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Health insurance is a big concern for many Illinois residents. We are still in a global pandemic, and while the economy is recovering many people remain worried about the uncertainty ahead.

The good news is that the Affordable Care Act open enrollment period is happening now through January 15, 2022. During this period, you can get both yourself and your family covered.

Planned Parenthood of Illinois can help you navigate all of the available choices and find the health insurance plan that best fits your needs. To address some frequently asked questions, we are turning to our enrollment specialist, Jan Dowers.

Q. How do you help people get health insurance?

As an enrollment specialist, I am a certified application counselor for the ACA. If someone comes to a PPIL health center seeking help, or shows up for an appointment without health insurance, they are referred to me or another enrollment specialist on the team. We then sit down and help them navigate their options to find the best health insurance solution for their situation.

Q. How can people get health insurance through the ACA?

When the ACA passed, Illinois took the opportunity to expand Medicaid coverage to more people statewide. This expansion allowed adults between the ages of 19 and 64 years old, with a certain income level, to get health insurance through Medicaid.

Today, an individual person in Illinois who makes $1,481 per month or less before taxes can qualify for Medicaid. If they are above that income level, they can still get health insurance, but they won’t qualify for Medicaid. Instead, they can purchase a private health insurance plan through what is known as the health insurance marketplace. The market is a collection of regulated health insurance plans that can make it more affordable for people to buy individual health insurance. 

Everyone’s circumstances are different. My job is to help folks figure out the best option for them.

Q. Why should someone get health care insurance?

If a PPIL patient needs family planning services, we offer sliding-fee scale services for people who are uninsured. Our mission is to serve everyone who needs care.

But what if that patient faces an unexpected emergency, like a car accident or a cancer diagnosis? They could be saddled with enormous medical bills and debilitating, lifelong debt. If you sign up for a health insurance plan now during open enrollment, you can worry less. Unexpected emergencies will be covered, and you can even get dental and vision benefits. Being insured is very important for overall health and well-being.

Recently, I helped a patient who did not have health insurance, but had very high blood pressure. The PPIL clinician felt they should go to the emergency room, but the patient was afraid of the cost. Although the patient was not eligible for Medicaid at that moment, their financial situation was on the verge of changing so I knew there was a possibility Medicaid could backdate their eligibility to cover her bills. Because of this, I advised the patient to follow our clinician’s advice to get the care they needed. When the patient returned for their 4-week follow up appointment with us, we were able to sign them up for Medicaid. And because their income level had changed in the last 30 days, Medicaid covered the cost of the emergency room visit. Now, moving forward, they are able to manage their hypertension proactively and not have to wait to be seen until they are so sick they have to go to the hospital.

Q. I’d like to sign up for health insurance, but the process is very confusing. Can you help?

You can learn more about open enrollment at healthcare.govGetCoveredIllinois.gov and GetCoveredAmerica.org also offer a lot of valuable information. 

You can also email or call us directly at [email protected] or (877) 520-7745. We are happy to help!

Tags: Obamacare, Obamacare Works, ACA, health insurance, openenrollment