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Application Assistance

Get Covered

Shawnee Health Service wants to help you Get Covered!

ACA Navigators

Shawnee Health Service Navigators are available at the locations listed below.

Our ACA Navigators can help you go through the online system as well as answer questions you might have about the Marketplace.  While on-line you will be able to compare insurance options and find out if you might be eligible, based on your income, for financial assistance to lower your costs.

ACA Navigators can help you understand things like Essential Health Benefits and how these will help improve your health.  Navigators are available during clinic hours and special event times.  You do not need to be a patient of Shawnee Health Service to receive assistance at no cost!

Don’t Miss This Year’s Open Enrollment!!!

The 2016 – 2017 Open Enrollment Period for the Marketplace runs from
November 1, 2016 through January 31, 2017

 
ADULT MEDICAID
Men and Women, ages 19 – 64, now qualify depending on income.
Household Size You are Eligible for an Illinois Medical Card if your Monthly Household Income is less than: You are Eligible for an Illinois Medical Card if your Annual Household Income is less than:
1 $  1,366 $  16,394
2 $  1,842 $  22,108
3 $  2,318 $  27,821
4 $  2,795 $  33,534
5 $  3,271 $  39,247
6 $  3,747 $  44,960

Medicaid applications can be submitted at any time.

Application Assistance is FREE

Shawnee Health Care

Carbondale, Carterville, Marion, and Murphysboro(844) 331-3069

AGING AND DISABILITY RESOURCE CENTERS:

Shawnee Alliance, Carterville – (618) 985-8322
The Place-University Mall, Carbondale – (618) 457-5200, ext. 67832

Learn More

Pregnant:

We help with enrolling in Moms & Babies Medicaid

Moms & Babies: Income up to:
$2828 / month for 2
$3566 / month for 3
Enroll Anytime

Kids:

Birth to 18 Years
We help with enrolling in All Kids

All Kids: Income up to:
$4221 / month for 2
$5324 / month for 3
Enroll Anytime

Adults:

19 to 64 Years
We help with enrolling in Medicaid

Medicaid: Income up to:
$1354 / month for 1
$1832 / month for 2
Enroll Anytime

Seniors and Disabled:

65+ Years or anyone on Medicare
We help with understanding Medicare, selecting drug plans & supplements, and signing up for assistance

Medicare Drug Plans:

  • Available regardless of income
  • Special enrollment for many
  • Annual enrollment 10/17/16 to 12/9/16

Medicare Supplements:

  • Available regardless of income
  • We provide information on options
  • Information available anytime

Programs to Help with Medicare Costs:

  • Medicare savings programs for Part B premium
  • Medicaid 2nd to Medicare
  • Medicare Part D Extra Help

Income up to:
$1471 / month for 1 ($17,655/year)
$1991 / month for 2 ($23,895/year)

Enroll Anytime

Minimum Essential Coverage

This is the type of coverage an individual needs to have to meet the individual responsibility requirement under the Affordable Care Act.  This includes commercial insurance policies, job-based coverage, Medicare, Medicaid, CHIP, TRICARE and certain other coverage.  Since January 2014, individuals that do not maintain Minimum Essential Coverage could be subject to a fine.


Financial Assistance through Healthcare.gov

Private insurance plans can be purchased through the federal marketplace. There are 2 types of financial assistance available to those who qualify.

 
  1. Individuals and families whose incomes are at or below 400% of the Federal Poverty Level (FPL) ($47,080/Individual, $97,000/Family of 4) can receive financial assistance on the Federal Marketplace.  This financial assistance is known as Premium Tax Credits and can be redeemed either at tax filing or taken in advance to assist with the cost of monthly insurance premiums.
  2. Individuals and families whose incomes are at or below 250% FPL ($29,425/Individual, $60,625/Family of 4) can receive additional financial assistance known as Cost-Sharing Assistance.  Cost-Sharing Assistance provides financial assistance in the form of lower out-of-pocket costs; such as lower deductibles and annual out-of-pocket maximums.

10 Essential Health Benefits

The Affordable Care Act ensures health plans offered in the individual and small group markets, both inside and outside of the Health Insurance Marketplace, offer a comprehensive package of items and services, known as essential health benefits.

  1. Ambulatory patient services
  2. Emergency services
  3. Hospitalization
  4. Maternity and newborn care
  5. Mental health and substance use disorder services, including behavioral health treatment
  6. Prescription drugs
  7. Rehabilitative and habilitative services and devices
  8. Laboratory services
  9. Preventive and wellness services and chronic disease management
  10. Pediatric services, including oral and vision care