In Pennsylvania, residents can buy health insurance through the state-wide marketplace, Pennie. Signing up for an ACA plan takes place during the open-enrollment period from November 1, 2022, to January 15, 2023. This article will provide step-by-step to choosing and enrolling in a health insurance plan using a 27-year-old self-employed freelancer in the state of Pennsylvania as our example.
How Do I Sign Up for an ACA Plan in Pennsylvania?
- Online: Go through Pennies website and click "get covered." Prompts will have you create an account and enter personal information to determine your eligibility and recommended plan.
- Phone: You can enroll in an ACA plan by calling Pennie's service center (844-844-8040).
- Through an Assister or Broker: Assisters and brokers can help you create an account and select a plan. It's important to note that only brokers can advise you on the best plan for your circumstances. Pennies website provides a search engine that allows you to search for assisters and brokers based on your zip code.
Step-By-Step to Signing Up Online with Pennie
Go to the Pennie website and click the “Get Covered” button at the top of the page. You will be presented with three options: Browser for health and dental plans, register with access code, and log in to existing accounts. Select browse for health and dental plans.
Step 1 – Accessing the Website
The browse for health and dental plans option will take you to Pennie’s plan comparison tool. The comparison tool allows you to see each eligible plan based on your personal information.
Once the page opens to the comparison tool, click the next button at the bottom right-hand of the screen. You will be prompted to enter the coverage year you are seeking, zip code, birthday, and household income. If you are seeking coverage for a spouse or dependent as well, you can select those options under Who is in your household and do they need coverage? Subsection.
Step 2 – Collecting Information
After you enter your personal information, you can browse the plans recommended by Pennie. Once you are done browsing, you click “ Create an Account and Sign up.”
The sign-up page will prompt you to enter basic information (first and last name, email address, phone number, and date of birth), create a security question, and set a password.
After your account is created, Pennie will generate your dashboard. Under the “Next” steps subsection, there is a tab that says “Start New Application.” Once you click on “Start New Application,” Pennie will have you complete a series of application questions, including primary contact information, family and household information, income information, and additional health information.
Step 3 – Applying for ACA and Selecting a Plan
After you complete all application components, you can review and sign off that all your information is correct, then submit your application. You will receive an eligibility determination letter about 1-2 weeks after submission. If you are deemed eligible for ACA coverage through Pennie, your letter will outline the next steps for enrolling in a healthcare plan.
Once you have your next steps, Pennie will instruct you to pay your first month's premium before your policy's start date. Once the premium is paid, your coverage will officially start.
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ACA Plans for 27-year-old freelancer in Pennsylvania
For this article, we are looking at the most affordable plans for a Single 27-year-old freelancer living in Pennslyvania. We reported no spouse, no kids, and no dependents for the household information. As a freelancer, you are deemed as self-employed, and will have to estimate your net income to see top plans based on your income level.
Top ACA Plans on Pennie
This is the most affordable plan with a $ 232.03-a-month premium. The plan includes a $75 copay for primary care visits and a $25 copay for generic prescription drugs. Preventive care services are fully covered under this plan. In contrast, specialty care visits have a $150 copay, and emergency room services have a $500 copay with a deductible.
This plan has a $361.86-a-month premium. For primary care, you have a $0 copay for in-network providers and 100% coinsurance for out-of-network service. Generic drugs have a $0 copay, while brand drugs have a $75 copay after the deductible. Additionally, preventive care services have a 0% coinsurance. Specialty and emergency care services have a 50% coinsurance after the deductible.
This plan has a $324.64-a-month premium and includes a $40 copay for primary care visits and a $3 copay for generic prescription drugs. This plan fully covers preventive care services. In contrast, specialty care visits have a $40 copay, and emergency room services have a $650 copay.
How can I Make Healthcare More Affordable?
Although Pennie outlines the least expensive options for ACA health plans, the monthly premium and out-of-pocket cost when you access care can be expensive. However, a few options can help you cut down on costs without sacrificing care.
Premium Tax Credit
Although Pennie outlines the least expensive options for ACA health plans, the monthly premium and out-of-pocket cost when you access to care can be costly. However, there are a few options that can help you cut down on costs without sacrificing care.
You can use a premium tax credit to lower your monthly insurance payment (premium) when purchasing a marketplace plan. The tax credit amount is based on an income estimate and household information you submitted on your marketplace application. The federal poverty level (FPL) is used as the baseline to determine tax credit eligibility.
- If your income is between 100% and 400% FPL: you qualify for premium tax credits in all states.
- If your income is about 400% FPL: you may qualify for a premium tax credit
Other options exist if none of the ACA marketplace plans fit your needs and budget. Mira is a subscription-based plan that allows you to choose between several options depending on your healthcare needs and budget. The graphic below illustrates the plan options through Mira.
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Pennie Marketplace FAQ(s)
Below are commonly asked questions about Pennie, such as enrollment criteria and other options for affordable healthcare.
Can I Use the Federal HealthCare Marketplace instead of Pennie?
No. If you are a Pennsylvania resident, you must use the Pennie marketplace. If you attempt to sign up through the Federal Marketplace (Healthcare.gov), it will direct you to the Pennie website.
Are there any requirements for eligibility to sign up for a Pennie?
To sign up for a marketplace plan, you must be a Pennsylvania resident that is either a citizen, U.S. national or have qualified immigration status. Additionally, if you receive health insurance through your employer or other government-based programs such as Medicaid, you still have enrolled in a plan with Pennie.
Pennsylvania has created a state-wide database called Pennie that allows residents to compare marketplace healthcare plans and sign up for the ACA. As a 27-year-old- freelancer in Pennsylvania, more affordable plans range between $232 and $270 per month. In contrast, some of the more expensive plans in the marketplace can be upward of $550. Depending on your income level, you can qualify for a premium tax credit that can reduce the monthly cost of your health insurance plan.
Although the tax premium credit can provide some financial relief, the cost of care with marketplace plans can still be expensive. You shouldn’t have to sacrifice coverage and accessible care due to a lack of affordability. With Mira, you can access low-cost urgent and primary care services, lab testing, and prescription drugs. Sign up today!
Originally from Houston, Texas, Alexandra is currently getting her Master's in Public Health with a health policy certificate at Columbia University. One of her life goals is to own her own art gallery!