November 1 marks the beginning of open enrollment on the Healthcare Insurance Marketplace.
Whether you’re new to the Marketplace or an old pro, please take action before time gets away from you during the holidays to ensure your child’s ABA therapy needs are covered by insurance for next year. We know it can be a hassle, but you’ll be glad you did!
Here are important things to keep in mind:
Don’t assume you’ll be re-enrolled automatically.
If you’re happy with your current Marketplace insurance plan and nothing has changed about your personal information or situation, you’ll “probably be automatically re-enrolled,” according to Healthcare.gov. Not very reassuring, is it? For your peace of mind, just login, follow the directions, and review your information. It doesn’t take long, and you can rest easy knowing your child’s ABA therapy will be covered for next year.
The deadline to enroll (and re-enroll) is December 15.
The Marketplace is a stickler about the deadline. If you want coverage that starts on January 1, you must enroll or re-enroll in a plan by December 15. If for some reason you miss the December 15 deadline, you have until January 15 to enroll for coverage that starts February 1. After that, you’ll have to buy health insurance on your own outside of the Marketplace or go without if you don’t qualify for a Special Enrollment Period.
Your first month’s premium is due when you enroll.
One of the advantages of shopping for health insurance on the Marketplace is you may qualify for savings on your monthly premium. Depending on your annual income, the savings can be significant. That’s another reason to login and review your information and your plan. You could be missing out on savings!
All plans on the Marketplace are required to cover behavioral health treatment.
Behavioral health treatment, like ABA therapy, is considered one of 10 essential health benefits that must be covered in all plans on the Marketplace. However, the extent of benefits can vary by state and the plan you choose. You can see a full list of what each plan covers, including behavioral health benefits, when you compare plans on the Marketplace website. In addition, all Marketplace health plans (and most other private insurance plans) must cover preventive services for children without charging a copayment or coinsurance. This includes autism screening for children at ages 18 and 24 months.
You can buy a child-only plan on the Marketplace.
There are a few circumstances why you might consider a child-only plan.
- Your employer-provided plan doesn’t cover ABA therapy.
- You share custody with an ex-spouse that lives in a different state.
- You’re on Medicare and the guardian of a grandchild, and they don’t qualify for Medicaid or CHIP, the Children’s Health Insurance Program.
Child-only plans are available on the Marketplace for children under the age of 21 with no parent or guardian covered on the same policy. Savings on premiums are available if you qualify. However, if your child has access to an employer-sponsored plan, you will not be eligible for a discounted Marketplace plan.
Need help deciding on a Marketplace plan? Talk with a local agent.
Healthcare.gov provides an easy way to find a local agent in your area to help you decide on the best plan for your needs. Start here and enter your ZIP Code. All agents have been trained and certified by the Marketplace.
Finally, if there’s anything else we can do to help, contact our autism experts today. As a Behavioral Health Center of Excellence®, we provide a holistic approach to ABA therapy that supports families as well as children, including being their insurance advocate.
A brighter future is possible with ABA therapy from The Behavior Exchange!