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Veterans and the Health Insurance Marketplace

By Jen Tayabji

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In every state in the country, the Health Insurance Marketplace opened October 1, 2013. The health care law (Affordable Care Act, also called "Obamacare") expands health insurance coverage to millions of Americans.

For veterans and their families, it is important to know if the Health Insurance Marketplace is for you. As part of health reform, the individual responsibility requirement (the individual mandate) requires that individuals have health insurance starting in 2014 that meets certain minimum standards or face a potential penalty. There are exemptions to this requirement such as hardship.

If you have TRICARE, the VA Civilian Health and Medical Program (CHAMPVA), the Spina Bifida health care benefits program, or coverage through other veterans health care programs, you do not have to do anything! You have health insurance that meets the new requirements. You should have received a notice from the VA recently about your coverage and the health reform law. Also, if you have Medicare, Medicaid, or insurance provided by your employer, you also do not need to do anything.

However, if you or someone in your family does not have health insurance, is underinsured, pays for an individual plan or policy, is on COBRA, or is a dependent on someone else' plan, you most likely have new and more affordable options for health insurance coverage through the Health Insurance Marketplace.

You can now apply for, and enroll in, health insurance coverage through the Health Insurance Marketplace through March 31, 2014. Health coverage starts as early as January 1, 2014, if you apply by December 15, 2013. Depending on your family size and your household income, you may be eligible for financial assistance such as Advanced Premium Tax Credits or cost-sharing reductions.

Through the Marketplace:

  • There will be new, affordable insurance options available.
  • Financial help is available so you can find a plan that fits your budget.
  • Insurance companies cannot deny you coverage because of a pre-existing condition and they cannot charge you more because of your health or if you are a woman.
  • All insurance plans will have to cover doctor visits, hospitalizations, maternity care, emergency room care, and prescriptions.

If you are currently on Medicare, you will not use the Health Insurance Marketplace to purchase supplemental, advantage or Part D prescription plans. Medicare will still have annual Open Enrollment for these plans, which occurs from October 15 through December 7 each year.

For more information on the Health Insurance Marketplace, or to enroll, please visit www.healthcare.gov or call the National 24/7 Call Center at 1 (800) 813-2596. If you have questions about your eligibility or about applying, you can call the above number to find in-person help in your area.

For more information on VA health insurance programs, and to see if you are eligible, please visit www.va.gov or call 1 (877) 222-VETS.

For more information on Medicare, please visit www.mymedicare.gov or call 1 (800) MEDICARE.

Jen Tayabji is a Community Organizer with Champaign County Health Care Consumers. She is also on staff with VVAW. She lives in Urbana, IL.

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