Need help finding your way around Indiana’s Health Insurance Marketplace? We can help! HealthNet has trained staff that can help you and your family understand your options and apply for a health insurance plan that works best for you. We offer this help for FREE.
When you are ready to apply for a health insurance plan, you can set up a time to meet with a trained HealthNet staff member at a:
HealthNet health center near you OR location in your community (Call 317-957-2070)
Understanding the Marketplace
What is the Marketplace?
The Marketplace is an online shopping site for health insurance plans. It lets you compare plans and find one that is right for you and your family. All Marketplace plans offer:
Doctor visits (well-child checks, annual exams, etc.)
- Maternity (pregnancy) and baby care
- Hospital stays
- Dental and Eyecare
Each plan must treat you fairly and cover your health care needs, even if you are already sick.
Is the Marketplace a private insurance plan or is it a government program?
The Marketplace is private insurance that you pay for each month.
Who can buy insurance in the Marketplace?
U.S. citizens or those who are lawfully present in the United States that do not have health insurance.
How do I know if I have health insurance?
You have health insurance if you have:
- Children’s Health Insurance Program (CHIP)
- Any health insurance plan through your job
- Any health insurance plan you bought that meets the rules of the Affordable Care Act
- Retiree health insurance
- VA health insurance
- Other health insurance plans
What is my household? Is it everyone I live with?
Your household is anyone you include on your tax return as a dependent
What is a premium tax credit?
A premium tax credit is a way the government helps you pay for the health insurance you buy through the Marketplace.
Why is it so important to have health insurance?
No one plans to get sick or hurt, but most people need health care at some point in their lives. Health insurance will pay for some of these costs so you don’t have to pay all of the costs on your own
I'm undocumented, can I still apply for the Marketplace?
Only U.S. Citizens and those who are lawfully present in the United States can apply for Marketplace.
I'm a Veteran, do I need help signing up for health insurance?
If you are enrolled in Tricare or the Veterans health care program, you do not need to sign up for the Marketplace.
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Signing up for insurance
Who do I contact if I need help signing up for health insurance?
HealthNet has navigators who can help you sign up for insurance. This service is free. To sign up, call 317-957-2070.
What do I need to sign up for health insurance through the Marketplace?
- Social security number for every person signing up for health insurance
- Needed paperwork if you are an immigrant
- Information about your employer/job
- Current income wages or tax return information (W2)
- Paperwork showing you are unemployed
- Email address (if you do not have an email address, we can help you get one for free)
When can I start looking at plans and prices in the Marketplace?
You can start looking during open enrollment. Open enrollment for 2019 is November 1 through December 15.
I signed up for health insurance through Marketplace last year. Do I have to do it again every year?
We urge everyone to review your current plan. It may have changed or there may be new plans that better meet your needs. Check your plan to see if you are eligible for the premium tax credit. If you don’t check your plan, you may not get the premium tax credit.
What are Navigators?
A Navigator is trained to help you explore your health insurance options through the Marketplace, Medicaid and the Children’s Health Insurance Program (CHIP). They can also help you fill out forms. This service is free.
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Can you sign up for insurance in the Marketplace at any time?
No. You can only sign up during a certain time, which is called open enrollment. Open enrollment for 2019 is November 1 through December 15.
What is a special enrollment opportunity?
A special enrollment opportunity lets you sign up for health insurance if you have a qualifying life event. A qualifying life event includes:
- Moving to a new state
- Getting married or divorced
- Having a baby, adopting a child, or placing a child for adoption
- Getting out of jail
- Gaining citizenship
- Adding or losing a dependent (a husband, wife, or minor children) who the insured person covers on their insurance
- Losing your health insurance because you turned 26 and can’t be on your parents’ plan
- Losing your insurance through your job
- Graduating and losing student health insurance
- Getting paid more money, so you cannot get Medicaid
- Expiring COBRA insurance
- The insurance plan ended in 2018
You have 60 days after your qualifying event to sign up. If you miss the 60 day period, you cannot sign up again until the next open enrollment.
I missed the deadline to sign up for the Marketplace?
If you missed the deadline, you might be able to qualify for a special enrollment opportunity.
I missed the deadline to sign up and I'm pregnant. Can I enroll in the Marketplace?
No. When your baby is born, you’ll be able to sign up for a special enrollment opportunity.
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If I do not get a health insurance plan, will I be charged money?
Yes, if you do not get health insurance, you will have to pay a fine unless you are eligible for an exemption.
What is an exemption?
An exemption is when you don’t have to pay a fine for not having health insurance. You can get an exemption if you:
- Cannot afford health insurance
- Are not a U.S. citizen, a U.S. national or a resident alien legally allowed in the U.S.
- Do not have insurance for less than three months in a row during the year
- Won’t file a tax return because you do not make enough money
- Cannot get Medicaid because Indiana did not expand Medicaid
- Are in a health care sharing ministry or a part of a recognized religious group who objects to health insurance
- Are a member of a government recognized Indian Tribe
- Are in jail
How do I apply for an exemption to the fine for not having insurance?
