Health Insurance Marketplace


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The Health Insurance Marketplace is Reopening


Special enrollment period: Feb. 15 – May 15, 2021

During this time of economic distress and displacement, the Health Insurance Marketplace will reopen for a special enrollment period beginning Feb. 15, 2021 and lasting through May 15, 2021. This will provide more Americans with immediate access to affordable health care coverage.

Mount Carmel encourages all who are uninsured or underinsured, including those who have lost employer-sponsored health insurance, to turn to HealthCare.Gov for assistance. The marketplace is trusted and appreciated by the 11.4 million Americans who currently use it to select their health insurance policies.

Mount Carmel is committed to the principle that healthcare is a basic human right and that all Americans should have access to high-quality, comprehensive health care. Trinity Health contracts with multiple marketplace insurers in each of our markets. More than 10 percent of the commercially insured people we serve in our communities purchase their health insurance from the marketplace. Additionally, we support reopening the marketplace, as it will expand opportunity for communities hardest hit by COVID-19 and is a critical step toward achieving racial equity.

If you need health insurance, help is here.

Learn More

Health Insurance Provides Peace of Mind

Having health insurance reduces or eliminates your risk of facing major expense if you or a family member suffers from an illness or injury.

Health insurance can be affordable. For some, government subsidies offset the cost of insurance. Others may be eligible for Medicaid when previously they were not. Avoiding penalties for not having insurance should be a factor too. Most importantly, health insurance provides peace of mind.

For millions of uninsured or underinsured people, the Health Insurance Marketplace allows you to compare plans to find one that fits your budget and coverage needs. Based on income and family size, you may even qualify to receive financial assistance when purchasing these plans.

What Will the Health Insurance Marketplace Plans Cover?

All plans include coverage for doctor visits, hospital stays, wellness care, prescriptions, emergency services, maternity and newborn care, pediatric services, laboratory services, rehabilitative services and devices, and mental health and substance use disorder services. Plans can also offer benefits like vision, dental, or medical management programs for specific diseases or conditions.

Health insurance Marketplace plans fall into four categories – Bronze, Silver, Gold, Platinum. Each plan has its own monthly and out-of-pocket costs:

  • Bronze covers 60% of the total average costs of care
  • Silver covers 70% of the total cost of care
  • Gold covers 80% of the total cost of care
  • Platinum covers 90% of the total cost of care

The Special Enrollment Period Begins February 15, 2021

If you do not have health insurance, you can sign up for 2021 coverage during a special open enrollment, February 15, 2021 - May 15, 2021. You can shop for plans by phone, through a broker, or at the online Marketplace, where you can compare benefits and costs easily.

If you currently uninsured, you should sign up for health coverage. With health insurance, you will be covered for things like doctors' visits and prescription medicines, which are not covered now – and may not be covered when your coverage ends.

If you are interested in more information, call [Ministry Specific Phone Number] to speak with someone who can help direct you.

You can also visit Healthcare.gov for additional information.

Financial Assistance

A surprisingly large number of people qualify for financial help when buying health insurance through the Marketplace. By using one of the calculators available, you can estimate how much assistance you could obtain—before you even visit the Marketplace site (www.HealthCare.gov). However, only the Marketplace will let you know the exact assistance you can expect.

Financial Assistance Calculator

This tool offered by Healthcare.gov provides a quick view of income levels that qualify for savings. Certain individuals may qualify at different levels. You’ll learn your exact savings and plan prices when you fill out a Marketplace application.

Financial Assistance Calculator

Another calculator option, from the Kaiser Family Foundation, is found below:

This tool developed by the Kaiser Family Foundation estimates health insurance premiums and subsidies for people purchasing insurance in the Marketplace.

Enter different incomes, ages, and family sizes to estimate your eligibility for subsidies and how much you could spend on health insurance:

 


 

2021 Financial Assistance Income Chart

Look for your income and household size on this chart to see whether you qualify for financial assistance when purchasing health insurance.

Household Size 100% 133% 150% 200% 300% 400%
1 $12,760 $16,971 $19,140 $25,520 $38,280 $51,040
2 $17,240 $22,929 $25,860 $34,480 $51,720 $68,960
3 $21,720 $28,888 $32,580 $43,440 $65,160 $86,880
4 $26,200 $34,846 $39,300 $52,400 $78,600 $104,800
5 $36,080 $40,804 $46,020 $61,360 $92,040 $122,720

Be Sure to Pick a Plan that Includes [Ministry Name] in Its Network

When you compare plans, you'll be able to see which hospitals are included in each one.

Be sure to choose a plan that includes [Ministry Name] in its network so you'll always have the latest treatment options, leading-edge technology, and the region's top-rated and most experienced physicians offering care centered around you and your needs.

To learn more and find a plan right for you, call [Ministry Specific Phone Number] to speak to someone who can help direct you.

Preventive Care Services

All marketplace plans must cover the following list of preventive services without charging you additional fees (copayment or coinsurance), even if you haven't paid your yearly deductible. However, you must receive these services from a healthcare provider in your network. Screenings are also available based on certain criteria and conditions.

Preventive Screenings For All Adults

  1. Abdominal aortic aneurysm one-time screening
  2. Alcohol misuse screening and counseling
  3. Aspirin use
  4. Blood pressure screening
  5. Cholesterol screening
  6. Colorectal cancer screening
  7. Depression screening
  8. Diabetes (Type 2) screening
  9. Diet counseling
  10. HIV screening
  11. Vaccines and immunizations
  12. Obesity screening and counseling
  13. Sexually transmitted infection (STI) prevention counseling
  14. Syphilis screening
  15. Tobacco use screening

Preventive Screenings For Women

  1. Anemia screening
  2. Breast cancer genetic test counseling (BRCA)
  3. Breast cancer mammography screenings
  4. Breast cancer chemoprevention counseling
  5. Breastfeeding comprehensive support and counseling
  6. Cervical cancer screening
  7. Chlamydia infection screening
  8. Contraception
  9. Domestic and interpersonal violence screening and counseling
  10. Folic acid supplements
  11. Gestational diabetes screening
  12. Gonorrhea screening
  13. Hepatitis B screening
  14. HIV screening and counseling
  15. Human papillomavirus (HPV) test
  16. Osteoporosis screening
  17. Rh incompatibility screening
  18. Sexually transmitted infection (STI) counseling
  19. Syphilis screening
  20. Tobacco use screening and interventions
  21. Urinary tract or other infection screening
  22. Well-woman visits

Preventive Screenings For Children

  1. Alcohol and drug use assessments for adolescents
  2. Autism screening
  3. Behavioral assessments
  4. Blood pressure screening
  5. Cervical dysplasia screening
  6. Depression screening
  7. Developmental screening
  8. Dyslipidemia screening
  9. Fluoride chemoprevention supplements
  10. Gonorrhea-preventive medication
  11. Hearing screening
  12. Height, weight and body mass index measurements
  13. Hematocrit or hemoglobin screening
  14. Hemoglobinopathies or sickle cell screening
  15. HIV screening
  16. Hypothyroidism screening
  17. Immunization vaccines
  18. Iron supplements
  19. Lead screening
  20. Medical history
  21. Obesity screening and counseling
  22. Oral health risk assessment
  23. Phenylketonuria (PKU) screening
  24. Sexually transmitted infection (STI) prevention counseling and screening
  25. Tuberculin testing
  26. Vision screening