ACCESS TO HEALTHCARE

ACCESS TO 
HEALTHCARE


The Healthcare Enrollment Assistance and Education Program assists individuals and families, regardless of income, in obtaining and maintaining health insurance. Federal and state certified staff helps individuals with enrollment in a public or private health insurance plan that meets their needs and educates them on how to use their health insurance plan to maintain good health.
Staff members are available to make presentations to community groups and organizations about the importance of health care insurance and how it can be used to improve the health of individuals, families, and communities.


FREQUENTLY ASKED QUESTIONS

1. Will PCS help me apply for health insurance through the Marketplace? 

Yes, PCS has 16 trained navigators located across the Texas Panhandle to help you obtain insurance through the Marketplace. 


2. Why is health insurance important to have? 

  • Health insurance covers essential health benefits critical to maintaining your health and treating illness and accidents.
  • Health insurance protects you from unexpected, high medical costs.
  • You pay less for covered in-network health care, even before you meet your deductible.
  • You get free preventive care, like vaccines, screenings, and some check-ups, even before you meet your deductible.
  • If you have a Marketplace plan or other qualifying health coverage, you don’t have to pay the penalty that people without coverage must pay.


3. If I don’t have insurance, will I have to pay a penalty? 

You might qualify for health coverage exemption from the requirement to have insurance. If you qualify, you won’t have to pay the penalty. PCS can help you apply for any exemptions.

If you don’t qualify for an exemption, you will have a pay a penalty fee. The penalty fee is either 2.5% of your household income, or $695 per adult and $347.50 per child under 18—you’ll pay whichever is higher. 

4. When can I enroll in health insurance through the Marketplace?  

The enrollment period for 2017 plans was November 1st, 2016 – January 31st 2017. 
The enrollment period for 2018 is November 1st, 2017 – December 15th, 2017.


5. What if I missed the enrollment period? 

If you experience certain types of life changes — like losing health coverage, getting married, or having a baby — you may qualify for a Special Enrollment Period to enroll in a Marketplace plan for the rest of the year. Please call PCS to make an appointment and we can help you with your application.

If you qualify for Medicaid or CHIP, you can apply for free or low-cost coverage through Medicaid and CHIP any time, all year. If you qualify, you can enroll immediately.


6. What is a premium tax credit?

It is tax credit you can use to lower your monthly insurance payment when you enroll in a plan through the Health Insurance Marketplace. Your tax credit is based on the income estimate and household information you put on your Marketplace application. If your estimated income falls between 100% and 400% of the federal poverty level for your household size, you qualify for a premium tax credit. You can use all, some, or none of your premium tax credit in advance to lower your monthly premium.


7. What if my income falls below 100% of the federal poverty level? 

Unfortunately, you will not qualify for a premium tax credit to reduce the cost of health insurance through the Marketplace.  
In Texas you might qualify for Medicaid if you are blind or disabled, and/or if you are a parent with dependent children with household incomes up to 15% of Federal Poverty Level (FPL). Children are eligible for Medicaid or CHIP with household incomes up to 201% of FPL, and pregnant women are eligible with household incomes up to 198% of FPL.

In some states Medicaid was expanded to individuals who fell between these two programs, however, Texas did not expand their Medicaid services. This has left many Texans without an option for affordable health insurance and inability to pay for regular medical care, medical bills and prescription drugs.

8. If I don’t have insurance, do you have a list of clinics that will see me for free or with a sliding scale payment option?
 
Yes, PCS has a list of available resources in Amarillo. Please call or email for this information.


9. Will PCS help me apply for Texas Benefits? 

Yes, PCS has trained staff located across the Texas Panhandle to navigate you through the “Your Texas Benefits” portal. 


10. Do you have a private computer space that I can use?

Yes, at every PCS location we have a private space with a computer, mouse and printer for your convenience. You will be able to use this computer to apply for Texas Benefits, Marketplace insurance, Workforce, and Social Security. PCS can help you as much or as little as you would like through this process.


CONTACT DEPARTMENT

Who will your message go to?


Kaitlin Mosley
Healthcare

Contact Us

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