Dear Valued Customer,

This issue of the “—————-” is focused on getting healthcare coverage.

Most health plans give you the best deal on services when you see a doctor who has a contract with your health plan. While you may be able to see doctors who don’t contract with your plan, visiting an “in-network” provider usually means you’ll have lower out-of-pocket costs.

Read on to learn about finding a doctor in your plan, reporting life and income changes to the Marketplace, see health plans and prices, and more.

We appreciate your continued business and look forward to serving you.

Kind regards,

You can preview Marketplace health plans and prices available in your area by using a simple tool. It lets you see plans and estimates of the prices you pay without filling out an application.

The prices shown reflect any lower costs you may be eligible for based on your income and household size.

Important. Marketplace Open Enrollment ended March 31. You can still buy a Marketplace health plan only if you qualify for a special enrollment period. You can apply for Medicaid and CHIP any time. Learn about special enrollment periods and other coverage options after Open Enrollment. Open Enrollment for 2015 coverage starts November 15, 2014.

How to view health plans and prices

Select the link below and answer a few questions.

Find plans and sample prices.

You’ll see Marketplace health plans available in your area, with premium estimates based on your income and household size. You’ll also get important details like deductibles, copayments, and out-of-pocket maximums, plus links to a summary of benefits, the provider network, drug coverage rules, and customer service contacts.

The premiums shown apply to people who don’t use tobacco.

The tool also provides:

• Plans and estimated costs for small business coverage available through the Small Business Health Options Program (SHOP Marketplace).
• Dental plan information for both individuals and families and small businesses.

Source: HealthCare.gov, “See health plans and prices before you apply.” http://www.healthcare.gov website. Accessed December 2, 2015. https://www.healthcare.gov/how-much-will-marketplace-insurance-cost/

© Copyright 2016. All rights reserved. This content is strictly for informational purposes and although experts have prepared it, the reader should not substitute this information for professional insurance advice. If you have any questions, please consult your insurance professional before acting on any information presented. Read more.

Once you have Marketplace coverage, you must report certain life changes. This information may change the coverage or savings you’re eligible for.

Important: Do not report these changes by mail. See below for instructions on how to report changes.

Life changes to report

You must report a change if you:

• Get married or divorced
• Have a child, adopt a child, or place a child for adoption
• Have a change in income
• Get health coverage through a job or a program like Medicare or Medicaid
• Change your place of residence
• Have a change in disability status
• Gain or lose a dependent
• Become pregnant
• Experience other changes that may affect your income and household size
• Other changes to report: change in tax filing status; change of citizenship or immigration status; incarceration or release from incarceration; change in status as an American Indian/Alaska Native or tribal status; correction to name, date of birth, or Social Security number.

When and how to report changes

You should report these changes to the Marketplace as soon as possible.

If these changes qualify you for a special enrollment period to change plans, in most cases you have 60 days from the life event to enroll in new coverage. If the changes qualify you for more or less savings, it’s important to make adjustments as soon as possible.

Important: Do not report these changes by mail.

You can report these changes 2 ways:

• Online. Log in to your account. Select your application, then select “Report a life change” from the menu on the left.
• By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325)

Learn more from the IRS about how changes can affect the premium tax credit you may be eligible for.

After you report a change

After you report changes to the Marketplace, you’ll get a new eligibility notice that will explain:

• Whether you qualify for a special enrollment period that allows you to change plans
• Whether you’re eligible for lower costs based on your new income, household size, or other changed information. You may become eligible for the first time, for a different amount of savings, or for coverage through Medicaid or the Children’s Health Insurance Program (CHIP). You also could become ineligible for savings–if your income has gone up, for example.

If you’re eligible for a special enrollment period

You’ll be able to shop for a different plan in the Marketplace. You usually have up to 60 days from the date of the qualifying event to enroll in a new plan.

If you have a special enrollment period, you can change plans 2 ways:

• Online. Log in to your account and select your application. Then select “Eligibility and Appeals” from the menu on the left. Next, scroll down and click the green “Continue to enrollment” button. You can then shop for plans and change your selection.
• By phone. Contact the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325).

If you’re not eligible for a special enrollment period but the tax credit you qualify for has changed

You can’t change plans. But you can choose to adjust the amount of the tax credit to apply to your monthly premiums.

Changing your profile information

You report changes that don’t affect your coverage or savings differently.

• To change your home address, email address, or phone number, update the information on your Marketplace Profile page.
• Be sure to report address, email, and phone changes to your insurance company too. Otherwise they may not know about your new contact information.

Source: HealthCare.gov, “Reporting life & income changes to the Marketplace.” http://www.healthcare.gov website. Accessed December 2, 2015. https://www.healthcare.gov/how-do-i-report-life-changes-to-the-marketplace/

© Copyright 2016. All rights reserved. This content is strictly for informational purposes and although experts have prepared it, the reader should not substitute this information for professional insurance advice. If you have any questions, please consult your insurance professional before acting on any information presented. Read more.

Once you’re enrolled in a health plan and your coverage has started, you can use it to help cover medical costs for services like:

• Filling a prescription at the pharmacy
• Going to the doctor
• Getting emergency care

If you haven’t had private health insurance before or if it has been awhile, you may want to learn about using your coverage and improving your health using our Roadmap to Better Care and a Healthier You.

If your health insurance company doesn’t pay for a specific health care provider or service, you can appeal an insurance company decision.

Unsure about your coverage? Learn what to do if you’re not sure you’re enrolled, or haven’t received your insurance card.

Learn more if your new coverage is through your state’s Medicaid or CHIP program.

Source: HealthCare.gov, “Common coverage questions.” http://www.healthcare.gov website. Accessed December 2, 2015. https://www.healthcare.gov/using-your-new-marketplace-coverage/#part=1

© Copyright 2016. All rights reserved. This content is strictly for informational purposes and although experts have prepared it, the reader should not substitute this information for professional insurance advice. If you have any questions, please consult your insurance professional before acting on any information presented. Read more.