UnityPoint Health - Madison

Health Care Reform

Enrollment for 2016 medical insurance through the Federal Marketplace closed in January 2016. But, you may still be eligible to apply if you have experienced something known as a qualifying event in the past 60 days. Some examples of qualifying events include: 

  • Getting married 
  • Having a child 
  • Getting divorced or separated and losing health insurance 
  • Moving to a new area 
  • Having a change in income. 

To learn if you are eligible, please visit healthcare.gov.

If you have lost your job or if you income is below $11,770 for one person, you may be eligible for BadgerCare. There is never a deadline to apply to BadgerCare (Medicaid). Visit  the health care screening website to see if you are eligible for Medicaid. 

You may be eligible for assistance with your insurance premiums. If you live in Dane County and if you income is between 100-150% of the Federal Poverty level, you may be eligible for assistance with your insurance premiums through United Way of Dane County's program known as HealthConnect.  

Need help Enrolling in Health Insurance in Dane County?

If you need help sorting through your best health insurance options under the Health Insurance Marketplace or BadgerCare, the following FREE assistance is available.

  • United Way of Dane County has up-to-date information about where to get help to sign up for health care coverage, and help to pay your premiums (monthly costs) through Health Connect. Call 2-1-1 anytime, day or night.
  • Covering Kids & Families will be doing enrollment at community sites throughout Dane County. Call 2-1-1 for dates and locations.
  • Dane County Job Center – 1819 Aberg Avenue, Madison
  • Certified Application Counselors from Access Community Health Centers are at the Job Center every Monday through Friday, 8:00 a.m. to 4:00 p.m. Walk-in.
  • Meriter Hospital – 202 S. Park Street, Madison
  • Certified Application Counselors are available by appointment only. Call (608) 417-5015
  • Independent insurance agents and brokers
  • Call 2-1-1 for the names of agents and brokers in your area who work with all of the health insurance companies that are selling plans through the Marketplace, as well as BadgerCare. They can answer questions and help you sign up, at no cost to you.

What is Health Care Reform?

The Affordable Care Act, also known as Health Care Reform and Obamacare, is a law passed in 2010 to give everyone better access to affordable health care and low-cost insurance. It includes major changes in how health care is provided and what insurance covers.

There are almost 100 provisions in the Health Reform law. You may have already noticed many of them when you visited your doctor for preventive care and didn't have to pay a co-pay. Here are a few other big changes that have already happened.

  1. Lifetime Cap. There is no longer a lifetime cap on how much an insurance company will pay for if you get sick, and your coverage cannot be canceled for making a mistake on your paperwork.
  2. Insurance Company Spending. Insurance companies must spend at least 80 cent of every premium dollar on your health care or improvement to care. Those who do not must issue rebates to members. Insurance companies who want to raise premiums by 10 percent or more must justify the change and receive approval.
  3. Young Adult Coverage. Young adults can stay on their parents health insurance until age 26, even if they are not in school, not living with their parents or not financially dependent on their parents.
  4. Pre-Existing Conditions. Insurance coverage cannot be denied to anyone because of a pre-existing condition, like asthma or diabetes. Also, women cannot be charged more than men. 
  5. Donut Hole Coverage. Seniors in the 'donut hole' of prescription drug coverage receive a 50 percent discount on brand-name prescription drugs covered by Medicare Part D.
  6. Preventive Services. Preventive services must be covered without copay or deductible. See a full list here.

Resources

Frequently Asked Questions
Glossary of Terms
Getting Health Insurance Under the ACA
¿Cómo obtener seguro médico a través de la Ley de Cuidado Médico de Bajo Costo?