using your email address as the user name and using a self-created password. Answer the three security questions and watch for an email from healthcare.gov to your email entitled “Your marketplace account has been created”; open up that email and then click on the link to complete the account creation and link of your email to healthcare.gov.

3) Then log in to your account using your user name and password and answer the four identity proofing questions.

4) Once your identity has been verified, start your application. Enter the name, SSN, DOB, address, and citizenship/immigration status for all household members (not just for those enrolling). All household members will normally include all persons listed on your federal income tax return. Separated but non-divorced spouses cannot file separately unless the insurance applicant is head of household with minor child(ren) in their care; otherwise, the applicant household will be denied the tax credits that would make their Marketplace insurance affordable.

5) When completing the income section of the application, use 2014 estimated gross income for all household members (child support and children’s social security is not counted because it is not taxable). If your income is between 100% and 400% of the federal poverty line for your household size, you should be entitled to tax credits in most cases to reduce your monthly premiums. If your income is between 100% and 250%, you should also be entitled to reduced out of pocket costs (deductibles, co-pays, and co-insurance) if and only if you choose a silver level plan. If your income is below 100% of the poverty line, you will fall in Virginia’s Medicaid expansion gap and not be entitled to tax credits that would make your premiums affordable; until Virginia expands Medicaid to cover all persons below 100% of poverty, your only option may be to use a local free clinic.

6) At the end of the application you will be asked whether you already have health insurance. If you have no health insurance or only self-insurance or COBRA insurance, you may be eligible for tax credits if you are otherwise income eligible. However, if employer insurance is available and if it meets minimum value (at least a bronze plan with 60% coverage) and costs the employee only no more than 9.5% of his gross income, then that employee and/or the employee’s family members will not be entitled to tax credits in the Marketplace.

7) Once the application is completed and submitted, you should receive an eligibility decision which you can open within 60 seconds. It will indicate any tax credits and any reduced out of pocket costs. It will also indicate whether you need to submit any further documentation to the federal processing center in London, KY within the next two months.

8) You can then continue to enrollment and plan selection for health and dental insurance by viewing all the available plans and picking one after comparing premiums, deductibles, out of pocket maximums, and the health providers in each insurance company’s provider network (important because all plans are HMOs!).

9) Once you choose a plan, you will need to call the insurance company at the number listed within two to three business days to make your first monthly premium payment (preferably by phone so you can get the payment receipt number and policy number).

10) If at any point in the process you need guidance, you can call the 24-7 federal call center at 800/318-2596 for help in answering a question or in dealing with a website glitch.

If you do not have access to a computer and/or if you have no email address, you may call the federal call center 24/7 to complete an application on the phone and to then pick a plan. You should have available with you all the information and documents that you would have otherwise gathered for an online application, including your driver’s license or photo ID, your social security cards for all household members, your immigration cards, your 2012 and 2013 federal income tax returns, your 2014 YTD paystubs and proof of any other household income as well as any information about employer provided or offered insurance.

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