The recent change to guarantee that the Florida Healthy Kids full-pay insurance complies with Minimum Essential Coverage under the Affordable Care Act has created a Special Enrollment Period. Families can enroll in health insurance through the HealthCare.gov marketplace so that children will maintain continuous coverage that can start on Oct. 1 when the Florida Healthy Kids rate changes take effect.
The ACA guarantees that consumers aren’t denied insurance because of a preexisting health condition. It ensures that consumers receive a comprehensive set of benefits, including free preventive care when they buy a health insurance policy.
It includes consumer protections like no annual or lifetime dollar amount of coverage, in addition to all 10 essential health benefits: ambulatory services; prescription drugs; emergency services; rehabilitative and habilitative services and devices; hospitalization; lab services; maternity and newborn care; preventive and wellness services and chronic disease management; mental health and substance use disorder services; and pediatric services, which must include dental and vision care for individuals up to the age of 19.
Families affected by the Healthy Kids full-pay changes can enroll in a high quality insurance plan through the federally-facilitated Health Insurance Marketplace online by completing an application at www.HealthCare.gov or by calling (800) 318-2596 (TTY: 1-855-889-4325).
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During the application process when asked if you are losing coverage, be sure to indicate that Sept. 30 is the last day of your Healthy Kids coverage. In order to avoid a gap in coverage you must enroll on or before Sept. 30.
Gaps in coverage of more than three months may cause taxpayers to be charged a prorated penalty when you file your tax return next year, so it pays to get covered when a change occurs. If someone discovers they don’t have any offer of health insurance coverage that’s affordable, they should still sign up on HealthCare.gov to apply for an exemption from paying the penalty for not having health insurance.
There are many types of qualifying events that trigger a SEP or people who need to obtain or change health insurance coverage. A change in employment, in income that affects your eligibility for tax credit premium subsidies, or in family status all qualify for a SEP.
Enrollment navigators across Florida are available at no charge to guide you through the processes. The navigators adhere to strict federal and state privacy standards and must offer impartial information that focuses on your best interests, not the interests of insurance companies. Find a navigator near you by calling (855) 352-4246 or online at www.CoveringFlorida.org.
Louisa McQueeney, navigator project manager, Florida CHAIN, St. Petersburg