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AARP Answers: ACA Insurance and the Coronavirus

The latest on special open enrollment periods, life-changing events and more

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I need health insurance now. Can I sign up for a plan under the Affordable Care Act (ACA)?

Yes. Under a new executive order, the Department of Health and Human Services (HHS) has opened up HealthCare.gov from Feb. 15 through May 15 so that people who need health coverage during the pandemic can sign up. In a recent report, the Kaiser Family Foundation estimates that about 15 million Americans may need to shop for coverage on the ACA marketplaces.

AARP had sent a letter to Congress last spring asking for a nationwide special open enrollment period: “Access to affordable health care coverage is more important now than ever,” said Nancy LeaMond, AARP’s executive vice president and chief advocacy and engagement officer.

It’s also important to note that those who have lost their jobs and their incomes may qualify for Medicaid — a free or low-cost health program that enrolls applicants year-round.

What if I live in a state that has its own health insurance marketplace?

You can still probably enroll in an ACA plan. After HHS announced the new special enrollment period for the federal marketplace, the states with their own ACA exchanges did the same thing. Check with your state marketplace to find out the time period for your special enrollment period.

Will my ACA plan cover coronavirus care?

The symptoms of COVID-19, the illness caused by the new coronavirus, include:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

The majority of people who get sick with COVID-19 have mild symptoms and are able to recover at home. Some cases, however, are more severe and may require medical attention.

In those instances, all ACA plans are required to cover emergency services and hospitalization. Policyholders, however, may have out-of-pocket costs from coronavirus-related care, depending on their individual plans and any copayment and cost-sharing responsibilities.

I have already tested positive for the coronavirus. Can a health plan deny me coverage?

No. All ACA plans must cover treatment for preexisting medical conditions. And plans can't terminate coverage due to a change in health status, “including diagnosis or treatment of COVID-19,” according to HealthCare.gov.

What will an ACA plan cost me?

There are four types of plans in the ACA marketplace, and your monthly premium and out-of-pocket costs depend on your plan:

  • Bronze: Lowest monthly premium; highest out-of-pocket costs. Deductibles can be thousands of dollars a year.
  • Silver: Moderate monthly premiums; moderate out-of-pocket costs.
  • Gold: High monthly premiums; lower out-of-pocket costs; low deductibles.
  • Platinum: Highest monthly premiums; lowest out-of-pocket costs; lowest deductibles.

Depending on your household income, you may also be eligible for a subsidy to lower your monthly premium, as well as assistance to help cover out-of-pocket costs.

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