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Affordable Care Act - Frequently Asked Questions

 

What is the Health Insurance Marketplace?

The Health Insurance Marketplace, sometimes called “an exchange or the Marketplace,” is a way for you to buy health insurance. The Marketplace may make buying health insurance easier and cheaper. The Marketplace will let you compare health plans, get answers to questions, and find out about tax credits for private insurance or health programs like the Children’s Health Insurance Program (CHIP). Open enrollment is from November 1, 2016 to January 31, 2017.  You could be covered as early as January 1, 2017.

How can I learn more about the Marketplace?

Visit www.healthcare.gov or call 1-800-318-2596.

What information do I need to apply for the Marketplace insurance?

Before you go to the Marketplace, you will need to have:

1. Social Security Numbers for you and every person who lives with you (or document numbers for legal residents);   

2. A working email address;

3. Employment and income information for every person who lives with you and needs coverage;

4. Policy numbers for any current health insurance plans covering people who live in your home; and

5. If you or someone in your household is eligible for insurance coverage through their employer, an Employer Coverage Tool will need to be completed.

To get more information about how to apply, visit www.healthcare.gov.

Will my employer offer exchange options or must I shop on my own?

Some employers may sign up with a Marketplace plan. You should check with your employer for more information.

Do I have to pay someone to help me get Marketplace insurance?

No. No one should charge to give you help - it’s against the law!

What are the costs of Marketplace plans?

Each health plan has its own premium costs and co-pays. Your cost may be less after you put in your financial information. When you apply (starting 11/01/2016) at www.healthcare.gov, you will be able to see the costs and copays for the health plans.

Must I buy health insurance from the Marketplace if I do not have insurance now? 

We encourage every Marketplace eligible person to buy insurance. When you apply, we will help you get information about the insurance plans and your choices in the Marketplace.

What if I can’t afford to purchase insurance?

You may qualify for help to pay your insurance premiums through the federal government. Harris Health Eligibility Centers can help you find out if you qualify.

What if I still do not purchase coverage?

Without insurance, most people will be charged a tax penalty of at least $695 by the Internal Revenue Service (IRS). For each year that you are not covered the penalty will increase.

Which Marketplace plans will Harris Health accept?

The list below lists all of the Marketplace Plans Harris Health currently accepts.

 Insurance Company Name Metal Level Plan Type

Blue Cross and Blue Shield of Texas

All Levels

HMO

Cigna Healthcare

All Levels All

Community Health Choice

All Levels All

Molina Marketplace

All Levels All

 

If you select a plan that Harris Health does not accept, we will not be able to provide your care.

What services will the Marketplace insurance cover?

Each Marketplace Plan may cover different services.  But, Essential Health Benefits and Preventive and Wellness services must be in all plans. Look at the plans on line at www.healthcare.gov.

Do Marketplace plans require that my doctor refer me to a specialist for it to be covered?

Each plan is different. Look at the plan you choose to see if a referral will be needed. Referral and authorization requirements are not yet known and will vary by plan.

Where can I go to apply for Marketplace coverage?

Enrollment fairs sponsored by Harris Health will be held from November 1, 2016 – January 31, 2017. 

You can also go online to see the most current calendar of enrollment fairs across Harris County.

To get more information about how to apply, visit www.healthcare.gov.