Health Insurance Marketplace

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Open Enrollment ended December 15, 2017

Special Enrollment Period

You may still be able to apply for a Special Enrollment Period if you have any of the following “life events”.

– Marriage
– Having a baby or adopting a child
– Moving to a different state
– Gaining citizenship
– Leaving incarceration
– Losing health coverage due to losing a job, divorce, individual policy ending or aging off a parent’s plan.

You can apply for MaineCare at any time during the year.

About the Marketplace

The Marketplace helps individuals, families and small business to find and buy health insurance coverage. Before you enroll, you will be provided with a clear picture of the premiums you will pay and the benefits and protections you will receive. You may be eligible for Tax Credits to help pay the monthly premiums. Coverage through the Marketplace will be based on income, household size, age and tobacco use. You can not be denied coverage or charged more because you have a pre-existing condition. Dependents can stay on their parent’s plan until they are 26 years old.

 Who is eligible for the Marketplace health coverage?

Many people may be eligible for Marketplace coverage. To receive coverage through the Marketplace, you:

– Must live in the United States
– Must be a U.S. citizen or U.S. national (or be lawfully present)
– Cannot be incarcerated

Most people also qualify for a Premium Tax Credit. An individual’s yearly income needs to be above $12,140 and for a family of 4, it needs to be above $25,100 yearly.

How can I get help?

The Marketplace will offer several kinds of assistance to help you apply for coverage and choose a plan that meets your needs.

– Online questions and answers (healthcare.gov)
– Online chat (healthcare.gov)
– A toll-free call center (1-800-318-2596, 24 hours a day, 7 days a week)
– People in your community trained to help you apply and enroll (SVHC Certified Application Counselors)

Who is already considered covered?

If you are covered by any of the following, you are considered covered and don’t have to pay a penalty.

– Any Marketplace plan, or any individual insurance plan you already have
– Medicare
– Medicaid
– The Children’s Health Insurance Program (CHIP)
– TRICARE (for current service members and military retirees, their families, and survivors)
– Veterans Health Care Programs (including the Veterans Health Care Program, VA Civilian Health and Medical Program (CHAMPVA), and Spinal Bifida Health Care Benefits Program)
– Peace Corps Volunteer plans

Other plans may also qualify. Ask your health coverage provider.

What if I don’t have coverage?

People who do not have coverage that qualifies as minimum essential coverage may have to pay a penalty. They will also have to pay the entire costs of their medical treatment throughout the year. There may be exemptions from this penalty and it is important to see if you qualify.

Who do I contact?

If you have questions or want to see if you qualify for Marketplace insurance, please contact our Certified Application Counselor:

Outreach & Enrollment Specialist

 (207) 625-2239