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For Providers: Health Insurance Marketplace Toolkit

On October 1, 2013, the Health Insurance Marketplace will begin accepting applications from eligible consumers for enrollment in an insurance plan. Enrollment will end on March 31, 2014. Coverage can begin as early as January 1, 2014.

The purpose of this Health Insurance Marketplace Toolkit is to serve as a quick-reference guide to help you answer your patients' questions.

In general:

  • Both the Federal government and the Hospital and Healthsystem Association of Pennsylvania (HAP) provide numerous websites and handouts, indicated in links below.
  • Patients who already have insurance, Medicare or Medicaid do not have to do anything regarding the Health Insurance Marketplace. They are already covered.
  • Open enrollment starts on October 1, 2013 and ends on March 31, 2014. Coverage will begun as early as January 1, 2014.
  • Contact information for enrollment assistance from the Health Insurance Marketplace, Crozer-Keystone Certified Application Counselors at our hospitals, as well as Independence Blue Cross are all provided below.

Click the text in shaded areas to learn more.

Ten Top Things Hospitals Should Explain to Patients (HAP)

HAP offers ten key messages you can share with patients, their families and the community. You may also download and print the attached PDF below.

Download Guide: Ten Top Things Hospitals Should Explain to Patients and Communities (PDF)

  1. The Marketplace is a new way to shop for health insurance coverage. A single, online source will help consumers get information about their health coverage options. That website is www.healthcare.gov.
  2. Each state will have a Marketplace. Pennsylvania's Marketplace is run by the federal government. Therefore, Pennsylvania does not provide its own enrollment website. Consumers should use www.healthcare.gov
  3. Open enrollment begins on October 1, 2013 and ends on March 31, 2014. Coverage can begin as soon as January 1, 2014. During 2014, the penalty for not having health insurance is $95 for an individual and $285 for a family.
  4. Health plans offered in a Marketplace generally will offer comprehensive coverage, including this set of essential health benefits:
    • Ambulatory patient services
    • Emergency Series
    • Hospitalization
    • Maternity and newborn care
    • Mental health and substance disorder services, including behavioral health treatment
    • Prescription drugs
    • Rehabilitative and habilitative services and devices
    • Laboratory services
    • Preventive and wellness services and chronic disease management
    • Pediatric services, including oral and vision care
  5. Individuals can buy insurance through a Marketplace if they live in the U.S., are U.S. citizens or U.S. nationals (or are lawfully present) and are not currently incarcerated.
  6. Nobody can be turned away or charged more because of their gender or a pre-existing condition.
  7. Initial information on average premiums for individuals to be offered on the Health Insurance Marketplace reveals that rates for the lowest cost plan in each medal level are less than the average premiums paid currently by Pennsylvanians in the non-employer based individual market. Many individuals may qualify for tax credits to help lower their costs. 
  8. Individuals will be able to choose a Marketplace plan by health plan category (bronze, silver, gold or platinum). The differences among the categories will be based on the average percentage of the costs the plan will cover. Find more information here. (link to PDF).
  9. Using a single application on www.healthcare.gov, consumers can find out if they and/or their family members are eligible for Medicaid, the Children's Health Insurance Program (CHIP) or for financial help paying for a private health insurance plan offered in the Marketplace.
  10. Resources are available now, including online and call center resources form the federal government and navigators that have been selected, certified and funded by the federal government to assist consumers with enrollment.

    Marketplace.cms.gov: Where organizations and individuals looking to help consumers can get the latest resources and learn more about the Marketplace.

    Healthcare.gov: Where individuals can learn about the federally facilitated Marketplace, upcoming benefits and where they can find local assistance.

    Health Insurance Marketplace Call Center: If you have questions, call 1-800-318-2596. TTY users should call 1-855-889-4325.

