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University of Illinois Extension

ACA Marketplace is Now Open

The Affordable Care Act (ACA) was passed to ensure that all Americans have access to health insurance. The Marketplace offers uninsured individuals and families various healthcare plans. If you currently do not have coverage or need coverage for 2015, it's time for you and your family to review your health insurance options. Annual open enrollment in the Illinois Health Insurance Marketplace (https://getcoveredillinois.gov/) is now open for coverage in 2015.

Open enrollment began on November 15, 2014 and will end on February 15, 2015. They only way to sign up for health insurance after February 15 is if you have a qualifying life event.

The Affordable Care Act requires that everyone have insurance coverage. If you do not purchase health insurance you will have to pay a penalty based on your income. The minimum penalty for not having coverage in 2015 is $325 or 2% of your income, whichever is higher.

Health insurance plans can change from year to year. Just because you enrolled for a certain health insurance last year, it is important to review your options before re-enrolling again because both the providers and prescriptions covered can change year to year. Make sure to review your renewal contract before reapplying for an insurance health plan.

Though plans will differ on providers and prescription coverage, all plans are required to cover the same ten essential benefits. These include:

  • Preventive and wellness services and chronic disease management
  • Prescription drugs
  • Laboratory services
  • Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Mental health and substance use disorder services, including behavioral health treatment
  • Rehabilitative services and devices
  • Maternity and newborn care
  • Pediatric services, including dental and vision care from birth to age nineteen

How much the plan will cost you in a typical year often influences your health insurance coverage decision. The health insurance premium is the monthly fixed charge you pay for the plan. There are four levels of health insurance coverage in the marketplace: bronze, silver, gold and platinum, respectively higher in monthly premium price. An added benefit of the ACA is that you cannot be denied coverage due to a pre-existing condition. As long as you sign up and pay for your health insurance you will maintain coverage for the year. You can lose your insurance coverage if you do not pay your monthly premiums.

There are health insurance navigators across the state to answer specific questions and to help you identify plans in your area. To find a navigator visit: https://getcoveredillinois.gov/get-help/ or call 866-311-1119866-311-1119. If calling or visiting a site for help, please make sure you have your social security card, income information, and a photo I.D.

Do not delay the process of researching your plans until the last few days because local navigators may be quite busy and you will not want to make a hasty decision.

Posted by Chelsey Byers Gerstenecker at 3:00 AM | Permalink
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