Affordable
Care Act
(Obamacare)
THE HEALTH INSURANCE MARKETPLACE
Frequently Asked Questions
For more information, please visit the Kaiser Family Foundation or visit healthcare.gov.
What is the Health Insurance Marketplace?
The Marketplace is a new way to get affordable health insurance. It is part of the country’s Affordable Care Act (commonly known as ObamaCare).
Who is the Marketplace for?
It is for people without insurance, & will provide affordable health insurance options. It is also for people with health insurance, who may be able to find more affordable options.
What if I have a pre-existing condition?
It’s ok! With the Marketplace, you can’t be turned down, can’t be charged more, and can’t be denied coverage because of your condition.
How much will I pay for the insurance?
The insurance is discounted based upon your income. Your Enrollment Specialist will be able to go over an estimate of pricing.
Am I eligible for the Marketplace?
To buy insurance in the Marketplace you must:
- Live in the United States
- Be a United States citizen, national or be in the country legally
- Not be incarcerated
Why do I need to enroll?
If you meet the guidelines and do not enroll, there is a penalty and you may have to pay a fee.
When can I enroll?
For 2018 coverage, the Open Enrollment period is currently ongoing and extends through December 15, 2017. Once the Open Enrollment period is over, individuals and families will not be able to enroll in Marketplace health plans until the next Open Enrollment period. However, if you experience certain changes in circumstances during the year, you will have a special 60-day opportunity to enroll in Marketplace health plans, outside of the Open Enrollment period.
For individuals and families buying non-group coverage on their own, outside of the Marketplace, you can only enroll in coverage during Open Enrollment periods and special enrollment opportunities, as well. American Indians and Alaska Natives can enroll in coverage throughout the year, not just during Open Enrollment.
How do I enroll?
You can enroll online at Healthcare.gov. Just be sure to select St. Thomas as your health provider.
What does Marketplace health insurance cover?
Insurance plans in the Marketplace will offer the same set of essential health benefits. Some plans may offer additional coverage and your Enrollment Specialist at St. Thomas can help you review these plans.
Essential Health Benefits
- Primary care & specialty care services (outpatient care you can get without being admitted to a hospital)
- Chronic disease management & preventative wellness services
- Pediatric Services
- Laboratory Services
- Emergency Services
- Hospitalization (such as surgery)
- Maternity and newborn care (care before and after your baby is born)
- Mental Health and substance use, including behavioral health treatment (includes counseling & psychotherapy)
- Prescription drugs
- Rehabilitative services and devices (services to help people with injuries, disabilities, or chronic conditions to gain or recover mental & physical skills)