Crozer-Keystone Certified Application Counselor Contacts, Hours

Crozer-Keystone provides Certified Application Counselors to help consumers understand their eligibility for the Marketplace; identify and compare their coverage options; help them select health coverage that best fits their budget and specific needs; help them enroll in a plan; and refer them to additional resources if needed. 

Download and post our flyer:

Crozer-Keystone Marketplace Key Contacts and Information (PDF)

Hospital Contact Numbers and Hours of Operation

Crozer-Chester Medical Center and Community Hospital:610-447-2336, 8 a.m. - 8 p.m.

Delaware County Memorial Hospital: 610-394-1720, 8 a.m. - 4:30 p.m.

Springfield Hospital: 610-328-8758, 8 a.m. - 4:30 p.m.

Taylor Hospital: 610-595-6101, 7 a.m. - 3:30 p.m.

Patient Service Center: 1-888-525-4772 option 3 for general phone inquiries.

Dedicated Assistance Line: Crozer-Keystone Health System provides a dedicated assistance line for persons with a disability and older adults. Please contact 1-800-254-7539 or 1-800-CKHS-KEY.

Note: If you do not connect with a Crozer-Keystone Certified Application Counselor, please leave a VoiceMail message. Someone will get back to you the next business day.

Government and Provider Resources and Contacts

Federal Government

Health Insurance Marketplace (www.healthcare.gov)

El Mercado de Seguros Medicos Comenzara Pronto (www.cuidadodesalud.gov)

Like Facebook.com/HealthCareGov

Follow @HealthCareGov on Twitter.

Government Contact Numbers

Marketplace Call Center: 1-800-318-2596
TTY: 1-855-889-4325
Espanol: 1-800-318-2596 

Independence Blue Cross

Care for Me Independence Blue Cross (www.ibx.com/careforme)

Phone: 1-888-475-6182

Helpful Videos

The YouToons Get Ready for ObamaCare

Los YouToons Se Preparan Para Obamacare

What Obamacare Means to You

Navigator Resources for Pennsylvania

Navigators provide consumers and the community with expert, fair, accurate, unbiased, culturally appropriate assistance to help them understand the new health insurance options available through the Marketplace. Following is a list of Navigators for Pennsylvania. 

Resources for Human Development, Inc. (RHD)

This non-profit organization is based in Philadelphia and will provide assistance in the ten counties in Pennsylvania with the highest rates of uninsured people. These counties include Philadelphia, Montgomery, Bucks, Chester, Delaware, Allegheny, Lancaster, York, Berks and Lehigh.

Pennsylvania Association of Community Health Centers (PACHC)

This organization represents and supports the largest network of primary health care providers in Pennsylvania. PACHC coordinates enrollment assistance in underserved areas throughout the Commonwealth. 

Pennsylvania Mental Health Consumers' Association (PMHCA)

PMHCA works in a consortium with Mental Health Association in PA and Mental Health America Westmoreland County to provide enrollment assistance to people who use or need behavioral health services in their insurance plans, particularly those who experience serious mental illness or serious psychological distress.

Mental Health America

This organization targets underserved individuals with behavioral health disorders who are uninsured or underinsured. The National Office of Mental Health America will serve as the lead agency in the initiative. The Mental Health Association of Southeastern Pennsylvania (MHASP) will serve Bucks, Chester, Delaware, Montgomery and Philadelphia counties in Pennsylvania.

Health Insurance Marketplace Quick Reference Enrollment Assistance and Outreach Guidebook

This quick reference guide from the Hospital and Healthsystem Association of Pennsylvania (HAP) includes pertinent information for consumers and physicians to help them navigate the Health Insurance Marketplace, learn about deadlines, patient privacy, qualified health plans, differences in the four major health plan categories (Bronze, Silver, Gold and Platinum), benefits, financial assistance programs, tax credit, Medicaid and CHIP information and much more.

Learn more: Health Insurance Marketplace Quick Reference Enrollment Assistance and Outreach Guidebook (PDF)

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