NAMI HelpLine

November 14, 2014

It’s time to look at your health care needs and options.

If you don’t have health insurance or are looking for more affordable health insurance and haven’t looked at the Health Insurance Marketplace―open enrollment is the time to look. During “open enrollment” you can buy private health insurance through the marketplace in each state. Depending on your income you can get financial help to pay for health insurance. If you have affordable employer-provided health insurance or are already covered by Medicaid or Medicare you cannot receive financial help paying for private health insurance coverage.

Do You Already Have Health Insurance through the Marketplace?

If you do, you must re-enroll every year or you will be automatically re-enrolled. It is also important to report any changes to your income to the marketplace.

  • This is a good time to check your health insurance coverage and see if it still meets your health and mental health care needs.
  • Anyone can change health care plans during open enrollment, but most people will be re-enrolled automatically if they take no action.
  • Carefully read all health insurance notices and updates.

Check Your Coverage

  • Even if you like your health plan, new plans may be available and premiums or cost sharing may have changed since last year.
  • Even if your income has not changed, you could be eligible for more financial assistance.

If You Live with a Mental Illness, Pay Attention to Possible Changes

  • Are a broad range of health and mental health care providers included in the health plan’s network of providers?
  • Are there enough medical specialists in the network to meet your needs?
  • Are needed medications included in the plan’s list of covered prescription drugs?
  • Is there adequate access to non-clinical, mental health-specific services and supports?
  • Does the plan have service limits, such as caps on the number of office visits for therapy services?
  • Are mental health and substance use services covered to the same extent as other “physical” health benefits are covered?

Where You Can Get Help

Health insurance can be complicated. If you or your family member needs help understanding your options, Healthcare.gov can help. It breaks down health insurance terminology and will tell you where you can get help in your local community. Each state has health insurance “navigators” to assist individuals with enrollment in health insurance. You can also call the 24-hour Healthcare.gov phone line for help at 1-800-318-2596.

The Kaiser Family Foundation also put together some great resources including a video explaining health insurance and a calculator you can use to figure out about how much health insurance will cost for you if you buy it through the Health Insurance Marketplace.

Important Dates to Remember

Nov. 15, 2014

Open enrollment begins

Dec. 15, 2014

Enroll before this date to have coverage Jan. 1, 2015

Feb. 15, 2015

Open enrollment ends

More information on specific topics for each state can be found at the National Disability Navigator Resource Collaborative.

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NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).