Starting Tuesday, October 1, 2013, healthcare.gov, will be the guide to the uninsured, those who have been denied coverage in the past, or those who want to look at options. The site will ask for information, including age and income and will then give a list of possible insurance coverage plans.
“That's where Illinois consumers can get information about their new healthcare coverage options and answer a few simple basic screening questions that will either access their eligibility for the Marketplace and Medicaid and then will be directed to the right place,” said Jennifer Koehler, Executive Director of Get Covered Illinois.
There are different levels of plans and payments—bronze, silver, gold, or platinum. Bronze will have lower premiums, but higher out of pocket costs.
According to information from the Iowa Insurance Division, with Bronze, the plan pays, on average 60%, while the consumer pays 40%. With the Silver plan, the plan will pay, on average, 70%, while the consumer will pay 30%. The Gold plan covers, on average, 80% and the consumer will pay 20%. With the platinum plan, the plan covers, on average, 90%, while the consumer pays 10%.
"People need to be aware. They need to look into all the options that they have,” said Austin Bird, Government Relations Coordinator for Genesis Health System.
Plans offered in the individual and small group market, in and out of the Health Insurance Marketplace, will have to offer essential health benefits. According to healthcare.gov, those benefits must include items and services within at least the following 10 categories: ambulance services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehab and habilitative services and devices; lab services; preventive and wellness services and chronic disease management; and pediatric services.
“There will be minor differences with any health plan, but the majority, the key parts of health care coverage will remain the same,” said Bird.
For both Iowa and Illinois, the deadline to enroll for coverage is March 31, 2014. If someone enrolls by December 15, 2013, coverage will start January 1, 2014. If someone is not covered by the end of 2014, they will face a fine of $95 or 1% of their income, whichever is greater. The fee increases every year. If you already have insurance, you do not need to worry about this.
You can enroll for coverage online or get help through a help desk or in person. The number to healthcare.gov is 1-800-318-2596 and someone will be available 24 hours a day, seven days a week. For GetCoveredIllinos.gov, the number is 1-866-311-1119. Someone will be available at that number seven days a week from 8 a.m. to 8 p.m.
There are trained navigators to help people through all of this information. Enroll Quad Cities, run by Genesis Health Systems will hold several events to help with enrollment.