Understanding the Healthcare Marketplace When You're On Dialysis

The Affordable Care Act has allowed for additional health insurance options for those that were previously uninsured and unable to obtain coverage due to pre-existing conditions. Each year during open enrollment, there is an opportunity to apply for coverage through the Marketplace and obtain qualifying health insurance for your medical needs. You may also apply for coverage outside of open enrollment if you experience a qualifying life event.

What is the Healthcare Marketplace?

The Marketplace is a website designed to help individuals, families, and small businesses compare and purchase health insurance. You may visit Healthcare.gov to research plans available in your state or be directed to your state’s website. All plans sold through the Marketplace are individual commercial policies.

When is the Marketplace Open Enrollment?

For Open Enrollment to begin in 2016, you may enroll between November 1, 2015 and January 31, 2016. First date of coverage can begin January 1, 2016. If you miss signing up for a plan by January 31, 2016, you can't enroll unless you are eligible for the Special Enrollment Period, according to HealthCare.gov.

How do I know if I qualify or need coverage through the Marketplace?

To be eligible for coverage through the Marketplace, you must live in the United States and be a lawful resident. In most states, if you are enrolled in Medicare part A and/or part B, you will not qualify to enroll in a plan through the Marketplace.

You may need coverage if:

  1. You are currently uninsured.
  2. Your employer is no longer offering coverage (including if you were previously covered under a retiree policy).
  3. Your current individual plan is no longer being offered in your state/county.

How can an Insurance Management Team member help?

As a DaVita patient, your insurance counselor is a dedicated resource for all insurance questions, concerns and issues. They may help you to understand your plan options, provide cost comparisons for you to be able to make an informed decision regarding your health insurance options, and assist you with enrolling in a plan of your choice.

If you have questions or feel that you may need new coverage through the Marketplace, please contact your insurance counselor today.