If you do not have health insurance through your job or are not covered by Medicare or another plan, the federal Health Insurance Marketplace can help you find coverage. Open enrollment for 2022 coverage begins Nov. 1 and ends on Jan. 15. Individuals must enroll by Dec. 15 for coverage that starts Jan. 1.
If you are receiving Medicare benefits, you do not qualify for assistance from the Health Insurance Marketplace. For Medicare enrollment answers, call the Yellowstone County Adult Resource Alliance Resource Center SHIP counselors at 406-259-5212. Medicare enrollment is open now through Dec. 7 for prescription drug coverage and Medicare Advantage plans.
There are many health insurance coverage websites, but the official site for the Marketplace is HealthCare.gov. This is the only website where you may be able to get premium tax credits. These credits reduce monthly premium costs. You have the option to enroll online, call the Marketplace directly or contact a Certified Application Counselor in your area for an appointment.
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At HealthCare.gov, you can get a clear picture of the cost, compare plans based on your health needs, and choose the combination of price and coverage that fits the needs of your family.
Through HealthCare.gov, you can also find out if you qualify for the Montana HELP Plan. In 2015, Montana expanded Medicaid to create the HELP plan for low-income Montanans who did not already qualify for Medicaid. This plan is open to people ages 19 through 64, depending on income and family size.
The Affordable Care Act, which makes the Marketplace possible, protects enrollees in several ways. It requires participating Marketplace insurance plans to cover people with pre-existing health conditions – including pregnancy – without charging more. It provides free preventive care, gives young adults more coverage options, ends lifetime and yearly dollar limits on coverage of essential health benefits. The law makes it illegal for health insurance companies to cancel your health insurance just because you get sick and protects your choice of doctors.
The Health Insurance Marketplace offers additional help for enrolled tribal members. Tribal members may apply anytime throughout the year – not just during designated open enrollment periods. Depending on income, members of federally recognized tribes may have no out-of-pocket costs other than, possibly, a monthly premium. Enrolled tribal members and descendants who are eligible for Montana Medicaid will not have premiums or copays.
Tribal members using Marketplace health insurance in coordination with Indian Health Service, tribal health or an Urban Indian Health Center may increase their health care options and save money. Tribal members with Montana Medicaid or private insurance should make sure the benefits coordinator is aware of that coverage status if care is needed from a specialist or someone outside of the local tribal health or IHS service unit.
Once open enrollment ends, you can only get coverage through the Marketplace if you qualify for a special enrollment period based on life changes, such as loss of health insurance coverage due to a job change, or a change in income, household size or marital status. If you are an enrolled tribal member, you may enroll at any time.
RiverStone Health Clinic has Certified Application Counselors available to assist you with enrollment. If you have questions or would like to schedule an in-person enrollment assistance appointment, please call 651-6540.