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Health Insurance Marketplace

Health Insurance Marketplace

The Affordable Care Act

The Affordable Care Act (the ACA, sometimes called Obamacare) requires everyone legally living in the U.S. to have health insurance beginning January 1, 2014. Those who are not covered by health insurance, either through an employer or through the Marketplace, will face tax penalties.

The Health Insurance Marketplace, also know as an exchange, allows consumers to review and compare health insurance plans available to them. Residents of Pennsylvania and New Jersey are on the Federal Exchange, which can be accessed at www.healthcare.gov or www.cuidadodesalud.gov. For information in other languages, visit https://www.healthcare.gov/language-resource/.

Important Dates for 2015 Enrollment

  • November 15, 2014  to Februay 15 2015: 2015 Open Enrollment Begins
  • December 31, 2014: Coverage ends for plans bought in 2014

St. Mary is Here to Help

If you need help understanding your health insurance options, or in signing up for coverage, St. Mary is here to help. Appointments are available with our trained Assistors, who can explain options and personally guide you through the process of creating an account, choosing a plan, and enrolling for health care coverage.

To make an appointment with a St. Mary representative, call 215-710-5888. We have trained Assistors at various locations throughout Bucks County to help you.

Whether you shop on the Marketplace by yourself, or come to St. Mary for assistance, you will need the following information to set up an account and enroll:

  • Social Security numbers (or document numbers for legal immigrants)
  • Income information for every member of your household who needs coverage (for example, pay stubs, W-2 forms, tax returnes from the prior year)
  • Policy numbers for any current health insurance plans covering members of your household
  • Email address (we will assist in setting up an email account if you don't have one)
  • Picture ID
  • Proof of unemployment, if you are unemployed
  • Knowlege of who your dependents are (or who can claim you as a dependent) 

Choosing a Plan

You will be able to choose from four levels of plans -- Platinum, Gold, Silver and Bronze -- from a variety of insurance providers. The plans differ in price and offerings.

When reviewing plan options, there are some important factors to consider:

  • The health status of you and your family
  • Your budget
  • The healthcare providers you want to be able to see

Make sure you understand what your monthly costs will be, what your copays will be at time of service, and whether the doctors you prefer will be on the plan.

 
 
 
  Learn more about the
  Affordable Care Act 

with this
  video from the Kaiser Family
  Foundation.

Information from St. Mary on the Marketplace

What Will The Plans Cover?

There will no longer be denials for pre-existing conditions. Coverage will include doctor visits, hospital stays, wellness care, prescriptions, emergency services and more. In fact, Ten Essential Health Benefits must be covered in every plan and certain Preventive Care Services will be provided at no additional costs to patients.

Financial Assistance

A surprisingly large number of people will qualify for financial help. For example, an individual earning up to $45,900 a year, or a family of four earning up to $94,200 a year, will qualify for a reduction of their monthly premiums, or a tax credit at the end of the year. The calculator below will give you a good idea of how much assistance will be available. Once you apply at the Marketplace, you will find out the exact amount.

Financial Assistance Calculator

Financial Assistance Income Chart

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