After You Enroll / Next Steps
- 1. You’ve chosen a health plan through the ACA Marketplace. Now what?
- 2. How do I use my new health insurance plan to visit the doctor?
- 3. How can I see if a doctor is my health plan’s provider network/aka “in-network”?
- 4. What should I do if I have already enrolled in a health plan, but my doctor is not in network?
- 5. Does my plan cover emergency care?
- 6. What do I do if I have chosen a plan, but have not paid my premium?
- 7. What should I do if I signed up for a health plan through the ACA Marketplace, but I have not received my insurance card?
Your enrollment is not complete until you make your first payment to your insurance company. To finish enrollment, you need to pay your premium by the end of the month before your coverage start date. You will be contacted by your insurance company about making your first premium payment, but it may be quicker to call your insurance company directly.
After you make the first monthly payment, be sure to verify that your insurance company received it. That way, you’ll know you are covered and can use your insurance. You should also contact your insurance company if you do not receive information about making a payment within a few days of selecting your plan on the Marketplace.
Before you schedule an appointment to visit a doctor, make sure they are in your new health plan’s provider network.
You can call your insurer or check their website for your doctor’s name.
You can also call your insurer or check their website to see if healthcare facilities, like hospitals, urgent care clinics and pharmacies are in-network.
Confirm with your insurance company that you are searching the provider network of the specific plan that you have. This is important because insurers may have a specific provider listed as in-network for some plans and out-of-network for other plans.
There are health plans on the Marketplace each year, and that means new opportunities for you to find the right coverage for you. If you enrolled in a plan last year, you can change plans during Open Enrollment. After Open Enrollment ends, you won’t be able to change your plan until the next Open Enrollment Period unless you qualify for a Special Enrollment Period.
In an emergency, you should get care from the closest hospital. Insurers cannot require you to get permission before getting emergency room services from a provider or hospital outside your plan’s network. Insurers cannot make you pay more than you would pay for a provider or hospital inside your plan’s network. If you have not received your insurance card, you may still be able to use coverage to pay for services. Call your insurer or have the emergency room do so, to confirm your coverage is effective.
Even though you have not received your insurance card, you may still be able to use your coverage for health care services. If you need to see a doctor or get a prescription filled before you get your insurance card, call your insurer to confirm your coverage is effective.
For the most up-to-date information about Medicaid eligibility and coverage, visit: www.ABE.Illinois.gov.