United Way of Central Texas is working to provide and connect Central Texans to health insurance.
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The Affordable Care Act (ACA) offers Texans an opportunity to enroll in a health insurance plan through www.healthcare.gov.
Open enrollment for 2018 runs from November 1, 2017 through December 15, 2017.
You may want to consider enrolling in a health plan if:
- You want to be protected from unexpected, high medical costs
- You want to access free preventative care such as screenings, check-ups and vaccines
- You have a pre-existing condition
- You have aged out of qualifying for your parent's policy
- You feel you pay too much for your current premium
- You don't have insurance
If you have questions or need help, United Way of Central Texas has Health Insurance Marketplace Navigators available to answer your questions, navigate through the website and help you consider insurance that is best for you and your family.
To schedule an appointment with a Health Insurance Marketplace Navigator, call (254) 778-8616 or email firstname.lastname@example.org for more information.
Please call 254-778-8616 to schedule an appointment at any of our office locations.
United Way of Central Texas
604 N 3rd St
Temple, TX 76501
United Way of Greater Ft Hood
208 W Ave A
Killeen, TX 76541
McLennan County Central Library
1717 Austin Ave
Waco, TX 76707
Heart of Texas Goodwill Industries
1700 S New Road
Waco, TX 76711
West Waco Library
5301 Bosque Blvd
Waco, TX 76710
*Our Navigators are happy to travel to meet with clients living in the following counties: Bell, Bosque, Coryell, Falls, Freestone, Hamilton, Hill, Lampasas, Limestone, McLennan, Milam, Mills, and San Saba.
Please call 254-778-8616 to schedule an appointment.
*Clients living in Williamson County may call to schedule with a Navigator at the United Way of Williamson County located in Round Rock. 512-255-6799
Please bring the following items with you to your scheduled appointment or when you visit one of our off-site locations.
- Social Security number and birthdate for everyone on your tax return
- Income information (pay stubs, Social Security or SSDI statement, self-employment ledger, etc.)
- Your most recent tax return
- Details and costs of health insurance offered to you and/or your spouse by an employer (even if it's too expensive and you don't buy it)
- List of medications (name and dosage) taken by family members who need insurance
- If applicable, immigration documents or Naturalization Certificates
- If applicable, access to email account, username and password for Healthcare.gov
Our goal is to help create a community where individuals are living healthier lives by increasing the number of individuals with health coverage.
• Inform the public about their health coverage options
• Help families and individuals find health coverage that fits their health needs and budget
• Educate individuals about their health coverage plan
Through a federal grant awarded to a regional consortium, United Way of Central Texas has Health Insurance Marketplace Navigators available on staff to educate and assist central Texans with the enrollment process.
Our Navigators are state and federally certified to provide unbiased information and assistance for individuals, families, and small businesses. They are local resources for enrollment into qualified health plans in the Marketplace, and public programs including Medicaid and the Children's Health Insurance Program (CHIP). Navigators help those who qualify for lower costs gain access through the Advanced Premium Tax Credit and Cost Share Reduction programs. In addition, navigators have a broad knowledge of local programs and can provide referrals to those unable to qualify for Marketplace programs.
- The Health Insurance Marketplace helps uninsured individuals, families, and small business owners find health coverage.
- United Way of Central Texas will provide Health Insurance Marketplace Navigators to educate, answer questions, and help individuals enroll in the Marketplace. Navigators cannot provide recommendations on care choices for individuals, but are available to help clients make informed decisions that best suit their needs. Funding for our navigators comes from a federal grant, not donor gifts.
- When you complete the enrollment application, navigators can tell you if you qualify for a plan through the Marketplace, a private insurance plan, or Medicaid or Children's Health Insurance Plan (CHIP). If you qualify for a private insurance plan, they may be able to tell you if you qualify for lower costs based on household size and income, and if you can still use the Marketplace to buy insurance at the going rate.
- Most people must have health coverage in 2017 or pay a fee. If you didn't have coverage in 2016, you will have to pay the higher amount of the two penalties; either $695 per adult, $347.50 per child under 18, or 2.5% of your income whichever amount is higher. For more information on these fees, click here.
- You are considered covered if you have Medicare, Medicaid, CHIP, an employer provided plan, any plan you purchased yourself, COBRA, retiree coverage, or some other type of health coverage.
- If you currently have an employer-provided plan, you can consider switching to a Marketplace plan. However, you won't qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn't meet minimum requirements. You may also lose any contribution your employer makes to your premium.
- Open enrollment for 2018 runs from November 1, 2017 through December 15, 2017. If you do not enroll during the open enrollment period, you may be able to qualify in two other ways. If you qualify, you may enroll for coverage through Medicaid and CHIP. You may also qualify for a Special Enrollment Period if you have qualifying life events, such as getting married, having a baby or losing health coverage. Learn more here.
- The Affordable Care Act and Texas from the U.S. Department of Health and Human Services provides information about how the Affordable Care Act affects Texans. For specific information about the Marketplace and enrollment, visit Healthcare.gov or US Department of Health and Human Services.
- Texas Health Options is a service of the Texas Department of Insurance designed to help Texans enroll in health plans and answers questions about insurance rights for individuals and small businesses.
- The Texas Department of Insurance Resources for ACA provides basic resources for people and employers including information about the federal Patient Protection and Affordable Care Act (PPACA).
Who is eligible for enrollment under the ACA?
To be eligible for health coverage through the Marketplace, you:
- must live in the United States
- must be a U.S. Citizen or national (or be lawfully present)
- can't currently be incarcerated
How long does the enrollment process take?
There are four steps in the enrollment process and the time it may take to complete the process may vary. However, it is recommended that you plan 90 minutes to complete the process. The first step is to set up an account. The second step is to complete the applications. Third step is to compare plans you qualify for and the final step is to enroll.
What if I already have insurance through my employer?
If you have job-based health insurance you like, you can keep it. You're considered covered. However, you may be able to change to Marketplace insurance if you want to. If you would like to explore Marketplace coverage options you can, but if your job-based coverage is considered affordable (less than 9.5% of annual household income) and meets the minimum value, you won't be able to secure lower costs on premiums or out-of-pocket costs in the Marketplace.
Can I get insurance through my parent's plan?
Young adults may be able to stay on their parents' plan until they're 26, get covered through their school's or employer's health plan, or enroll in Medicaid or a Marketplace plan. Having coverage will protect you from large healthcare costs such as an accident, having a baby, or unexpected illness.
What happens if I don't get health insurance coverage?
Consumers who don't enroll in coverage may have to pay a fee when they file taxes for 2016. If you didn't have coverage in 2016, you will have to pay the higher amount of the two penalties; either $695 per adult, $347.50 per child under 18, or 2.5% of your income; whichever is higher. People with very low incomes may be eligible for hardship exemptions. Each person in a household, if uninsured, will be assessed the penalty. This will be enforced by the IRS.
The project described was supported by Funding Opportunity Number CA-NAV-15-001 from the Centers of Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.