Help Your Patients Enroll in Health Insurance

Health insurance shoppers can visit www.healthcare.gov or call 1-800-318-2596 to learn about health insurance plans available in their area and to see if they qualify for subsidies to purchase health coverage and reduce cost sharing. Medicaid enrollment is open throughout the year.

Background

Since opening in 2013, the ACA's health insurance marketplaces have helped millions of people shop for and enroll in health coverage. Many people have also been able to get financial assistance to help them afford the plans offered by the marketplaces. Physicians and their staffs can help get the word out about enrollment opportunities and educate their patients about community-based health insurance enrollment assistance. To help you help your patients make informed health insurance choices, as well as to answer questions that you might have, the American College of Physicians has put together a series of documents to address questions about the changes in healthcare coverage brought about by the marketplaces.

Open enrollment for 2019 starts on November 1, 2018 and ends on December 15, 2018 for states that utilize the federal marketplace. The deadline for states administering their own exchanges may vary slightly from the federal enrollment period; please refer to our state-specific resources to find the exact enrollment period for each state. After the open enrollment period, special enrollment opportunities are available under certain circumstances such as a change in family status (including marriage or birth of a child), residence or income. Health insurance shoppers can visit www.healthcare.gov or call 1-800-318-2596 to see if they qualify for a special enrollment period. Medicaid enrollment is open throughout the year. 

Resources

The following documents include general information on resources that are available to you and your patients, and answers to frequently asked questions about insurance enrollment. In addition, ACP has also assembled state-specific resources to tell you more about what is happening in your area and help you provide your patients with accurate contact information.

Affordable Care Act Issues Physicians Need to Know: This document provides practical information to physicians and their patients regarding provider network adequacy issues, the health insurance appeals process, information about cost sharing, and how physicians can help their patients acquire non-covered drugs.

ACP's State-by-state Guides to Helping Patients Enroll: Find information about how the insurance marketplace will operate in your state and a resource guide you can give to your patients to help them find the appropriate people to answer their questions about health insurance.

Questions and Answers about Health Insurance Marketplaces and the Affordable Care Act

• ACP's Frequently Asked Questions about Patient Enrollment in Health Insurance Marketplaces
• ACP's Questions & Answers About Physician Concerns on the ACA

ACP Health Insurance Enrollment Comment Center

Have questions or comments about ACA health insurance marketplaces and enrollment? Contact ACP staff at policy-regs@acponline.org to share your thoughts.

Other Resources

• From ACP: An Internist's Practical Guide to Understanding Health System Reform
• From Coverage to Care: From Coverage to Care is an initiative designed to help people understand how health insurance works and find the physician or health care professional that's right for them. Resources include videos and educational brochures and poster. Materials are available in English or Spanish.
• HHS Info about Marketplaces: For Professionals | For Patients (English) | For Patients (Spanish)
• Web MD: Health Insurance Checklist
• AARP Health Law Answers Tool, Health Care Reform Guide
• Kaiser Family Foundation
• Health Insurance Marketplace
• National Partnership for Women and Families
• Internal Revenue Service: Information on Reporting Income Changes for Premium Tax Credit
• Additional resources available at healthcare.gov