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.
Starting October 1, 2013, you can visit Healthcare.gov (En Español: CuidadoDeSalud.gov) to fill out an application and see plan choices. This process will help you determine if you qualify, or can get lower cost coverage through Medicaid or theChildren’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.
*You can sign-up for Medicaid or CHIP at anytime.
Insurance carriers participating in the marketplace include:
- Aetna Inc.
- Blue Cross Blue Shield of Illinois
- Carle Foundation
- Coventry Health Care Inc.
- Humana Inc.
- Land of Lincoln Health
Paper applications can also be printed out from the CMS.gov website. The Marketplace will have paper forms and an address to mail to soon.
Questions or to enroll via phone? Call 1-800-318-2596
Plan and cost information will also be on the Health Insurance Marketplace soon. For more key features about this law, visit here.
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 first step is to provide some basic information. Then choose a user name, password, and security questions for added protection.
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.
Choose a plan that meets your needs and enroll. Coverage starts as soon as January 1, 2014.
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
Other Useful Marketplace Links
For Illinois (individual coverage is based on your home address)
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.
- Social Security Numbers (or document numbers for legal immigrants)
- 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)
- Policy numbers for any current health insurance plans covering members of your household
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
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.
Kaiser Family Foundation– http://kff.org/
Independent analysis and information about the Affordable Care Act.
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.
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.
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).
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.