Pennsylvania’s ACA market places closes Jan. 15

There are only a few days left to sign up for health insurance through Pennsylvania’s Affordable Care Act marketplace. The deadline to enroll in Obamacare plans through Pennie, the commonwealth’s exchange, is Jan 15.

Individual and family plans sold through Pennie are intended for people who do not have health insurance through work and do not qualify for government insurance programs such as Medicare and Medicaid.

About 362,000 Pennsylvania residents have already signed up for health insurance plans through Pennie during this year’s open enrollment period, said Zachary Sherman the marketplace’s executive director.

“We expect that we’ll see a good influx of folks coming in, signing up last minute,” he said.

New Jersey residents have a little extra time. Get Covered NJ will be open until Jan 31.

What do plans on Pennie cover?

All plans sold through health-care marketplaces like Pennie and Get Covered NJ must meet specific requirements under the ACA.

These include the 10 essential health benefits:

  1. Outpatient care

  2. Hospitalization

  3. Emergency care

  4. Pregnancy- and birth-related care

  5. Mental and behavioral health

  6. Prescription drugs

  7. Rehabilitative services and devices

  8. Lab work

  9. Preventative care as well as management of chronic care

  10. Pediatric care, including dental and vision

All plans also cover birth control.

Will I get financial assistance?

It’s likely, but the amount varies.

Tax credits are based on income and ensure that no one pays more than 8.5% of their income for a “silver” plan. (Plans are ranked by “metal level.” Bronze plans have the lowest monthly premium and highest out-of-pocket costs, platinum has the highest premiums, and silver plans fall in the middle.)

Sherman said that about 90% of people who enroll get assistance at a value of over $500 per month on average.

What if I have very expensive insurance from work?

Until this year, the ACA’s “family glitch” meant that people who had expensive employer-based insurance were unable to sign up family members through the marketplace. The IRA changed that this year. If the cost of health insurance for the entire family through an employer is more than 9.6% of income, you could be eligible for a subsidized plan through the marketplace.

Where do I sign up?

Pennsylvania residents should visit Pennie (pennie.com) or call 1-844-844-8040. The phone line will be open on Sunday, the last day of enrollment, from 8 am until the midnight deadline.

New Jersey residents should visit Get Covered NJ (getcovered.nj.gov) or call 1-833-677-1010.

You can browse plans with only your zip code, but you will need to provide additional information such as income and number of household members to get precise prices.

People who live in a state that does not have its own marketplace use healthcare.gov.

What if I miss the deadline?

Sherman urged people not to miss the deadline and to make sure they have access to the health care that comes with insurance, as well as protection from unforeseen medical and financial hurdles.

“We’re really focused on trying to get people to come through,” he said.

Special enrollment periods are available for people who lose insurance or have a change to their coverage needs during the year due to a job change, divorce, a birth, death of a family member, or an out-of-state move.

Outside of these circumstances, the best way to make sure that you and your family in Pennsylvania have insurance on Feb. 1 is to sign up before the Jan. 15 deadlines.

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