Your Health Insurance Coverage Options: How to Get Covered

November 12, 2014 / SAMHSA / Affordable Care Act, Behavioral Health, Community, Health Reform, Insurance, Office of Behavioral Health Equity, Outreach, Parity / No Comments

By: Juliet Bui, Public Health Analyst, Substance Abuse and Mental Health Services Administration, Office of Behavioral Health Equity

Get ready to apply for health insurance coverage! Enrollment for 2015 coverage opens on November 15, 2014, but you don’t have to wait until then to start getting the information you need to make the right choice. Here are some ways to get started:

Understand how health insurance works. Also, if you are an immigrant or refugee, there are some other things you need to know about eligibility.
See if you qualify for lower costs.
Preview plans and prices.
Gather the documents you need to apply.

Did you know that all Marketplace insurance plans cover mental health and substance abuse services as an essential health benefit? These services include behavioral health treatment, such as psychotherapy and counseling, mental and behavioral health inpatient service, and substance use treatment. Also, Marketplace plans can’t deny you coverage or charge you more just because you have a pre-existing condition, including mental and/or substance use disorders, and they can’t apply yearly or lifetime dollar limits on coverage of essential health benefits. Not only that, but coverage for behavioral health services must be generally comparable to coverage for medical and surgical care.

Choosing a plan, applying, and enrolling can be confusing. But there’s good news. In every state, there are people trained and certified to help you understand your health coverage options and enroll in a plan. These people are sometimes called “Navigators” or “Assisters.” VisitLocalHelp.HealthCare.gov to find help in your area.

Remember, if you can afford health insurance and don’t have coverage in 2014, you may have to pay a penalty. In 2014, the penalty is 1% of your yearly household income or $95 – whichever is greater. You may also have to pay for the entire cost of all your medical care.

If you have questions about the Health Insurance Marketplace, you can call 1-800-318-2596, 24 hours a day, 7 days a week. TTY users should call 1-855-889-4325. For more information about outreach and enrollment for diverse populations, visit the SAMHSA Office of Behavioral Health Equity resources page.

This blog is part of a series of webinars,infographics, and blog posts that aim to provide clear information about the Affordable Care Act (ACA).