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What This Year’s Health Insurance Open Enrollment Season Means for You

Sign-up periods for Medicare, employer-plans and the new insurance marketplace are happening at the same time. Which, if any, requires your attention?

What can I do at the marketplace?

You shop for and fill out an application to buy a health insurance plan. The marketplace is run by either your state or the federal government, depending where you live. You can find out who runs the marketplace in your state online at Healthcare.gov or by calling 800-318-2596. You'll be able to compare prices, benefits and premiums of various insurance plans that meet the law's requirements and find out if you qualify for financial help.

What if I need help to apply?

Telephone (800-318-2596) and online-chat help is available 24/7 to assist you in completing your application.

Is online the only way I can apply for coverage?

No. You can also enroll by mail or in person at the marketplace in your state or through an insurance broker. For details call 800-318-2596.

What if I think I might be eligible for Medicaid?

The marketplace will also tell you if you qualify for free or low-cost coverage through Medicaid and let your state's Medicaid agency know so your coverage can start as soon as possible.

Can I switch from my private individual plan to one offered through the marketplace?

If your private individual plan ends before March 31, 2014, you can use the marketplace during open enrollment to replace it, with coverage beginning as early as Jan. 1, 2014. And if your current individual plan doesn't meet the law's minimum standards, you might be required to shop in the marketplace. Either way, be sure to check what financial help might be available to you for premiums and other out-of-pocket costs. If your plan ends after March 31, you may qualify for a special enrollment period that lets you shop the marketplace for a new plan. Contact your current health insurance provider for details.

When is open enrollment for employer-sponsored plans?

There's no set window, but it often opens in mid- to late fall.

Do existing employer-sponsored and individual plans have to provide the same benefits offered in plans available through the marketplace?

Yes and no. The health care law requires so-called grandfathered plans — plans that existed on March 23, 2010, and have stayed basically the same — to include some of its key provisions, such as no limits on lifetime coverage. But grandfathered plans aren't required to have all of the consumer rights and protections that new plans must offer, such as free preventive screenings and the right to appeal the denial of a medical claim.

How do I find out if my plan is grandfathered?

Although health plans must disclose whether they're grandfathered, plan materials can be hard to decipher. Your best bet is to consult your insurance company or your health plan benefits administrator at work.

Next page: Should you stick with a health plan offered by your employer? »

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HEALTH INSURANCE EXCHANGES: How does the marketplace work and how much does it cost?

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