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Affordable Care Act

In March 2010, a health reform law was passed called the Patient Protection and Affordable Care Act (ACA).  The law was created to make preventive care more accessible and affordable for Americans.  This law (known as Obamacare) will take effect October 1st, 2013 and requires everyone to have health insurance or face financial penalties.  Open enrollment starts October 1, 2013 for coverage starting as early as January 1, 2014.  Open enrollment ends March 31, 2014.

 

 

Health Insurance Marketplace

Marketplace Health Plans

National Marketplace Process

National Marketplace Help Resources

Marketplace Application Checklist

Useful Links

 

 


Health Insurance Marketplace

 

Starting October 1, 2013, you can visit the official Illinois Marketplace, GetCoveredIllinois.gov.  Illinois residents will be able to choose high quality and affordable health insurance plans through the Illinois Health Insurance Marketplace. 

The national site, Healthcare.gov (En Español: CuidadoDeSalud.gov) also allows you to enroll in the marketplace, fill out an application and see plan choices and get other information and help.  This process will help you determine if you qualify, or can get lower cost coverage through Medicaid or the Children's Health Insurance Program (CHIP)*.  All Marketplace plans offer the same set of comprehensive benefits. They cover things like pre-existing conditions, pregnancy, hospitalizations, prescriptions, and doctor’s visits.  Visit here for a list of what is covered.  Plan and cost information is avaliable on the Health Insurance Marketplace.  For more key features about this law, visit here.

*You can sign-up for Medicaid or CHIP at anytime.  

 

Insurance carriers participating in the marketplace include:

  • Aetna Life Insurance Company      
  • Blue Cross Blue Shield of Illinois  
  • Coventry Health and Life Insurance Company  
  • Health Alliance Medical Plans, Inc.   
  • Humana Insurance Company and Humana Health Plan, Inc.  
  • Land of Lincoln Health Insurance Company    

Questions or to enroll via phone?

Call 1-800-318-2596

Español, llame 1-800-318-2596

TTY: 1-855-889-4325

 

Get Covered Illinois Help Desk: 866-311-1119

 

Paper Applications

Paper applications can also be printed out from the CMS.gov website or below. 

 

Individual Short Form: http://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/marketplace-app-short-form.pdf

Individual without Financial Assistance: http://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/marketplace-app-no-financial-assistance.pdf

Family Form: http://www.cms.gov/CCIIO/Resources/Forms-Reports-and-Other-Resources/Downloads/marketplace-app-standard.pdf

 

Mail your signed application to:
Health Insurance Marketplace
Dept. of Health and Human Services
465 Industrial Blvd.
London, KY 40750-0001

 

In Person Help

Will County Health Department

The Will County Health Department is taking appointments for one-on-one sessions to help with enrolling in the Marketplace.  Call 815-727-5990 to speak to In-Person Counselors with questions or to schedule an appointment.  You can visit their website at www.willcountyhealth.org.  They will also conduct an informational program about the Law and Marketplace at our library on October 16th.  Regsiter here for the program.

Navigator Appointments

On October 26th, you can get one-on-one help from a State-certified Navigator that will walk you through the enrollment process and can help you find a plan that fits your budget and health care needs. Registration is required. Once you are registered for this day, the navigator will call you to schedule an appointment during the 10am-2pm timeframe, held at the Minooka Branch. If you have a personal laptop, please bring it to the appointment.


Marketplace Health Plans

 

For every plan, you will pay a monthly premium and out-of-pocket expenses when you receive services. In general, the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care. The way you pay your portion of these costs is through deductibles and copayments or co-insurance.

The Marketplace offers four categories of plans, plus a catastrophic plan:
• Bronze plan: You pay 40% of your costs, the plan covers 60%
• Silver plan: You pay 30% of your costs, the plan covers 70%
• Gold plan:  You pay 20% of your costs, the plan covers 80%
• Platinum plan: You pay 10% of your costs, the plan covers 90%
• Catastrophic Plan: Available up to age 30

 


 

The Process 

 

Visit the Using the Marketplace and the Help Center for information on how to apply for coverage in the National Marketplace.  Below are the steps you will take to apply.

 

Create an account

The first step is to provide some basic information. Then choose a user name, password, and security questions for added protection. 

Apply

Starting October 1, 2013, you’ll enter information about you and your family, including your income, household size, and more.  Use this checklist now to help you gather the information you’ll need.

Pick a plan

Next you’ll see all the plans and programs you’re eligible for and compare them side-by-side.  You’ll also find out if you can get lower costs on monthly premiums and out-of-pocket costs.

Enroll

Choose a plan that meets your needs and enroll.  Coverage starts as soon as January 1, 2014.

 


Marketplace Help Resources 

 

The Marketplace will offer several kinds of assistance to help you apply for coverage and choose a plan that meets your needs.  These resources (below) can be found in the Marketplace Help Center.

