2020 Open Enrollment is Here -and Ends Dec. 15

Find out how to get help with enrolling and what to do if you don't qualify for ACA tax credits or Medicaid. 

Frequently Asked Questions

When is open enrollment and where can I get help?

  • The Affordable Care Act Marketplace open enrollment period starts on November 1st until December 15th.
  • Schedule an appointment at www.coveringflorida.org or call Covering Florida for more info at 877-813-9115.
  • Covering Florida Navigators provide FREE enrollment assistance in all of Florida’s 67 counties and offer confidential one-on-one customer service, phone assistance, and virtual appointments to anyone looking to enroll for health care coverage.

How do Special Enrollment Periods work?

  • You qualify for a Special Enrollment Period if you've had certain life events, including losing health coverage, moving, getting married, having a baby, or adopting a child.
  • Florida residents impacted by Covid-19, including job or wage loss and related health insurance loss may qualify.
  • If you qualify for an SEP, you usually have up to 60 days following the event to enroll in a plan, so don't delay calling us to learn your options.
  • Call the Covering Florida navigators (877-813-9115) today for information on eligibility and to schedule an appointment for Special Enrollment.

What if I have a pre-existing condition?

  • All Marketplace plans must cover treatment for pre-existing medical conditions.
  • No insurance plan can reject you, charge you more, or refuse to pay for essential health benefits for any condition you had before your coverage started.
  • Once you’re enrolled, the plan can’t deny you coverage or raise your rates based only on your health.
  • Medicaid and the Children's Health Insurance Program (CHIP) also can't refuse to cover you or charge you more because of your pre-existing condition.
  • Under the law, insurers are prohibited from using a consumer’s health status to deny coverage (guaranteed issue), set individual and small group market rates (community rating), exclude coverage of pre-existing conditions, or cancel a policy.
    • Guaranteed issue: The requires insurers to offer health insurance products to everyone in the market, regardless of health status.
    • Community rating: The ACA’s rating rules prohibit insurers from charging higher premiums based on an insured’s health status and they can only vary rates based on geographic rating area, age (limited to a 3:1 differential), tobacco use (limited to a 1.5:1 differential), and whether or not it is individual or family coverage.
    • Ban on Pre-existing Condition Exclusions: Under the ACA, insurers are not allowed to limit or exclude coverage of services and treatment based on an enrollee’s pre-existing condition.

Why don't I qualify for tax credits on the ACA Marketplace?

  • In Florida, if your income is too low you will not qualify for tax credits in the ACA Marketplace.
  • When the health care law was passed, it required states to provide Medicaid coverage for all adults 18 to 65 with incomes up to 133% of the federal poverty level, regardless of their age, family status, or health.
  • The law also provides premium tax credits for people with incomes between 100% and 400% of the federal poverty level to buy private insurance plans in the Health Insurance Marketplace.
  • The U.S. Supreme Court later ruled that the Medicaid expansion is voluntary with states. As a result, some states, including Florida, haven’t expanded their Medicaid programs.
  • Adults in those states with incomes below 100% of the federal poverty level, and who don’t qualify for Medicaid based on disability, age, or other factors, fall into a gap.
    • Their incomes are too high to qualify for Medicaid in their states.
    • Their incomes are below the range the law set for savings on a Marketplace insurance plan.
  • Florida still has the opportunity to expand access to health care through Medicaid expansion. Click here to learn more and take action. Urge our lawmakers to pass expansion in 2021!

If you don't qualify for tax credits or Medicaid - watch to learn why and what Florida can do about it.


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