Stay Covered All Year Long

Newlyweds need to update their coverage

Now that you have health insurance through the Marketplace, it is important to keep it throughout the year so you can get the health care you need. Keep your coverage up to date so you will have continuous access to health insurance benefits, like medications and care for HIV and other health issues, free preventive care, hospital stays and substance use and mental health services. Here are some things you can do to stay covered all year long.

Pay your premiums on time! Your premium is the amount you pay each month to the health insurance company. It is important to pay by the due date on the bill so you do not lose your coverage. You may be responsible for paying this bill, or in some cases, the AIDS Drug Assistance Program (ADAP) or another Ryan White HIV/AIDS Program may pay it. Talk to your Ryan White Program case manager to find out who pays your premium. If you think you won't be able to pay your premium bill, let your case manager know.

Report income and household changes! Have you had any changes in your household this year, such as getting married or divorced, moving to a new location, or having or adopting a child? Has income changed for you, or anyone in your household, because of losing a job, getting a raise or working more or fewer hours? If so, these changes need to be reported to the Marketplace because they might affect the amount of financial assistance or the type of health coverage available to you.

You may be eligible for a Special Enrollment Period (SEP) that allows you to change insurance plans or enroll in Medicaid. If your household income went down, you may also be eligible for extra financial assistance. If your household income went up, you may owe money back at tax time. Ask your Ryan White case manager or an enrollment assister for help with reporting income and household changes to the Marketplace.

What to do if you lose coverage: Talk to your case manager right away! The Ryan White Program may be able to help pay for your HIV medications and fill gaps in your HIV care. If you lose coverage because you did not pay your premium, you may not be able to re-enroll until the next Open Enrollment Period. If you lose coverage for other reasons, such as moving or getting married or divorced you might be able to reapply during a Special Enrollment Period.

For more information: The ACE TA Center created the Stay Covered All Year Long information sheet for people living with HIV who have enrolled in health insurance through the Marketplace. The Special Enrollment Periods fact sheet describes the life events or special circumstances that allow people to enroll in or change health insurance outside of Open Enrollment.

The ACE TA Center works with the Ryan White HIV/AIDS Program to help diverse clients get enrolled in health coverage. Go to targethiv.org/ace