For some exemptions, you have to apply through the Marketplace (www.healthcare.gov). Other exemptions you have to apply when doing your taxes.
I don't have insurance. Do I have to get insurance in 2019?
Yes, everyone has to get health insurance. If you don’t get health insurance, you will have to pay a tax penalty (a fine), unless you qualify for an exemption.
How much will I have to pay if I don't get health insurance?
Each year the fine for not having insurance goes up. There are two ways to find out how much you will pay. The fine is whatever costs more between these two ways:
- 2.5% of your family income (if you make enough money to file taxes)
- $695 per adult for the year ($347.50 for each child under 18) up to $2,085 per family.
For example, Mary and Billy have a family income of $20,000 a year, and one child.
- 2.5% of their family income is $500.
- Mary would pay $695. Billy would pay $695 and they would pay $347.50 for their child for a total of $1,737.50.
Mary and Billy would have to pay the $1,737.50 because it costs the most. They will also have to pay all of their health care costs.
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What health services do the plans offer in the Marketplace?
- primary care services
- emergency services
- maternity (pregnancy) and newborn care
- mental health and substance use disorder services
- lab services
- preventive services
- chronic disease care
- pediatric services including dental and eye care
Please check the details of each plan for more information.
Can I purchase a vision and dental plan?
This is different for each plan. Please check the details of your plan for more information.
How long can I stay on my parents' insurance?
You can stay on your parents’ insurance until you are 26 years old, even if you are married or can get insurance through your job. The day you turn 26, you will be dropped from your parents’ insurance. You will get a special enrollment opportunity to sign up for Marketplace insurance (60 days before and 60 days after your birthday).
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Insurance and your job
I can get insurance through my job. Can I see if I can get a better deal in the Marketplace?
You can look at plans in the Marketplace, but in order to get insurance there are certain guidelines you have to meet. If you can get insurance through your job, you might not qualify for premium tax credits.
I already have health insurance through my job. Do I still need to sign up for a health insurance plan in the Marketplace?
No. Most people do not have to sign-up for a health insurance plan if they already have one.
Can I get Marketplace insurance for my husband/wife and children if my employer doesn't offer family coverage?
Yes, if you meet the guidelines based on your household income, you might be able to get Marketplace insurance.
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Medicaid and CHIP
I have Medicaid, do I need to do anything to keep my insurance?
No. Medicaid will tell you when it is time to renew your insurance.
How do I know if I can get Medicaid?
- Fill out the Medicaid form on the Marketplace website. Once you fill out the form, you can see if you or your family members can get Medicaid. OR
- Fill out the Medicaid form on the Indiana Medicaid website.
If I use the Marketplace to sign up for a health insurance plan, can my children stay on Medicaid?
Yes, if the amount of money you make meets the rules set by Medicaid.
I tried to get Medicaid before, but was told I could not get it. Should I try again?
Yes. You should still fill out a Medicaid form since there are new rules that might let you get Medicaid, even if you could not before.
When can I enroll in Medicaid or the Children's Health Insurance Program (CHIP)?
You can sign up for Medicaid or CHIP at any time, if you meet the guidelines.
I have Medicare/Medicaid, can I still purchase insurance?
No, if you have Medicare and/or Medicaid, you don’t need to purchase insurance.
I need insurance, but the Healthy Indiana Plan (HIP) is closed, what do I do to avoid the penalty?
Save your denial letter and keep it in a safe place. Depending on your income, you may be able to get help paying for private insurance through the Marketplace.
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After signing up
How do I pay for my insurance plan?
Most insurance companies have you pay once a month. Check with your insurance company for more information.
Does my health insurance start as soon as I sign up for a Marketplace plan?
No. If you sign up between the 1st and 15th days of the month during open enrollment, your insurance will start the first day of the next month.
For example, if you sign up on January 3rd, your insurance will start February 1st.
If you sign up on January 16th, your insurance will start on March 1st.
Do I have to file taxes?
If you want to get Marketplace insurance, you have to file your taxes. Your tax information is used to find out your household size, income, and if you are able to get the premium tax credits and cost-sharing reductions.
What happens if my income changes? Will my premium change?
Maybe. Please report any changes in income and household size to the Marketplace within 30 days. Your premium, cost sharing reductions and premium tax credits are based on your income and household size.
What life changes do I have to report to the Marketplace?
- Get married or divorced
- Have a child, adopt a child, or place a child for adoption
- Have a change in income
- Get health insurance through a job, Medicaid, Medicare, etc.
- Change where you live
- Have a change in your disability status
- Add or lose a dependent (a husband, wife or minor children) who the insured person covers on their insurance
- Get pregnant
- Change your tax filing status. You can file as a single person, the head of your household, married filing jointly and separately or as a qualified widower.
- Change in citizenship or immigration status
- Go to jail or get out of jail
- Change in American Indian/Alaska Native or tribal status
- Change your name, birth date or Social Security Number
- These changes can be reported on the Marketplace website or by phone at 1-800-318-2596 (TTY:1-855-889-4325).
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