The ACA Marketplace Open Enrollment period for 2025 begins on Nov. 1, 2024, and runs through Jan. 15, 2025. To ensure your coverage starts on Jan. 1, 2025, it’s crucial to apply and enroll by Dec. 15, 2024. Applications submitted after Dec. 15 but before Jan. 15 will have coverage starting on Feb. 1, 2025.
Samuel U. Rodgers Health Center (Sam Rodgers) provides high-quality, compassionate, and affordable health care and offers free application and enrollment assistance. Whether you need help applying for the ACA Marketplace or understanding your health insurance options, Sam Rodgers’ staff provides the support needed to make the process easier for you and your family.
Why the 2025 Enrollment Period Is Different
This year’s enrollment period is expected to see more activity due to the resumption of the Medicaid Annual Renewal process, which was paused for several years during the COVID-19 pandemic. Many adults and families have lost their Medicaid coverage because of procedural issues or income changes. This has created a larger group of people now eligible for the ACA Marketplace.
James Torres, program manager for health insurance services at Samuel U. Rodgers Health Center, emphasized the importance of the upcoming enrollment period: “A lot of people have lost Medicaid or employer insurance in the last year, and they should know that the open enrollment period for the Health Insurance Marketplace for 2025 starts on Nov. 1. This is their opportunity to see if they can obtain quality health coverage for themselves or their families.”
Expanding Access to More People
The ACA Marketplace covers a wide range of individuals, including those who don’t receive employer-sponsored health insurance. The ACA also serves a diverse group of individuals, and many health centers, like Sam Rodgers, provide assistance in multiple languages to help more people access the coverage they need.
Income eligibility for the Marketplace is generally broader than Medicaid, making it a valuable option for those who may no longer qualify for Medicaid but still need affordable health insurance.
What Marketplace Plans Offer
ACA Marketplace plans are comprehensive, covering essential health benefits such as:
- Doctor visits
- Hospitalization
- Emergency care
- Pregnancy care
- Prescription drugs
- Behavioral health services
- Rehabilitation services
- Laboratory services
- Free preventive care
Sam Rodgers’ Health Insurance Services staff can help you review your options, including finding a plan that fits your health care needs and budget. The staff will also make sure your doctors and hospitals are in-network before you choose a plan.
What You Need to Enroll
If you need help applying for ACA Marketplace insurance, Sam Rodgers provides free in-person or virtual application assistance to anyone living in its service areas. Its health insurance counselors will:
- Meet with you during the application process and again after enrollment.
- Help you report life changes like a new job, address, or income change.
- Find out if your preferred providers are in-network before you choose a plan.
- Explain every aspect of your health insurance coverage to ensure you understand your options.
To enroll, you will need information for everyone in your household, including their name, date of birth, Social Security numbers, and proof of eligible immigration status. Acceptable documents include a Certificate of Citizenship for naturalized citizens, a U.S. passport, or a Legal Permanent Resident Card for those applying for health coverage.
Employment documents are also required, such as a recent pay stub for anyone employed or a federal income tax return for anyone who is self-employed.
If you have a current Marketplace plan for 2024, bring your login information for healthcare.gov.
What Happens After You Enroll
After enrolling in a Marketplace plan, make sure to take important next steps. First, pay your first premium before Jan. 1, 2025, to ensure your coverage begins on time. Failing to make this payment can result in termination of your plan.
Also, remember to report any life changes—such as a new job, address, marriage, or birth of a child—to the Marketplace. Sam Rodgers’ staff can help you navigate these updates to ensure your coverage and financial assistance remain accurate.
Using Your New Health Plan
Once you’ve enrolled, you should:
- Find a Primary Care Provider (PCP): Establish a relationship with a doctor who can help manage your health.
- Schedule your annual physical: Preventive care is key to maintaining your health.
- Stay within your plan’s network: Using providers outside your network could result in higher costs.
Sam Rodgers’ Health Insurance Counselors will help you understand your plan’s details and ensure you’re confident in using your health insurance.
Tax Requirements for Financial Assistance
If you received financial assistance, such as an Advance Premium Tax Credit (APTC), you’re required to report it on your 2024 Federal Income Tax Return. The APTC lowers your premiums, but you must report it on your 2024 tax return to avoid issues with future financial assistance. Have questions about this? Contact Sam Rodgers at (816) 889.4797.
Contact Sam Rodgers for ACA Enrollment Assistance
Getting help is easy. Call 816.889.4797 or visit https://samrodgers.org/services/health-insurance-services. Also, it won’t hurt to reach out before Nov. 1 to make sure your paperwork is in order.
