Healthcare Coverage Guide
Health insurance helps you pay for the healthcare you and your family need, like medicines and check-ups. The new healthcare law helps us get health insurance that is affordable and covers what we need.
The Health Insurance Marketplace
The Health Insurance Marketplace, a source of information about consumers' health insurance options as well as an enrollment portal for Pennsylvanians, is available at Healthcare.gov.
- Dec. 15, 2016: Last day to enroll in or change plans for new coverage to start Jan. 1, 2017.
- Jan. 31, 2017: 2017 Open Enrollment ends. Enrollments or changes between Jan. 16 and Jan. 31 take effect March 1, 2017.
- No enrollment deadlines for the SHOP Insurance Marketplace (Small Employers).
- No enrollment deadlines for Medicaid or the Children’s Health Insurance Program (CHIP).
You can apply anytime.
If you don’t enroll in a 2017 health insurance plan by Jan. 31, 2017, you can’t enroll in a health insurance plan for 2017 unless you qualify for a Special Enrollment Period.
See a full list of plans and programs that meet the health law’s coverage requirements on the www.healthcare.gov website. Some people qualify for an exemption from the fee based on income or other situations.
Only one payer (Independence Blue Cross) will offer products on the SHOP (for small employer groups) and individual exchange. Members enrolled in an Aetna or United HealthCare product in 2016 will need to change plans during this enrollment period. CKHS participates in all Independence Exchange products and is a tier 1 (low-cost) provider in the Independence “Proactive” tiered products.
5 Things to Know About the Healthcare Law
- You can’t be denied because you’re sick or have been sick.
- All plans cover prescriptions, doctor visits and hospital care.
- You can find a plan that fits your budget.
- If you don’t have insurance, you may pay a penalty.
- You can get help to enroll in a plan.
The Health Insurance Marketplace is for people who don’t have health coverage.
If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying coverage, the Marketplace can help you get covered.
- If you have job-based insurance: You can buy a plan through the Marketplace, but you’ll pay full price unless your employer’s insurance doesn’t meet certain standards. Most job-based plans do.
- If you have Medicare: You can’t switch to Marketplace insurance, supplement your coverage with a Marketplace plan, or buy a Marketplace dental plan. Learn about Medicare and the Marketplace.
Medicaid and the Children’s Health Insurance Program (CHIP)
Medicaid and CHIP provide free or low-cost coverage to millions of people and families with limited income, disabilities, and some other situations.
Many states are expanding Medicaid to cover all households below certain incomes. See if your state is expanding and if your income is in range to qualify. (Pennsylvania has expanded Medicaid Coverage)
Your children may qualify for CHIP even if you don’t qualify for Medicaid.
Medicare Open Enrollment
Oct. 15, 2016 to Dec. 7, 2016
Medicare open enrollment is the time you can decide whether to stay with your current plan or change plans. In most cases, you must stay enrolled in the plan you select throughout 2017. Some products use limited provider networks - please check this listing carefully so that you can make an informed decision when deciding what plan is best for you. Consider all the factors that will be in place for 2017 including the provider network, total cost, benefits, prescription drug coverage and formulary, quality of care, and other factors based on your individual needs.
Get Ready to Apply
Applying for coverage is easy. When you're ready to enroll, make sure you know:
- Your household size
- Your income for 2016 (an estimate)
- If anyone in your family can get health insurance through an employee
- The names of your preferred doctors and hospitals
Our financial counselors are responsible for helping consumers - via phone call and on a walk-in basis at our hospitals - to learn about the basics of health coverage, identify and compare their coverage options and help them select health coverage that best fits their budget and specific needs.
Marketplace and Provider Quick Links
Government Contact Numbers
- Marketplace Call Center: 1-800-318-2596
- TTY: 1-855-889-4325
- Espanol: 1-800-318-2596
Health Plan Contact Numbers
Independence Blue Cross