Today is the first day of open enrollment for obtaining 2018 health care through the Affordable Care Act’s federal Marketplace.

Enrollment closes Dec. 15. This is the shortest open-enrollment period since the program was launched in 2014. Previously, enrollment was open through the end of January.

After Dec. 15, only those who qualify for a Special Enrollment Period will be able to get healthcare through the program.

Determining exactly how many people in this area are insured under the ACA has been difficult, but based on information The Madison Courier was able to obtain, it appears around 1,200 plans were purchased through the Marketplace for 2017 in Jefferson and Switzerland counties in Indiana and Trimble and Carroll counties in Kentucky.

Only two insurance providers remain in Indiana’s ACA Marketplace –- CareSource and Celtic Insurance. Only one — CareSource — will serve this area.

MDwise and Anthem participated in 2017 but have dropped out for 2018. Anthem said earlier this year that the change in their decision to stop ACA Marketplace offerings will not affect anyone who has employer-provided health insurance, Medicare Advantage, Medicare Supplement, Medicaid or those who enrolled in “grandfathered” plans that were purchased before March 2010.

CareSource will be the only Marketplace provider available for residents In Jefferson, Scott, Jennings, Ripley, Dearborn, Ohio and Switzerland counties in Indiana and in Trimble and Carroll counties in Kentucky.

The healthcare.gov website, where enrollment takes place, says participants who purchased plans for 2017 who do not renew or change their existing plan by Dec. 15 could be automatically enrolled with CareSource in the same plan or in a plan closest to the one purchased last year.

To be safe, however, officials recommend participants log into their Marketplace accounts now to update the application with the expected 2018 income and household information and compare plans.

It is important to remember that the online healthcare.gov portal will be shut down for 12 hours every Sunday for maintenance by the U.S. Department of Health and Human Services, which reduces the available time between now and Dec. 15 to sign up for or renew plans.

It is better to start the application process now, said J Hopkins, senior vice president of ClaimAid, which provides certified “navigators” to walk people through the application process.

The first step, Hopkins said, is to create an account on healthcare.gov. This will enable users to start the application process and, if necessary, log back in to edit any information before submitting the completed application for approval.

During the application process, a user will have to provide information about how many dependents will be on the plan and estimate income for 2018. After that, the user will choose from Bronze, Silver and Gold premium packages.

“The goal is to determine if someone qualifies for a Premium Tax Credit,” which is based on household income and establishes how much an enrollee will pay out of pocket, Hopkins said.

Tax credits or premium subsidies are available to households or individuals whose income is from 139 percent to 400 percent of the Federal Poverty Level.

Tax credits will be applied in advance each month. So, if an enrollee chooses a plan that costs $200 a month and qualifies for a tax credit of $150 a month, the enrollee will pay $50 premiums out of pocket each month. All of that information must be included on the enrollee’s federal tax return for the 2018 fiscal year for the credits to be applied, Hopkins said.

After an application is completed, the enrollee still has time to decide whether to participate in the Marketplace plan, Hopkins said. Once they have coverage, premium and tax-credit information, the enrollee can look at other options that may be available to compare programs, such as private insurers or the state’s Healthy Indiana Plan.

The healthcare.gov plan will go into effect Jan. 1 when the enrollee pays the first month’s premium, Hopkins said.