7 things you need to know about the Health Insurance Marketplace

7 things you need to know about the Health Insurance Marketplace

After months of contentious political debate, the long-awaited opening of Health Insurance Marketplaces, a key component of the Affordable Care Act (ACA), launches today.

Formerly called “health exchanges,” the government subsidized program gives millions of uninsured, underinsured and other eligible Americans, access to enroll in reasonably priced health care plans.

In Illinois, more than 1.6 million have no health insurance, according to state officials. Government leaders expect more than 300,000 of those people to enroll in the Marketplace this year. They will be able to choose from eight insurers with a total of 162 different plans available.

Despite education and marketing efforts by federal officials, scores of Americans say they know very little about the details of the plans or if they qualify for enrollment, officials say. Only 4 in 10 Illinois residents say they are aware of the Insurance Marketplaces, according to a new study by the Commonwealth Fund.

Many health systems, including Downers Grove-based, Advocate Health Care, are doing their part to help eligible patients to enroll in the Marketplace. Advocate financial counseling representatives are training  as Certified Application Counselors to help facilitate enrollment and to make the process as smooth as possible. “We are going to do all we can to help our patients get access to the care they need,”  says Susan Clarke, Advocate’s executive director of patient access.

Here are some key points and answers to frequently asked questions you need to know:

How do I know if I’m eligible to enroll?
Illinois residents can get detailed information about the financial qualifications required under the ACA by visiting getcoveredillinois.gov. You will be asked to provide your individual or family income which will be compared against the federal poverty level to determine your eligibility.

What is the deadline for enrollment?
You must enroll by March 31, 2014. But if you want your coverage to begin on January 1, 2014, enrollment must be completed by December 15, 2013.

Will I face a penalty if I don’t have health insurance?
Those people who don’t buy insurance by March 31, 2014, will be charged a $95 penalty or 1 percent of their income, whichever is greater. The penalties will be deducted from tax refunds or added to 2015 tax bills. The penalty rises to $325 or 2 percent of your income in 2015 and $695 or 2.5 percent of your income in 2016.

I already have insurance through my job. Do I have to do anything?
Being insured through your company plan qualifies for “minimum basic coverage,” and will keep you from paying any penalties. Depending on your current coverage, you may be able to reduce your costs through one of the Insurance Marketplace plans. Check out HealthCare.gov for more details.

Will my children be covered under these plans?
Under provisions of the ACA, children can be covered under their parent’s insurance plan until the child turns 26-years-old.

Will I be denied coverage for having a pre-existing condition?
Starting in 2014, individuals cannot be denied health insurance coverage for pre-existing conditions under the terms of the ACA.

Where can I find more help with the enrollment process?
Beginning today, Illinois residents can call 866.311.1119 between the hours of 8 a.m. to 8 p.m. seven days a week to speak directly to an enrollment counselor. The federal government also has a help desk at 800.318.2596.

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One Comment

  1. Its is great to know affordable health care exists but do we know how much we are covered for in all what we are paying for , since most of the premiums come up to the same amounts as previous ones were.

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health enews Staff
health enews Staff

health enews staff is a group of experienced writers from our Advocate Health Care and Aurora Health Care sites, which also includes freelance or intern writers.