Health Insurance Marketplace

What is the Health Insurance Marketplace?

Health Insurance MarketplaceOn March 23, 2010, President Obama signed the Affordable Care Act into law. The law made several changes to health insurance in the United States. One of those changes is the creation of new Health Insurance Marketplaces in each state. All Americans, with a few exceptions, will be required to have health insurance starting January 1, 2014.

The Marketplace is the one-stop-shop for finding individual health insurance. Starting October 1, 2013, you will be able to compare and purchase coverage options, apply for help paying for insurance, and enroll in Medicaid and CHIP. The Marketplace in West Virginia and Pennsylvania can be accessed by visiting HealthCare.gov.

What coverage can I get?

Medicaid

Medicaid is health insurance for individuals and families with low income. People eligible for Medicaid can be enrolled with no monthly premium payment and low or no co-pays. Under the Affordable Care Act, Medicaid was expanded to cover millions of Americans that otherwise would not be able to afford insurance. Some states have opted not to expand Medicaid coverage, though.

In West Virginia, Medicaid is available for all individuals earning less than 138% of the federal poverty level. Pregnant women and infants under 1 year old are eligible with incomes under 155% of the federal poverty level.

In Pennsylvania, Medicaid is available for pregnant women and infants under 1 year old earning less than 215% of the federal poverty level, children in families up to 157% of the poverty level, and adults under 138% of the poverty level.

To sign up for Medicaid, or for more information, visit HealthCare.gov or call our Certified Application Counselor at (304) 432-8211. Certain other groups may also be eligible for Medicaid in certain circumstances. Your local county assistance office can provide more information.

Children's Health Insurance Program

The Children's Health Insurance Program (CHIP) is a program that provides insurance to children in low income families who do not qualify for Medicaid. Families under 200% of the poverty level receive CHIP coverage with no monthly premium. Families between 200% and 300% of the federal poverty level pay a reduced amount for the coverage. CHIP coverage may also be available with no discount for families above these levels as well.

To apply for CHIP or get more information, visit HealthCare.gov or call our Certified Application Counselor at (304) 432-8211.

A child with a cast

Qualified Health Plans

The new Health Insurance Marketplace will offer qualified health plans for individuals and small businesses. People at any income level are able to purchase coverage through the Marketplace. All coverage offered in each state's Marketplace will be comprehensive.

The Marketplace will offer help paying premiums and co-pays to families with low income. Cost-sharing reductions are available for families under 250% of the federal poverty level. Premium assistance is available for families under 400% of the poverty level.

To find a qualified health plan, apply for help with premiums and co-pays, or get more information, visit HealthCare.gov or call our Certified Application Counselor at (304) 432-8211. Qualified health plans can also be bought outside the Marketplace, (through insurance agents, etc.) but help with premiums and copays is only available through the Marketplace.

What about Medicare?

Medicare is a great benefit of turning 65. There are, however, many choices to make when signing up for Medicare. Should you choose traditional Medicare or a Medicare Advantage Plan? Should I have a plan that includes prescriptions or get a separate plan?

Even though there are so many questions, finding coverage can be easy. Visit the Medicare Plan Finder to search and compare plans available.

For low income seniors, help paying Medicare premiums may be available. For information on the help available, call us at (304) 432-8211 in Blacksville and (304) 775-4671 in Burton.

What if I need help?

Our full-time Certified Application Counselor can help you find coverage through the Health Insurance Marketplace. Jason Whipkey is available to meet with patients both our Blacksville and Burton locations.

Call us at (304) 432-8211 in Blacksville or (304) 775-4671 in Burton to schedule a meeting.

What insurance do you accept?

The mission of the Clay-Battelle Health Services Association is to provide quality comprehensive health care to residents of our service area without regard to their ability to pay. Part of that commitment is accepting a wide range of health plans. Below are some of the many health plans that we accept. If you have questions regarding your specific plan's coverage and network, contact your health insurer.
Aetna logoDelta Dental logoCigna logoThe Health Plan logoMultiPlan logoUnited Concordia logoUnicare logoHighmark Blue Cross Blue Shield logoHumana logoUnited Healchcare logoCoventry & HealthAmerica logoWV PEIA logo