Pennie, the state's new health insurance marketplace, recently extended the enrollment period from Tuesday, December 15 to Tuesday, December 22 for Pennsylvanians to have the health care coverage they need starting January 1, 2021. After December 22nd, consumers have until Friday, January 15th to enroll, but that coverage would not begin until February 1, 2021.
Pennie was rolled out on Nov. 1 with no major glitches and has been working well. About 300,000 people have signed up for coverage as of late this week — similar to the pace of when Pennsylvanians used the federal exchange. Uncertainty over the future of the Affordable Care Act, which was enacted in 2010 and which the U.S. Supreme Court took up in November, should not deter anyone from getting insured through Pennie.
PHLP has answered some of the most asked Pennie questions:
Q: Who can enroll in Pennie?
A: Pennie was designed for state residents who are US citizens or legal US residents, and do not have access to health insurance through a private company, their workplace, a family member’s employer, or a government program, such as Medicare or Medical Assistance (Medicaid). If you are not covered through one of these options, you can buy health insurance through Pennie.
Q. What is a special-enrollment period?
A: A special-enrollment period is also known as a qualifying event, such as loss of insurance coverage, marriage or birth of a baby or adoption of a child. When an individual experiences a qualifying event, they can sign up for health insurance outside of the open enrollment period.
Q: What health plans are available?
A: The coverage available through Pennie comes from the state’s major health insurers, including its Blue Cross-Blue Shield plans, UPMC, Geisinger, and others. Throughout Pennsylvania, you have a choice of buying insurance from at least two insurers depending on where you live.
Health insurance plans are sold in four primary levels of coverage: Bronze, Silver, Gold and Platinum. Plans vary. You have the option to pay more for your monthly premium and less when you use care or pay less for your monthly premium and more when you use care. In addition to these metal-tiered plans, a minimum coverage plan is available to people younger than 30.
Q: What if I cannot afford the health insurance premiums or other costs?
A: Sliding-scale financial assistance is available if you cannot afford to pay the full cost of your premiums. Depending on your income and household size, you may qualify for government subsidies to help keep your out-of-pocket expenses down, including copayments, or tax credits to help reduce your monthly premiums if you cannot afford to pay for your full costs. Pennsylvanians with limited incomes may be eligible for Medical Assistance (Medicaid).
Q: What will Pennie’s health insurance cover?
A: The Affordable Care Act requires that all newly purchased insurance plans, including those on Pennie, cover what is known as essential health benefits: doctor visits, hospitalization, emergency care, maternity care, pediatric care (including dental and visual coverage), preventive and wellness services and chronic disease management, rehabilitative services, mental health and prescriptions. Insurance companies cannot deny access or charge higher premiums if you have a pre-existing health condition or become ill. Dental and vision coverage for adults are offered separately from health insurance plans.
Q: Where can I get help enrolling in Pennie?
A: You may enroll for health coverage through Pennie online or by phone. Because of the COVID pandemic in-person assistance is limited. Pennie’s website provides links to certified counselors and insurance brokers trained in Pennie’s insurance plans. Visit Pennie’s website: www.pennie.com or call 1-844-844-8040.