Questions and answers
We know health insurance can be complicated. Here are answers to the most common questions we hear.
Options for 2021 coverage:
Open Enrollment began Sunday, Nov. 1, 2020, and ran through Friday, Jan. 15, 2021. If you enrolled between Nov. 1, 2020, and Dec. 22, 2020, your health coverage would have taken effect on Jan. 1, 2021. If you enrolled between Dec. 23, 2020, and Jan. 15, 2021, your coverage would have started Feb. 1, 2021.
If you missed Open Enrollment, the COVID-19 Special Enrollment Period (SEP) began Feb. 15, 2021, and ends Aug. 15, 2021.
This SEP is available to everyone, which means new and current enrollees are eligible to purchase coverage or switch plans, even if you already enrolled during the most recent Open Enrollment Period. The Qualifying Life Event (QLE) that you will select for this enrollment period will be whatever the current date is that you enroll on Pennie’s website yourself or with our team’s help. Your coverage effective date will be the first day of the next month, even if you apply on the last day of the month before.
Shop for and enroll in a Geisinger Marketplace plan by clicking here or contacting one of our knowledgeable, friendly representatives at 800-223-1282, Monday through Friday, 8 a.m. to 5 p.m.
Once you meet your deductible, GHP pays a percentage and you pay a percentage of the remaining costs. The percentage you pay is called coinsurance.
If you have a plan with 20 percent coinsurance, GHP will pay 80 percent of covered services after your deductible has been met and you pay the remaining 20 percent. Once you reach your maximum out-of-pocket you will no longer have to pay coinsurance.
Under the Affordable Care Act (also known as the ACA, or healthcare reform), the below metallic tiered categories are based on how you and your plan splits your healthcare costs. There are four metallic levels (bronze, silver, gold and platinum).
- Bronze: Your health plan pays 60% on average. You pay about 40%.
- Silver: Your health plan pays 70% on average. You pay about 30%.
- Gold: Your health plan pays 80% on average. You pay about 20%.
- Platinum: Your health plan pays 90% on average. You pay about 10%.
As you go from bronze to platinum, the monthly premiums tend to go up. So, a bronze plan would generally have a lower premium than a platinum plan.
If your question isn’t answered here, call us at 800-223-1282.