Insurance Enrollment Assistance

Social Work Department

Call 717-299-6371 or speak with a receptionist at one of our locations to schedule an appointment with a social worker who can consider your eligibility for a variety of programs.

Our social workers can help you apply for Medical Assistance or CHIP anytime of the year.

If you are an adult and do not quality for Medical Assistance, you may qualify for Marketplace Health Insurance.

Medical Assistance (also known as Medicaid)

Medical Assistance (also known as Medicaid) is a public health insurance program administered by the state of Pennsylvania. Medical Assistance has a comprehensive benefit package with very little cost sharing. There are various Medicaid categories for adults, children, and older and/or adults with a disability.

Children's Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) also offers a comprehensive coverage for children whose household income is too high to qualify for Medical Assistance. Depending on income, CHIP is either free, low-cost, or at-cost (for higher income families). Children must be uninsured to qualify.

Health Insurance Marketplace

The Health Insurance Marketplace (also known as the “Marketplace” or “exchange”) is a service that helps people shop for and enroll in affordable health insurance.The Marketplace provides health plan shopping and enrollment services through websites, call centers, and in-person help. You may be eligible for a tax subsidy to help pay premium costs. The federal government operates the Marketplace, available at HealthCare.gov.

Lancaster Health Center has social workers who are trained as Marketplace Certified Application Counselors to assist you in exploring eligibility for Marketplace Insurance. Our Certified Application Counselors will help you to create an account, apply for affordable insurance, pick the best plan that fits your needs, and enroll in an insurance plan.

The 2019 Open Enrollment for Marketplace insurance is November 1- December 15.  If you enroll by December 15, your new coverage starts January 1, 2020.

If you have life changes during other times of the year, you may qualify for a Special Enrollment Period if you or anyone in your household in the past 60 days:

  • Got married. Pick a plan by the last day of the month and your coverage can start the first day of the following month.
  • Had a baby, adopted a child, or placed a child for foster care. Your coverage can start the day of the event — even if you enroll in the plan up to 60 days afterward.
  • Were divorced or legally separated and lost health insurance. (Note: Divorce or legal separation without losing coverage does not qualify you for a Special Enrollment Period.)
  • You will be eligible for a Special Enrollment Period if someone on your Marketplace plan passes away and as a result, you are no longer eligible for your current health plan.
  • Moved to a new home in a new ZIP code or county.
  • Moved to the U.S. from a foreign country or United States territory.
  • If you’re a student, moved to or from the place you attend school.
  • If you’re a seasonal worker, moved to or from the place you both live and work.
  • Moved to or from a shelter or other transitional housing.

Note: Moving only for medical treatment or staying somewhere for vacation does not qualify you for a Special Enrollment Period.

Important: You must prove you had qualifying health coverage for one or more days during the 60 days before your move. You do not need to provide proof if you are moving from a foreign country or United States territory.

You may qualify for a Special Enrollment Period if you or anyone in your household lost qualifying health coverage in the past 60 days OR expects to lose coverage in the next 60 days…

  • Lost job-based coverage
  • Lost individual health coverage for a plan or policy you bought yourself
  • Lost eligibility for Medicaid or CHIP
  • Lost eligibility for Medicare
  • Lost coverage through a family member

Other life circumstances that may qualify you for a Special Enrollment Period:

  • Changes that make you no longer eligible for Medicaid or the Children’s Health Insurance Program (CHIP)
  • Gaining membership in a federally recognized tribe or status as an Alaska Native Claims Settlement Act (ANCSA) Corporation shareholder
  • Becoming newly eligible for Marketplace coverage because you became a U.S. citizen
  • Leaving incarceration
  • Starting or ending service as an AmeriCorps State and National, VISTA, or NCCC member

Check here to see if you might qualify for a special enrollment period.

Already have Marketplace Health Insurance coverage?

It is very important to re-enroll with one of our Certified Application Counselors or by calling the Marketplace at 1-800-318-2596 or logging into your Healthcare.gov account. If you do not do this, you may lose your tax subsidy and your premiums may go up.  

Marketplace plans can change each year, including costs and coverage. You may benefit from a change, and you never know until you compare.

Will I qualify for lower out-of-pocket costs?

This online Subsidy Calculator  will help give you an idea of what the cost of your insurance will be. This tool illustrates health insurance premiums and subsidies for people purchasing insurance on their own in new health insurance exchanges (or “Marketplaces”) created by the Affordable Care Act (ACA). With this calculator, you can enter different income levels, ages, and family sizes to get an estimate of your eligibility for subsidies and how much you could spend on health insurance.

Call 717-299-6371 or speak with a receptionist at one of our locations to schedule an appointment with a social worker who can consider your eligibility for a variety of programs.

You can also apply online or call the Marketplace at 1-800-318-2596.

What to bring with you to an enrollment assistance appointment with a social worker:

  1. ID – driver’s license, state ID, or any other picture ID that you have
  2. Pay-stubs from the last month and documentation of any other income
  3. Documentation of immigration status
  4. Tax return (most recent)
  5. Bank statement (some Medical Assistance categories require this)
  6. Social Security numbers for all household members