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The Phelps Health EnrollU team is here to help you with any questions about health insurance coverage. Whether you are looking to find coverage through the Affordable Care Act and Missouri Health Insurance Marketplace or have questions about Medicare, our certified and licensed navigators and counselors are ready to assist you.

You do not have to be a Phelps Health patient to receive assistance with EnrollU. We provide this free service to the community.

What Is Health Insurance?

Health insurance helps you pay for medical care and can protect you from high healthcare costs, like emergency department visits or hospital stays after an accident. Health insurance can reduce the amount you personally pay when you have medical needs. How much you pay depends on your health insurance plan.

Below are some important things to consider when buying health insurance:

  • What health services the plan covers
  • How much you will pay for the plan (in other words, your monthly premiums)
  • How much you will pay for doctor appointments and prescription medicines


General Insurance Terms

Deductible: The amount you owe for healthcare services your insurance or plan covers before your health insurance or plan begins to pay.
Copayment: The amount you are required to pay as your share of the cost for a medical service or supply, like a doctor’s visit or hospital outpatient visit. A copayment is usually a set amount, rather than a percentage. For example, you might pay $10 or $20 for a doctor’s visit.
Co-Insurance: The amount you are required to pay as your share of the cost for services after you pay any deductibles. Co-insurance is usually a percentage (for example, 20%).
Out-of-Pocket Maximum: The most you pay during a policy period (usually one year) before your insurance or plan starts to pay 100% for covered essential health benefits. The out-of-pocket maximum normally includes the yearly deductible and may also include any cost sharing you have after the deductible.


What Is the Missouri Health Insurance Marketplace?

The Missouri Health Insurance Marketplace is a website where you can compare and buy the health insurance plan that best fits your needs. You can get help understanding Marketplace health plans and applying for insurance online, in person or by phone.

You can use the Missouri Health Insurance Marketplace if you meet the following criteria:

  • You are an individual or family buying insurance on your own.
  • You do not have access to affordable coverage through your job.

If you use the Missouri Health Insurance Marketplace to buy coverage, you may qualify for financial help. When you fill out an application, you will find out if you can get new tax credits to lower your monthly premiums and out-of-pocket healthcare costs. These tax credits are available to people with income at a certain level.

You qualify for premium tax credits if you meet the following criteria:

  • You do not have access to affordable health insurance through work,
  • You do not receive Medicare,
  • You use the Missouri Health Insurance Marketplace to buy insurance, and
  • You have household income between 100% and 400% of the federal poverty level.

You qualify for lower out-of-pocket if you meet the following criteria:

  • You receive a premium tax credit,
  • You choose to buy a silver-level plan through the Missouri Health Insurance Marketplace, and
  • You have income at or below 250% of the federal poverty level.


Services We Offer

The Phelps Health EnrollU team can provide you with the following services:

  • Guidance/enrollment assistance in federal, state and county health insurance coverage and/or programs
  • Enrollment assistance with the Affordable Care Act and Missouri Health Insurance Marketplace
  • Help with SSI (Supplemental Security Income) or SSDI (Social Security Disability Insurance)
  • Help with enrollment in Medicare (including Parts A, B, C, D and Medicare supplements)
  • Assistance with enrollment in Missouri Medicaid, MSP (QMB, SLMB), SSA Extra Help
  • Insurance counselors to help answer your questions about insurance costs/coverage
  • Financial navigation services exclusive for Delbert Day Cancer Institute patients
  • Community education and outreach opportunities


Certified Application Counselors

The Centers for Medicare and Medicaid Services recognizes Phelps Health as a Certified Application Counselor Designated Organization (CDO). Phelps Health Certified Application Counselors (CACs) are licensed, trained professionals ready to assist individuals and/or families seeking health coverage options through the Missouri Health Insurance Marketplace.

  • Since every person’s situation is unique, we provide one-on-one, personalized help.
  • Our professional CACs have completed specialized training and are licensed with the Missouri Department of Insurance.
  • We do not work for commissions off of insurance products, and Phelps Health receives no commissions, as well. Our CACs offer free, unbiased help with insurance questions and enrollment.


Special Enrollment Periods

If you missed the open enrollment period and did not sign up for health insurance but have had certain life changes, such as getting married or divorced, having a baby or moving to another state, you may qualify for a special enrollment period to start your coverage sooner. 

**The American Rescue Plan has provided a Special Enrollment Period (SEP) until August 15, 2021, for individuals and families to enroll in Affordable Care Act (ACA) health insurance coverage via the Health Insurance Marketplace. See flyer for details.**

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