The Health Insurance Marketplace, a key part of the Affordable Care Act,
took effect in 2014. It’s a new way for individuals, families, and
employees of small businesses to get health coverage.
Important things to know about the Insurance Marketplace:
The Marketplace is a new way to shop for health insurance
coverage. A single, online source will help consumers get
information about their health coverage options. Pennsylvania’s
Marketplace is run by the federal government. Therefore,
Pennsylvania does not provide its own enrollment website.
Consumers should use www.healthcare.gov or
Consumers can make side-by-side comparisons of private insurance
plans’ benefits and price. They can also find out if they are
eligible for financial assistance to offset the cost of the
coverage. Consumers can also enroll for coverage online.
Open enrollment begins on November 15, 2014 and ends on February
15, 2015. Coverage can begin as soon as January 1, 2015. During
2015, the penalty for not having health insurance is $325 for an
individual and up to $975 for a family.
Health plans offered in a Marketplace generally will offer
comprehensive coverage, including this set of essential health
Ambulatory patient services
Maternity and newborn care
Mental health and substance disorder services,
including behavioral health treatment
Rehabilitative and habilitative services and
Preventive and wellness services and chronic
Pediatric services, including oral and vision
Nobody can be turned away or charged more because of a
Individuals will be able to choose a Marketplace plan by health
plan category (bronze, silver, gold or platinum). The
differences among the categories will be based on the average
percentage of the costs the plan will cover.
Using a single application on www.healthcare.gov,
(www.CuidadoDeSalud.gov) consumers can find out if they and/or
their family members are eligible for Medicaid, the Children's
Health Insurance Program (CHIP) or for financial help paying for
a private health insurance plan offered in the Marketplace.
Main Line Health has Certified Application Counselors who can
also assist with questions. Contact Financial Counseling
Department at (484)596-1783.
If I have Medicare, do I need to do anything?
No. Medicare isn’t part of the Marketplace. If you have Medicare, you’re
covered and don’t need to do anything about the Marketplace.
The Marketplace won’t affect your Medicare choices or benefits. No
matter how you get Medicare, whether through Original Medicare or a
Medicare Advantage Plan (like an HMO or PPO), you won’t have to make any
For more information, call 1.866.CALL.MLH.