Public Exchange / Health Insurance Marketplace
Choose the plan that covers YOUR doctor and includes YOUR hospital of choice.
Trinity Mother Frances providers and hospitals are ONLY included in the Blue Choice PPO Plan and Assurant Health's Aetna PPO Network.
Please read the commonly asked questions below to help you make an informed decision about your healthcare.
Q: What is a public exchange/Health Insurance Marketplace?
A: A provision of the Affordable Care Act calls for the government to create public exchanges, an online Marketplace that will allow both uninsured and insured consumers the opportunity to shop for insurance coverage that best fits their budget and individual needs. In addition, there are cost sharing subsidies available to individuals and families who meet eligibility requirements. Open enrollment is November 15, 2014 through February 15, 2015. The last date to enroll for coverage that starts January 1, 2015 is December 15, 2014.
Q: Will the plan I purchase on the public exchange/Health Insurance Marketplace allow me to continue to seek care at Trinity Mother Frances Hospitals and Clinics?
A: The individual/family Health Insurance Marketplace insurance carriers in our area are Blue Cross Blue Shield of Texas and Assurant Health. Blue Cross Blue Shield of Texas offers two networks, the Blue Choice PPO and the Blue Advantage HMO. It’s important to note that TMFHC is not included in both health insurance networks. The Blue Choice PPO and Assurant Health’s Aetna network are the only ones that include TMFHC in the Health Insurance Marketplace.
If you have a Trinity Mother Frances physician and want to continue to use Trinity Mother Frances Hospitals & Clinics, you will need to choose the Blue Choice PPO or Assurant Health. By choosing either of these networks you will have access to all Trinity Mother Frances hospitals and providers. If you choose a plan that does not include Trinity Mother Frances Hospitals and Clinics, you could be responsible for up to 100 percent of costs.
Q: How will a public exchange/Health Insurance Marketplace affect my coverage if I have Medicare?
A: There will be no effect to you if you are on Medicare. You already have coverage through Medicare, and you do not need to make any changes.
Q: How will the public exchange/Health Insurance Marketplace know whether I am eligible for Medicaid?
A: The public exchange/Health Insurance Marketplace is equipped to evaluate the eligibility of individuals for Medicaid or financial assistance. Once eligibility is determined, the public exchange/Health Insurance Marketplace will help direct individuals to health insurance plans that meet their needs.
Q: How can I determine if I am eligible for Medicaid or financial assistance?
A: Individuals can determine if they are eligible for Medicaid or financial assistance in four ways: online at www.HealthCare.gov, by phone at (800) 318-2596, by mail, or in-person with the help of a trained assistant or navigator. Additional information is available by visiting www.HealthCare.gov or calling (800) 318-2596.
Q: Will there be out-of-pocket costs and co-pays for plans offered on the public exchange/Health Insurance Marketplace?
A: As with all health insurance plans, there will be different levels of out-of-pocket expenses and co-pays based on the type of insurance selected. Typically, if an individual has a higher monthly premium, he/she usually pays less out-of-pocket costs. A person may find it beneficial to select a higher premium insurance to avoid large out-of-pocket expenses and to minimize any pre-service deposit requirements for non-emergency care.
Q: Where can I find more information?