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If you don’t have health insurance through your job or aren’t covered by Medicare or another plan, the Health Insurance Marketplace can help you find coverage. Open enrollment for health insurance coverage in 2020 through the Marketplace runs November 1 through December 15.

There are many health insurance coverage websites, but the official site for the Marketplace is HealthCare.gov. This is the only website where you may be able to get premium tax credits. Premium tax credits provide financial assistance for monthly premium costs. At HealthCare.gov, you can get a clear picture of the cost, compare plans based on your health needs, and choose the combination of price and coverage that fits your needs and the needs of your family.

As you shop, keep in mind that the lower your monthly premium costs, the higher your out-of-pocket costs will be for co-payment and deductibles. The higher the premium, your out-of-pocket costs will be lower. Once you fill out the application, you’ll know immediately if you’re eligible for tax credits to lower the cost of your monthly premiums.

Through HealthCare.gov, you can also find out if you qualify for the Montana HELP Plan. In 2015, the Montana Legislature expanded Medicaid to create the HELP plan for Montanans whose income was too high to qualify for Medicaid and too low to buy Marketplace insurance. This plan is open to 19 through 64-year-olds, depending on income and family size.

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Once you get health insurance, it’s important to know how to use it wisely. Your insurance should work to keep you healthy, not just help pay for treatment when you are sick. Establishing a trusting, ongoing relationship with a primary care provider who can take care of your basic needs in non-emergency situations is a good first step. Make sure to pay attention to healthcare providers that are “in-network”. In-network providers will usually cost you less than out-of-network providers. If you have questions about your coverage, call the member service number on your insurance card.

Once open enrollment ends, you can only get coverage through the Marketplace if you qualify for a special enrollment period based on life changes. Some of those qualifying life changes include loss of health insurance coverage due to a job change, or a change in income, household size or marital status. If you are an enrolled tribal member, you may enroll in coverage at any time.

Thousands more Montanans now have health coverage and access to medical care they need to live healthier lives thanks to the Affordable Care Act and the Montana HELP Plan.

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J.“Scooter” Gates, is the Care Manager Team Coordinator at RiverStone Health, and can be reached at 651-6540.

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