Can I get Obamacare health insurance if I have type 1 diabetes?

Can I get Obamacare health insurance if I have type 1 diabetes?

How the Affordable Care Act helps

Thanks to the Affordable Care Act (ACA), health insurance companies in the United States cannot deny you health insurance coverage or discriminate against you in any way if you have a pre-existing condition, including type 1 diabetes, type 2 diabetes, and other chronic diseases. If you have type 1 diabetes, your health insurance company cannot kick you off your plan. They also cannot charge you more for your plan.

The ACA also implemented annual maximums on what an individual can spend out-of-pocket for their health care costs. Even if you are managing a chronic condition like type 1 diabetes, there is a limit on your out-of-pocket costs for covered care. These limits exist for each calendar year and also throughout your lifetime. In 2020, this limit will be $8,150, not including your monthly health insurance premium. Learn more by grabbing our free step-by-step guide to enrolling in Marketplace health insurance here.

How to enroll in an Affordable Care Act plan

Insured through an Obamacare health plan? Want to learn more about your specific plan’s coverage for type 1 diabetes? Feel free to contact the HealthSherpa Consumer Advocate Team at (872) 228-2549 for assistance. 

If you’re interested in enrolling in a health insurance plan from the Marketplace, you can shop for plans here, call a Consumer Advocate at (872) 228-2549, or enter your zip code below to see available plans in your area. 

Affordable Care Act health insurance affordability

Marketplace plans can be quite affordable, especially if you qualify for subsidies and/or cost-sharing reductions. Last year, most consumers who used HealthSherpa paid a monthly premium of $35 or less for ACA health insurance. Anyone who is eligible can enroll in a plan during Open Enrollment Period (OEP) (typically November 1 to January 15), or you can enroll during Special Enrollment Period (SEP) if you have a Qualifying Life Event, such as losing your health coverage, having a child, moving, or another event.

Affordable Care Act health insurance benefits

Due to the ACA, all health insurance purchased on the Health Insurance Marketplace cover many essential health benefits. These benefits include prescription drugs, mental health care, emergency care, pre-existing conditions, and more. Your insurance will likely cover diabetes supplies like blood glucose test strips, insulin pumps, and other supplies as well.

Medicaid, CHIP, and Medicare

Some people may qualify for other coverage options as well. If you are low income, consider applying for Medicaid or CHIP (Children’s Health Insurance Program). You can apply for Medicaid or CHIP at any time, even outside of Open Enrollment, and if you qualify you can enroll and have your health coverage start almost immediately. For Medicare, those who are eligible can apply when they turn 65.