Marketplace Insurance in Illinois: What You Need to Know

For most people, healthcare costs can be a significant burden on their budget. In Illinois, the Affordable Care Act (ACA) has made it possible for people to access affordable health insurance through the healthcare marketplace. In this article, we will discuss all the essential information about marketplace insurance and how it works in Illinois.

What is Marketplace Insurance?

Marketplace insurance, or also known as health insurance exchange, is a platform that provides a place for people to compare and purchase health insurance plans. It was established by the ACA to help individuals, families, and small business owners find health insurance plans that fit their budget and meet their coverage needs. In Illinois, the marketplace is called Get Covered Illinois.

How Does It Work?

The healthcare marketplace operates based on the principle of risk pooling. It offers a variety of health insurance plans from different insurers, and they are offered on a tiered system based on their coverage and pricing. It offers four different coverage levels: bronze, silver, gold, and platinum. The higher the metal level, the more the plan covers and the higher the monthly premiums.

Individuals and families can choose the level of coverage they want and their preferred insurer. They can also apply for financial assistance to help pay for their premiums and out-of-pocket expenses.

Who is Eligible?

Anyone can purchase health insurance through the marketplace, but to be eligible for financial assistance, you must meet certain criteria. You must be a U.S. citizen or legal resident, not have access to affordable employer-sponsored coverage, and have an income between 100% and 400% of the federal poverty level (FPL). In 2021, the FPL for an individual is $12,880 and for a family of four is $26,500.

How to Enroll in Marketplace Insurance in Illinois?

Enrolling in marketplace insurance in Illinois is a simple process. You can enroll online, by phone, or in-person through a certified enrollment counselor. Here is a step-by-step guide on how to enroll:

Step 1: Create an Account

The first step is to create an account on the Get Covered Illinois website. You will need to provide some basic information about yourself, including your name, address, and Social Security number.

Step 2: Fill Out the Application

Fill out the application with information about your household size, income, and any health insurance coverage you currently have. This information will determine whether you are eligible for financial assistance and what type of plans you qualify for.

Step 3: Review Your Plan Options

After submitting your application, you will be presented with plan options from various insurers. Compare the plans based on their coverage, monthly premiums, and out-of-pocket expenses to find the one that suits your needs and budget.

Step 4: Select Your Plan

Once you have reviewed all the options, select the plan that you want to enroll in. You will need to provide your payment information and sign the agreement to confirm your enrollment.

Step 5: Confirmation

After enrolling, you will receive confirmation of your coverage from your insurer. You can also log in to your account on Get Covered Illinois to view your plan details, make changes to your coverage, and pay your premiums.

FAQs

1. What is the Open Enrollment Period?

The Open Enrollment Period is a period when individuals can enroll, renew or change their marketplace insurance coverage. In Illinois, the Open Enrollment Period usually runs from November 1 to December 15 every year.

2. What is the Special Enrollment Period?

The Special Enrollment Period is a period outside of the Open Enrollment Period when individuals can enroll, renew or change their marketplace insurance coverage if they experience a qualifying life event such as losing their job, getting married, or having a child.

3. What type of financial assistance is available?

There are two types of financial assistance available: premium tax credits and cost-sharing reductions. Premium tax credits lower your monthly premiums, while cost-sharing reductions lower your out-of-pocket expenses, such as deductibles, copayments or coinsurance.

4. What happens if I don’t have health insurance?

If you don’t have health insurance, you may face a penalty when you file your taxes. The penalty is calculated as a percentage of your income or a flat rate, whichever is higher.

Conclusion

Marketplace insurance provides an affordable option for people who need health insurance coverage. If you live in Illinois and want to enroll in marketplace insurance, visit the Get Covered Illinois website to learn more about your options and eligibility for financial assistance.