Affordable Care Act Information

How to get insurance through the Affordable Care Act

If you do not have health insurance and want to enroll in the official Health Insurance Marketplace, which offers affordable options through major insurance companies, you need to sign up during open enrollment. For insurance coverage in 2015, the enrollment period was November 15, 2014-February 15, 2015.

You generally cannot buy Marketplace health coverage until the next open enrollment period (in fall 2015) unless you qualify for a special enrollment period. (Learn about special enrollment periods.)

Note: You may apply for Medicaid and the Children’s Health Insurance Program at any time. Learn more from Healthcare.gov.

Get covered

During open enrollment, you may shop for plans by phone, through a broker, at onsite enrollment locations or by using the online Health Insurance Marketplace, where you can easily compare plans. You may also compare plans on the Illinois health insurance exchange website, GetCoveredIllinois.gov.

Help is available from Loyola Medicine, by calling (800) 424-6309, as well as from others in your community. We're here to help you understand the law and how to select the right plan for you and your family.

If you do not have insurance, the law states you will have tax penalties.

Plan ahead to shop for insurance in time to have coverage for all of the next year. For example, in order to have received coverage by January 1, 2015, you would have needed to enroll in your plan by December 15, 2014. Last year, open enrollment began in November.

Stay Covered

If you bought a health plan through the Marketplace, you probably will be automatically enrolled for the next year. If you don’t take any action, your coverage most likely will start January 1. Close to that date, your health insurance company will let you know if you will be enrolled automatically.

Even if you will be automatically re-enrolled, Get Covered Illinois recommends reviewing your plan.

You must update the information you provided on your Marketplace application, such as your income, who's in your household and whether you are offered health insurance coverage through a job. This is true even if you accept your automatic enrollment. If your income has risen or your household size has changed and you do not report these changes, you may owe money when you file your tax return. Learn more about reporting changes.

How to enroll

There are several ways to sign up or learn about your options:

  • Online: Shop for coverage at GetCoveredIllinois.gov.
  • On the phone: Call our Affordable Care Act information line to speak with Loyola counselors, (800) 424-6309.
  • In person: Meet with an expert at an event in your community. Visit Get Covered Illinois' event list, or call (708) 240-4435 for locations and times.

Choosing a plan

Through the Marketplace, you will be able to choose between different levels of healthcare plans, from a variety of approved insurance providers. Each will have different amounts of coverage and different monthly premiums. Only one simple application is required.

When you compare plans, you will be able to see which hospitals are included in each. By choosing a plan that allows you to get care from Loyola physicians and hospitals, you will have the peace of mind that comes with choosing healthcare you know and trust. Loyola is affiliated with several plans offered through the insurance marketplace, including:

  • Blue Cross PPO
  • Blue Cross Choice
  • Blue Precision
  • Land of Lincoln Preferred
  • Co-Options Land of Lincoln National
  • Land of Lincoln Freedom
  • Humana Choice POS
  • Humana Chicago HMOx
  • United HealthCare Compass

If you have additional questions, send us an email at LUMCHIXInfo@lumc.edu or call us at (800) 424-6309.

Financial assistance calculator

The ACA gives millions of individuals with too little or no insurance access to health plans at different cost levels. The law also provides financial assistance to those who qualify based on family size and income. For example, an individual earning up to $45,900 a year, or a family of four earning up to $94,200 a year, may qualify for a reduction of their monthly premiums, or a tax credit at the end of the year. This subsidy calculator will give you a good idea of how much assistance will be available.

Once you apply at the Health Insurance Marketplace, you will find out the amount of financial assistance for which you may be qualified, including whether you're eligible for Medicaid.

What do the plans cover?

Coverage includes doctor visits, hospital stays, wellness care, prescriptions, emergency services, maternal and newborn care, pediatric care 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 cost to patients. Also, patients cannot be turned away because of pre-existing conditions.  

Resources

  • GetCoveredIllinois.gov. This is the Illinois health insurance marketplace site.
  • GetCoveredIllinois hotline, (888) 809-2796. This help desk answers questions about signing up for insurance and Medicaid, shopping for insurance plans and finding an informational event.
  • Healthcare.gov. This is the federal government website with links to the health insurance exchanges offered across the country.
  • LUHS help desk, (800) 424-6309. Loyola counselors will answer questions about signing up and shopping for insurance.
  • Cost and financial aid calculator. This tool developed by Kaiser Family Foundation calculates what insurance may be available to you.