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Marketplace Education & Enrollment

Our fight for the health of every person in every Williamson County community begins with helping individuals and families connect to the many healthcare options available across Central Texas.  

Through a federal grant awarded to a regional consortium, United Way of Williamson County has Healthcare Marketplace Navigators available on staff to educate and assist central Texans with the enrollment process.

Navigators are federally certified to provide unbiased information and assistance for individuals, families, and small businesses with the following:

  • Inform the public about their health coverage options
     
  • Help families and individuals find health coverage that fits their health needs and budget
     
  • Educate individuals about health coverage
     
  • Connect low-income individuals and children to Texas Benefits including CHIP, Medicaid, SNAP, and TANF. 

How to Get Help

Open enrollment runs from November 1 through December 15, 2017. 

If you or someone you know has questions about the Health Insurance Marketplace or would like to schedule an appointment to meet with a Healthcare Marketplace Navigator, call (512) 255-6799 or email Healthcare@unitedway-wc.org.

Si Usted ó alguna persona cercana a Usted tiene preguntas acerca del Mercado de Seguros Médicos o necesitan una cita con un Navegador del Mercado de Seguros, llame al (512) 255-6799 ó envíenos un correo electrónico a Healthcare@unitedway-wc.org.

 

 

 

 

What to Bring to Your Appointment

Please bring the following items with you to your scheduled appointment. 

  • Social Security number and birthdate for everyone on your tax return.
     
  • Income information (pay stubs, Social Security or SSDI statement, self-employment ledger, etc.).
     
  • Your most recent tax return.
     
  • Details and costs of health insurance offered to you and/or your spouse by an employer.
     
  • List of medications (name and dosage) taken by family members who need insurance.
     
  • A list of primary care providers or physicians you might want in your new provider network. 
     
  • If applicable, immigration documents or Naturalization Certificates.
     
  • If applicable, bring your sign in information for Healthcare.gov including email address, user name, and password.

 

Marketplace Information & Resources 

Important things to know about the Health Insurance Marketplace

  • The Health Insurance Marketplace helps uninsured individuals, families, and small business owners find health coverage. 

  • United Way of Williamson County will provide Health Insurance Marketplace Navigators to educate, answer questions and help you enroll in the Marketplace. Navigators cannot provide recommendations on care choices for individuals. Instead, they can help you make informed decisions about coverage that best suits your needs and your budget. Funding for our navigators comes from a federal grant, not donor gifts.  
     
  • United Way of Williamson County is not able to fund individuals or provide financial assistance for insurance premiums. 
     
  • When you complete the enrollment application, navigators can tell you if you qualify for a plan through the Marketplace, Medicaid or Children's Health Insurance Plan (CHIP). If you qualify for a marketplace plan, they may be able to tell you if you qualify for lower costs based on household size and income. 
     
  • Most people must have health coverage in 2018 or pay a fee.
  • You are considered covered if you have a marketplace plan, Medicare, Medicaid, CHIP, an employer-provided plan, a qualified plan you purchased yourself, COBRA, or retiree coverage. 
     
  • If you currently have an employer-provided plan, you can consider switching to a Marketplace plan. However, you won't qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn't meet minimum requirements. You may also lose any contribution your employer makes to your premium.
     
  • If you do not enroll during the open enrollment period, you may be able to qualify in two other ways. If you qualify, you may enroll for coverage through Medicaid or CHIP. You may also qualify for a Special Enrollment Period if you have qualifying life events, such as getting married, having a baby or losing health coverage. Call one of our Healthcare Marketplace Navigators at (512) 255-6799 for details. 

Resources

United Way of Williamson County has bilingual, certified Marketplace Navigators available to help customers work through the enrollment process. Call (512) 255-6799 to schedule an appointment with a Marketplace Navigator. 

Visit Insure Central Texas or call 2-1-1 for more information about getting help in Central Texas

How the Affordable Care Act Affects You and Texas Health Options from the Texas Department of Insurance are resources designed to help Texans enroll in health plans, and answers questions about insurance rights for individuals and small businesses.

The Texas Department of Insurance Resources for ACA provides basic resources for people and employers including information about the federal Patient Protection and Affordable Care Act (PPACA).

The U.S. Department of Health and Human Services provides information about how the Affordable Care Act affects you. For specific information about the Marketplace and enrollment, visit Healthcare.gov or U.S. Department of Health and Human Services

FAQs

Who is eligible for enrollment under the ACA? To be eligible for health coverage through the Marketplace, you:

  • must live in the United States
  • must be a U.S. Citizen or national (or be lawfully present)
  • can't currently be incarcerated

How long does the enrollment process take?
There are four steps in the enrollment process and the time it takes to complete the process may vary. However, we recommend that you plan at least 2 hours to complete the process. The first step is to set up an account. The second step is to complete the applications. The third step is to compare plans for which you qualify. The final step is to enroll. You MUST pay the first months premium for coverage to start. 

What if I already have insurance through my employer?
If you have job-based health insurance you like, you can keep it. You're considered covered. However, you may be able to change to Marketplace insurance if you want to. If you would like to explore Marketplace coverage options you can, but if your job-based coverage is considered affordable (less than 9.56% of annual household income) and meets the minimum requirements you won't be able to secure lower costs on premiums or Premium Tax Credits in the Marketplace. 

Can I get insurance as part of my parent's plan?
Young adults may be able to stay on their parents' plan until they're 26, get covered through their school's or employer's health insurance plan, or enroll in Medicaid or a Marketplace plan. Having coverage will protect you from large healthcare costs such as an accident, having a baby or unexpected illness. 

What happens if I don't get health insurance coverage?
Consumers who don't enroll in coverage may have to pay a fee when they file taxes for 2017. If you didn't have coverage in 2017, you will have to pay the higher amount of the two penalties; either $695 per adult, $347.50 per child under 18, or 2.5% of your income, whichever is higher. People with very low incomes may be eligible for hardship exemptions. Each person in a household, if uninsured, will be assessed a penalty. This will be enforced by the IRS. 

What if I had health insurance coverage for part of the year?
The penalty fee will be pro-rated for the months you were without coverage.