AARP Pennsylvania State President Joanne Grossi provides important health insurance information
The open enrollment deadline for health insurance has been extended to August 15.
On March 11, President Joe Biden signed into law the American Rescue Plan Act of 2021, a bill to speed up the United States’ recovery from the economic and health effects of the COVID-19 pandemic and ongoing recession.
As part of the many elements of the bill, the federal government mandated that the open enrollment deadline for any Health Insurance Marketplace be extended to August 15.
In the state of Pennsylvania, most individuals can apply for health insurance through Pennie, the state’s Affordable Care Act marketplace.
“This is really important, people should know that if you don’t have health insurance right now, it is worth your time to apply,” said Joanne Grossi, AARP Pennsylvania State President.
Through Pennie, you can estimate costs and sort through various plan options that are available.
Insurance plans are organized into four metal tiers, and are differentiated by the amount paid for the monthly premium, as well as the deductibles and copayments for each medical care visit and/or medical service provided.
“The best plan is going to be determined by your health status and income,” said Grossi.
The metal tiers are: bronze, silver, gold and platinum.
- Bronze plans have the lowest monthly premiums and the highest deductibles and copays, and cover roughly 60 percent of care costs. They’re designed to help you in case of a catastrophic event, serious illness or injury.
- Silver plans have moderate monthly premiums, deductibles and copays. They cover roughly 70 percent of costs. They’re the only plans eligible for cost-sharing subsidies.
- Gold plans have higher monthly premiums and lower deductibles and copays, and cover roughly 80 percent of care costs.
- Platinum plans have the highest monthly premiums and the lowest deductibles and copays, and cover roughly 90 percent of care costs. These are for people who have significant health care needs and are willing to pay the highest premiums.
“If you’re a healthy 25-year-old, a bronze plan might be great for you… [however] you’re taking a chance that if something catastrophic happens, you’re going to have high co-pays and deductibles,” added Grossi. “If you’re a 55-year-old with diabetes or a history of cancer or something, you probably want the gold plan because it’s much more coverage and fewer deductibles and copays.”
Through the American Rescue Plan, an increased level of financial assistance will be available for many in the state through 2022. Roughly 80% of those who apply will likely receive some type of financial assistance, which is determined based on family size and income.
Most people already enrolled in the marketplace are likely to see their premium costs go down.
Grossi noted that those who are receiving unemployment benefits after losing their job and subsequently their healthcare, are eligible to receive the highest amount of financial assistance.
The COVID-19 pandemic has brought to light the importance of having health insurance coverage.
“Any of us at any time can get struck with an illness, and these costs if you get ill are catastrophic,” said Grossi. “The second leading cause of why people file for bankruptcy is medical bills.”
“To have health insurance gives you a peace of mind that you need, that you can be treated well, and that you can have a healthy life because you can get preventive services,” she added.
The Affordable Care Act has made preventive services — such as blood pressure tests, cancer screenings, vaccines — free for all. Furthermore, people making up to 133% of the federal poverty level are also eligible for Medicaid in Pennsylvania.
“I think this pandemic has taught us that there’s nothing more important than our health,” said Grossi.
The deadline to apply for health insurance coverage for 2021 is August 15.
You can enroll through the Pennie website, enroll by phone by calling (844) 844-8040, or through an assister or broker who can help get through the enrollment process or offer advice on what may be the best plan for you.
Bilingual and Spanish-speaking representatives are also available at the call center for assistance.
For more information provided in Spanish, click here.
This article is part of Broke in Philly, a collaborative reporting project among more than 20 news organizations focused on economic mobility in Philadelphia. Read all of our reporting at brokeinphilly.org.