The Health Insurance Marketplace
The Rockbridge Area Health Center offers free, one-on-one appointments with Certified Application Counselors to assist with sign-up process through the Affordable Care Act.Open enrollment for the Affordable Care Act is now closed. Outside of open enrollment, you can only get health coverage 2 ways:
- With a Special Enrollment Period.
- Through the Children’s Health Insurance Program (CHIP) or Medicaid
What is the Marketplace?
The Marketplace is a destination where consumers can compare insurance options in simple, easy to understand language. At the Marketplace, consumers will be able to compare insurance options based on price, benefits, quality and other factors with a clear picture of premiums and cost-sharing amounts to help them choose the insurance that best fits their needs.
Financial help to lower costs is available for people who qualify. Consumers may be eligible for a free or low cost plan, or savings that lower monthly premiums right away.
What is a Special Enrollment Period?
A Special Enrollment Period (SEP) is a period of time outside open enrollment when consumers can sign up for health insurance through the Affordable Care Act. To be eligible for an SEP, a consumer must have a qualifying life event.
Some life events that may qualify you for a SEP are:
Loss of health coverage
Change in household
Change in residency
Release from incarceration
Click here to see if you qualify.
Penalty for being uninsured: https://www.healthcare.gov/fees/fee-for-not-being-covered/
Children’s Health Insurance Program (CHIP) and Medicaid
Applications are accepted throughout the year for the following programs. They have no enrollment fees or monthly premiums. Some programs charge nominal copayments for services.
FAMIS and FAMIS Plus (also known as Children’s Medicaid) are Virginia’s health insurance programs for children. It covers all the medical care growing children need to avoid getting sick, plus the medical care that will help them if they do get sick or get hurt. Children enrolled in FAMIS or FAMIS Plus are automatically enrolled in Smiles for Children, which offers comprehensive dental care at no cost.
For pregnant women:
Medicaid was created to assist people who have lower incomes, but coverage is dependent upon other criteria as well. In addition to children and pregnant women, the elderly, disabled adults and parents meeting specific income thresholds may qualify for full coverage Medicaid.
Plan First is a *limited* Medicaid program that offers free yearly family planning exams (including PAP smears), contraceptives, Sexually Transmitted Infection testing, family planning education, pregnancy testing, transportation to non-emergency family planning visits and more. Plan First does not cover sick visits.
The Governors Access Plan (GAP) is a Medicaid program that offers coverage for primary medical and behavioral health services, as well as coverage for diagnostics, lab work and prescriptions for uninsured adults with serious mental illnesses. The application for GAP is a 2 part process:
- Complete the financial application by calling (855) 869-8190
- Complete a Serious Mental Illness (SMI) screening (at no cost) with our screener at RAHC or at your local Community Services Board.
The Rockbridge Area Health Center offers free, one-on-one appointments with Certified Application Counselors to assist with applications through the Affordable Care Act and the Medicaid programs. Eligibility for the Affordable Care Act is determined through the Health Insurance Marketplace; eligibility for any of the Medicaid programs is determined through the Cover Virginia call center or the local Department of Social Services.
For questions or to schedule an appointment, please call (540) 464-8700 and select option 1.