The New Law The Affordable Care Act (ACA) requires everyone legally living in the U.S. to have health insurance beginning January 1, 2014. It also gives millions of individuals with too little or no insurance, access to health plans at different cost levels. In addition, the law provides financial assistance to those who qualify based on family size and income.
You will be able to view plans at www.healthcare.gov, an online Health Insurance Marketplace, also known as an “Exchange,” where you can one-stop-shop for a plan that fits your budget and coverage needs.
You can also receive assistance from SJHS Health Insurance Services. Established to ensure access to healthcare services by reducing barriers for consumers, we are committed to serving the members of our community with dignity, compassion and integrity. We have assembled a team of highly skilled, multi-cultural insurance professionals to create an environment and support system in unison with state, local, federal and private agencies.
We’re here to help you learn about the law and how to select the right plan for you and your family. Schedule an appointment by calling 1.855.88.SJMED (75633) or request more information.
What Will the Plans Cover? Coverage includes doctor visits, hospital stays, wellness care, prescriptions, emergency services, maternal and newborn care, pediatric care and more. In fact, Ten Essential Health Benefits must be covered in every plan and certain Preventive Care services will be provided at NO additional cost to patients. Also, individuals who are not covered by Medicare cannot be turned away due to pre-existing conditions, as has been the case in the past.
Sign Up Begins in the Fall If you do not have health insurance or are not eligible for Medicare, you can sign up during open enrollment: from November 1, 2015 to January 31, 2016. (Medicare Annual Enrollment Period is October 15 - December 7.) You can shop for plans by phone, through an approved insurance broker, at on-site enrollment locations such as SJHS's Health Insurance Services, or at the online Health Insurance Marketplace, where you can easily compare benefits and costs. If you choose not to enroll for insurance, the law states that you will face tax penalties.
Take a few minutes to learn a little, or a lot, about the New Law.
Long Overview Video >
Short Overview Video
The Marketplace The Health Insurance Marketplace is available online, by phone, or through an approved insurance broker, and it's designed to make buying health coverage easier by comparing plans side by side, in simple language and with no fine print. You will be able to choose between four levels of health plans - Platinum, Gold, Silver, and Bronze - from a variety of approved insurance providers, and each will have different amounts of coverage and different monthly premiums.
SJHS Health Insurance Services offers three convenient locations staffed with licensed insurance agents:
Located at SJHS Mishawaka Medical Center off the Main lobby, next to Joe's Java 5215 Holy Cross Pkwy. Mishawaka, IN 46545
To schedule an appointment call 1.855.88.SJMED (75633) or contact us now for more information.
Learn more about the Marketplace in English or Spanish.
What is the Health Insurance Marketplace?
El Mercado de Seguros Medicos
Financial Assistance When you buy health insurance coverage in the Marketplace, you may be able to get a premium tax credit that lowers what you pay in monthly premiums. This will depend on your household size and income. . For example, an individual earning up to $45,900 a year, or a family of four earning up to $94,200 a year, will qualify for a reduction of their monthly premiums, or a tax credit at the end of the year. The calculator and chart on this page will give you a good idea of how much assistance may be available for you. Once you apply at the Marketplace, you will find out the exact amount of assistance you qualify for.
Financial Assistance Income Chart Look for your income and household size on this chart to see if you qualify for financial assistance.
Why Choose Us? When you compare plans, you'll be able to see which hospitals are included in each one. Make sure you choose a plan that includes Saint Joseph Health System so you'll always have the latest treatment options, leading-edge technology, and physicians from some of the nation's finest medical schools. Because when you treat the region's most critical patients, you're better at treating everything.