Getting Covered

Do you have questions on how the new health insurance Marketplace works? We have answers! The Commonwealth Institute, with the help of Consumers for Affordable Health Care, produced this short, easy-to-understand video to help consumers get covered.

Through the Marketplace, you can compare prices and benefits in one place. You can also see which plans your doctor accepts and what prescription drugs are included. All plans must cover the ten “essential health benefits” listed below:

• Ambulatory patient services
• Emergency services
• Hospitalization
• Maternity and newborn care
• Mental health and substance abuse disorder services, including behavior health treatment
• Prescription drugs
• Rehabilitative and habilitative services and devices
• Laboratory services
• Preventive and wellness services and chronic disease management
• Pediatric services, including oral and vision care

The Marketplace also makes coverage more affordable. If you cannot get affordable coverage through your employer or a public program like Medicaid, you may be eligible for tax credits that will lower your monthly premium. If you choose a “silver” plan, you may also be eligible for additional cost-sharing subsidies to help pay for other out-of-pocket expenses for care that aren’t fully covered by your insurance plan.

Finally, you cannot be denied insurance if you have a pre-existing condition, lose coverage if you get sick, or pay more because of your health status.

You can visit the Marketplace at healthcare.gov to find a plan that works for you. If you have difficulty applying for coverage online, try calling the Marketplace at 1-800-318-2596 for assistance. To locate in-person assistance in Virginia, visit enroll-virginia.com.

Health insurance can be complicated, so don’t get discouraged if you need help. Remember, if you need health insurance, now you can get it.

–Ben Paul, Program Assistant