Affordable Care ActOpen enrollment is now closed.
Open enrollment is the period of time during which individuals who are eligible to enroll in a Qualified Health Plan can enroll in a plan in the Marketplace. For coverage starting in 2016, the Open Enrollment Period is November 1, 2015–January 31, 2016. Individuals may also qualify for Special Enrollment Periods outside of Open Enrollment if they experience certain events. (See Special Enrollment Period & Qualifying Life Event)
Basic information on ACA:
To enroll on your own:
Certified Application Counselors (CACs) are individuals who must complete state and/or federal training, must be working on behalf of an organization that is certified by the Center for Medicare & Medicaid Services (CMS), and CANNOT give advice on insurance plans
Navigators are organizations that are funded through CMS for outreach & enrollment, individuals must complete federal/state training and CANNOT give advice on insurance plans
Agents & Brokers are individuals who complete state and federal training and CAN give advice on insurance plans.
What to bring with:
Marketplace Application Checklist
If you want to talk to someone:
- Federal: 1-800-318-2596
- Local Resources: Great Rivers 2-1-1, simply dial 211
How can I get coverage outside of open enrollment?
Outside open enrollment, you can enroll in Marketplace insurance only if you have certain life events that give you a special enrollment period. You can apply for Medicaid or the Children's Health Insurance Program (CHIP) any time. If you're qualified you can enroll right away.
Buying a Marketplace Plan outside of open enrollment:
In order to buy a Marketplace health insurance plan outside the open enrollment period, you must have a qualifying life event. Qualifying life events that create a special enrollment period include:
Special Enrollment Periods
- Getting married
- Having, adopting, or placement of a child
- Permanently moving to a new area that offers different health plan options
- Losing other health coverage (for example due to a job loss, divorce, loss of eligibility for Medicaid or CHIP or BadgerCare, expiration of COBRA coverage, or a health plan being decertified). Note: Voluntarily quitting other health coverage or being terminated for not paying your premiums are not considered loss of coverage. Losing coverage that is not minimum essential coverage is also not considered loss of coverage.)
- For people already enrolled in Marketplace coverage, having a change in income or household status that affects eligibility for tax credits or cost-sharing reductions
If you have a qualifying life event, you get a special enrollment period. This means you can enroll in or change your health insurance plan outside the open enrollment period. Most special enrollment periods last 60 days from the date of the qualifying life event.
Medicaid and CHIP: Enroll any time
In Wisconsin, the Medicaid & CHIP Program is called BadgerCare. You can enroll at any time—there is no limited enrollment period for these programs. Medicaid and CHIP provide health coverage to millions of families with limited incomes. You can find out if you qualify for Medicaid or CHIP by filling out a Marketplace application, or by visiting or calling your local Medicaid office.
Wisconsin did not expanded Medicaid but you may still be eligible, especially if you have children, are pregnant, or have a disability. Every state's eligibility rules are different. If it looks like you're eligible for Medicaid or CHIP, the Marketplace will pass along your information to your state agency, where you'll be able to enroll.
The Western Region for Economic Assistance is the Medicaid/CHIP/BadgerCare agency for Buffalo, Clark, Jackson, La Crosse, Monroe, Pepin, Trempealeau, and Vernon Counties. To apply you can complete an application on line or by calling their offices Monday-Friday 8:30am-4:00pm 1-888-627-0430 or completing a paper application (available at the county offices or by printing it and mailing it to address listed on the first page). If you live in another county please check the following website to find your local Medicaid office.
The following agencies are part of the Western Region Enrollment Network and will continue to offer Certified Application Counselors (CACs) to help with applying for health insurance through the MarketPlace. If you need assistance please contact one of these local agencies:
Locate an insurance agent that can assist you and enter the county in which you live in the bottom left box to get a list of local agents.
- Black River Memorial Hospital, 715-284-5361
- Gundersen Health System, 1900 South Ave, La Crosse, (800)362-9567 ext 58660
- La Crosse County Human Services, 300 4th St N, La Crosse 608-784-HELP
- Marshfield Clinic, 1000 N Oak Ave, Marshfield 800-782-8581 ext. 94475
- Mayo Clinic, 700 West Ave, La Crosse, 1-866-789-4374
- Memorial Medical Center, Neillsville, 715-743-3101
- Scenic Bluffs Community Health Center, Cashton 608-654-5100
- St. Clare Health Mission, 916 Ferry St., La Crosse 608-392-9546
- Tomah Memorial Hospital, 321 Butts Ave, Tomah 608-374-6699
- Workforce Connections, Wanda Palmer, 608-790-8136
Information needed to enroll:
- Social security numbers (or document numbers for legal immigrants
- Employer and income information for every member of your household who needs coverage (pay stub or W-2, etc)
- Policy numbers for current health insurance plans covering members of your household
- If anyone in your household is eligible for a job-based insurance plan you will need to have their employer complete an employer coverage tool (available on the healthcare.gov website
The Marketplace will remain open after Feb 15, 2015, but depending on individual circumstances, tax credits may not be available.