ACA (Affordable Care Act) - Health Insurance

Official US government web site for health insurance information

This is where to send library users who are looking for health insurance information. The open enrollment period begins November 1, 2024 and ends January 15, 2025.

Know important dates:

Open enrollment is November 1, 2024 through January 15, 2025
Policies purchased between November 1, 2024 and December 15, 2024 will become effective January 1, 2025.

You can generally buy Marketplace health insurance only during the annual Open Enrollment period. Additional items to consider:

• Provide a glossary of terms that people may not understand like: premiums, deductibles, out-of-pocket maximums, copayments, and coinsurance.
   
• Review Computer Use policies to help more people access computers when needs exceed the number of computers available.
   
• Encourage knowledge of household income. To find out if they are eligible people will need income information, like on a W-2, current pay stubs, tax return.
   
• Provide monthly budget examples. There will be different types of health plans to meet a variety of needs and budgets.
   
• Encourage people to know their health insurance choices at work. If not, they may need to get insurance through the Marketplace or from other sources. If they have no coverage, they may need to pay a fee.
   
• Connect people to websites to explore current options.
   
• Learn more about health insurance for adults up to age 26, and programs for people and children in families with limited incomes including Medicaid and the Children’s Health Insurance Program (CHIP). Medicare covers people who are 65 and older or who have certain disabilities.

 Important Dates for 2024/25:

• Open enrollment will be November 1, 2024 through January 15, 2025.
• Insurance coverage will begin January 1, 2025.

Unless you or your library have been approved in one of the categories below, you should limit the assistance you give library users to assistance similar to that for tax preparation. 

All types of enrollment assisters – including in-person assistors, Certified Application Counselors, and agents and brokers – are required to complete specific training and are subject to federal criminal penalties for violations of privacy or fraud statutes, on top of any relevant state law penalties.

Navigators have a vital role in helping consumers prepare electronic and paper applications to establish eligibility and enroll in coverage through the Marketplaces and potentially qualify for an insurance affordability program. They also provide outreach and education to raise awareness about the Marketplace, and refer consumers to health insurance ombudsman and consumer assistance programs when necessary. Navigators play a role in all types of Marketplaces, are funded through state and federal grant programs, and must complete comprehensive training.

The Federally-facilitated Marketplace will designate organizations to certify application counselors who perform many of the same functions as Navigators and non-Navigator assistance personnel—including educating consumers and helping them complete an application for coverage.

CMS expects agents and brokers to play a key role in the new Marketplaces. To the extent permitted by states, agents and brokers will play an important role in educating consumers about Marketplaces and insurance affordability programs, and in helping consumers receive eligibility determinations, apply for premium tax credits and cost-sharing reductions, compare plans, and enroll in coverage. In particular, CMS anticipates that agents and brokers will play a critical role in helping qualified employers and employees enroll in coverage through the Small Business Health Options Programs (SHOPs). We anticipate that many consumers will want to obtain professional advice from agents and brokers when applying for and selecting a qualified health plan.