By now, most Americans are aware of the changes instituted by the Affordable Care Act and the impact this law has had on health insurance. Terms like “premium tax credit,” “federal subsidy,” “Health Insurance Marketplace,” and “individual mandate,” however, are still often unfamiliar to consumers now navigating a system reorganized under completely different criteria and governed by federal law. Understanding the new terminology is paramount in understanding much of what constitutes the Affordable Care Act and is a key part of being able to successfully choose, enroll and manage a health insurance policy.
That being said, perhaps one of the most confusing aspects of the Affordable Care Act is the Special Enrollment Period and why you must have a Qualifying Life Event in order to enroll in health coverage. Prior to the Affordable Care Act, consumers had the benefit of enrolling in individual health insurance or making changes to their existing policies at any time during the year. On the flip side, insurers had the right to practice medical underwriting and charge more for, or deny coverage to, consumers who had serious or preexisting health conditions. Under the new law, these conditions have changed. Insurers may no longer ask consumers any health questions (with the exception of whether or not you are a smoker) and no consumer can be denied health insurance based on a preexisting condition; however, consumers may not enroll or make changes to their health policies whenever they choose, but are now subject to the rules of Open Enrollment, Special Enrollment and Qualifying Life Events (QLE’s).
For 2015, Open Enrollment will begin November 1st and end January 31st. During Open Enrollment, you may purchase health insurance or make changes to your current policy for any reason. Currently, however, we are in the Special Enrollment period, which means consumers are required by law to have a Qualifying Life Event in order to purchase insurance. A Qualifying Life Event is some special circumstance, such as a recent move or the loss of access to minimum essential coverage, that allows the consumer to purchase insurance outside of Open Enrollment. Although this does limit your ability to enroll in health coverage, the good news for 2015 is that the list of Qualifying Life Events has been expanded and the Healthcare Marketplace is offering more opportunities for consumers to get insured during Special Enrollment.
In order to determine whether or not you may have a Qualifying Life Event, it is important for you to take a look at the list provided on your Blue Cross Blue Shield of North Carolina health quote. Reading the list of QLE’s will help you to determine if one of these special circumstances applies to you. Although the process of obtaining health insurance has changed under the ACA, the expansion of these QLE’s allows you greater freedom outside of Open Enrollment to manage your current health plan or enroll a new health plan according to your life circumstances.
For more information on Blue Cross Blue Shield of North Carolina health insurance coverage, the Marketplace and healthcare gov to apply for your subsidy, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our experienced and professional agents. Let us help you navigate through the Health Care Reform changes in accordance with the new regulations of The Affordable Care Act, also known as Obama care.