 

       Online questions and answers  

       Online chat — available now  

                                                               

A  toll-free call center—available now   

 

Facebook

Facebook.com/HealthCareGov

Facebook.com/CuidadoDeSaludGov

 

Twitter

@HealthCareGov - Twitter.com/HealthCareGov
@CuidadoDeSalud - Twitter.com/CuidadoDeSalud

 

YouTube

YouTube.com/HealthCareGov

 

Other Useful Marketplace Links

Health Insurance Marketplace (Spanish version- CuidadoDeSalud.gov)

Dental Coverage

Get an estimate on cost and savings

How to get lower costs throught the Marketplace    

Medicaid Questions

Plan Information

Sign-up for email or text updates

State by State Fact Sheet         

          For Illinois (individual coverage is based on your home address)

 


 

 

Marketplace Application Checklist

 

 

When you apply for coverage in the Health Insurance Marketplace, you'll need to provide some information about you and your household, including income, any insurance you currently have, and some additional items.

Use the checklist below to help you gather what you need to apply for coverage.  Open enrollment starts October 1, 2013 for coverage starting as early as January 1, 2014.  Open enrollment ends March 31, 2014.

  1.  Social Security Numbers (or document numbers for legal immigrants)
  2. Employer and income information for every member of your household who needs coverage (for example,  from pay stubs or W-2 forms- Wage and Tax Statements)
  3. Policy numbers for any current health insurance plans covering members of your household

 


 

Useful Links

 

Avoiding Scams

AARP- http://www.firstseniorfinancialgroup.com/aarp-warns-obamacare-scam/

 

Care and Coverage Information

Health Resources and Service Administration (HRSA)- http://www.hrsa.gov/index.html

An agency of the U.S. Department of Health and Human Services, the HRSA is the is the primary Federal agency for  improving access to health care services for people who are uninsured, isolated or medically vulnerable.    

Insure Kids Now- www.insurekidsnow.gov

Provides answers to children's insurance questions.

Medicaid Affordable Care Act- http://www.medicaid.gov/AffordableCareAct/Affordable-Care-Act.html

Details how the Affordable Care Act will affect Medicaid beginning in 2014.

Rural Assistance Center- http://www.raconline.org/

An online library focused on health and human services for rural America

U.S. Department of Health and Human Services- http://www.hhs.gov/healthcare/

Information about the Marketplace, Prevention and Wellness, Facts and Features and the ACA law.

VA Affordable Care Act- http://www.va.gov/health/aca/

Explains the impact of the Affordable Care Act on former troops and their families.

Will County Health Department- www.willcountyhealth.org

The Will County Health Department is taking apointments for one-on-one sessions to help with enrolling in the Marketplace.  Call 815-727-5990 to speak to In-Person Counselors with questions or to schedule an appointment.   

 

Illinois Specific Sites

Get Covered Illinois- http://getcoveredillinois.gov/

The official Illinois Marketplace to get coverage.

Illinois.gov- http://www2.illinois.gov/gov/healthcarereform/Pages/TheAffordableCareAct.aspx

Illinois Health Matters- http://illinoishealthmatters.org/

Information for individuals, families and small businesses on how health care reform will be implemented in our state.

Illinois Department of Insurance- http://insurance.illinois.gov/

A clearinghouse of information on the ACA and how it relates to IL. Frequently updated.

Local Help- LocalHelp.healthcare.gov

(En Español: ayudalocal.cuidadodesalud.gov )

Identify local Affordable Care Act (ACA) consumer assistance destinations in your area. Local consumer assisters can provide personal help in applying for healthcare coverage through the ACA.  Please note, this site is still in the process of updating locations, so please check back for more locations to be added.

 

Fact Sheets

AARP- http://www.aarp.org/health/health-care-reform/health_reform_factsheets/

HHS- http://www.hhs.gov/healthcare/facts/factsheets/index.html

 

Financial Information

Kaiser Family Foundation- http://kff.org/

     Subsidy Calculator

Independent analysis and information about the Affordable Care Act.

HHS- http://www.hhs.gov/healthcare/insurance/premiums/index.html

Provides information about Premiums.

Modified Adjusted Gross Income (MAGI)- MAGI Summary

Eligibility for Medicaid and subsidized health insurance through the Exchanges will be calculated using a
household’s Modified Adjusted Gross Income (MAGI).  This PDF contains more information about MAGI.

 

Health Information

Centers for Medicare and Medicaid Services (CMS)- http://marketplace.cms.gov/

FAQ for the Marketplace- https://questions.cms.gov/faq.php?id=5005&rtopic=1993

Medline Plus- http://medlineplus.gov

Provides information on health topics, a medical encyclopedia, interactive health tutorials and videos, drug information and more.

 

Non-for-Profits and other Independent Organization Information

Consumer Reports Free Guides to Health Care Reform- http://www.consumerreports.org/cro/2013/03/download-our-free-guides-to-health-care-reform-and-medicare/index.htm

What does the new law mean for you and your family? Download these guides for answers.

Consumer Reports

Our Consumer Reports database also includes a "Health" section that includes a "Helath Law Helper" to learn how the law affects you.  (A Three Rivers Library Card is required for use outside the library).

In-Person Assistance- http://www.enrollamerica.org/best-practices-institute/assistance-resource-center#ipa_program

Information about navigators, in-person assistance personnel, or certified application counselors from Enroll America, a nonpartisan 501(c)(3) organization.  

 

Small Businesses Information

Small Business Health Care Consortium- http://cbhconline.org/smallbusiness/

A consortium is for small business owners, self employed entrepreneurs and non-profits to help them educate and advocate for health reform to meet the needs of small businesses.

Small Business Majority Health Coverage Guide- http://healthcoverageguide.org/

Provides independent, unbiased information to small business owners on everything they need to know about offering health insurance.