Patrick & Justine LeonardHealth Coverage Advisors

FAQ

Straight answers to the questions people ask first.

If yours is not here, call Patrick at (267) 226-0949.

What is the difference between the Marketplace and a private plan?
Marketplace plans are sold through Pennie, Pennsylvania's official marketplace. They cannot turn you down because of a health condition, and they may come with tax credits based on household income and size. Private plans are separate from the Marketplace. They are medically underwritten, which means you answer health questions and not everyone qualifies. They are not eligible for Marketplace tax credits, and you can apply any time of year. Patrick checks both.
When is Open Enrollment?
Pennie's Open Enrollment runs from November 1 to January 15. Enroll by December 15 for coverage that starts January 1. If you enroll between December 16 and January 15, coverage starts February 1. Source: pennie.com. Dates are set by Pennie and can change.
Can I sign up outside Open Enrollment?
For a Marketplace plan, you need a qualifying life event, such as losing health coverage, getting married, having a baby, or moving. That opens a Special Enrollment Period, which has a limited window. Private plans can be applied for any time of year if you qualify.
I just lost my health coverage at work. What should I do?
Act quickly. Losing job-based coverage usually opens a Special Enrollment Period. The Marketplace asks for proof that your coverage ended, so keep any letter from your employer. Call Patrick at (267) 226-0949 or take the Coverage Check and he will walk you through it.
Can a private plan turn me down because of my health?
Yes. Private plans are medically underwritten, so an application can be declined based on your health answers. Marketplace plans cannot turn you down for a pre-existing condition. That is one reason Patrick looks at both.
What is the difference between a deductible and an out-of-pocket max?
The deductible is what you pay for covered care before the plan starts sharing the cost. The out-of-pocket max is the most you pay for covered care in a plan year. After you hit it, the plan pays 100% of covered costs for the rest of the year. The calculator on the How It Works page shows how a big bill splits.
What is the difference between an HMO and a PPO?
An HMO has a narrower network, and you usually need a referral to see a specialist. A PPO has a broader network, lets you see specialists without a referral, and covers some care outside the network, usually at a higher cost to you.
Do I qualify for a tax credit?
Marketplace tax credits depend on your household income and household size. Patrick checks what you qualify for before he quotes anything.
I own a small business. Can Patrick help?
Yes. Many of Patrick's clients are small business owners, a lot of them in the trades. Whether you are covering yourself and your family or thinking about your employees, he will talk through what fits a business your size.
Do we have to meet in person?
No. You can talk by phone, by video, or in person at the Allentown office at 1320 Hausman Road, Suite 303. Pick whichever works when you book.
Is the Coverage Check free?
Yes. It takes about two minutes, and there is no obligation to buy anything.
Is this website run by the government?
No. This is Patrick Leonard's website. It is not affiliated with Pennie, HealthCare.gov, or any government agency. The official Pennsylvania marketplace is pennie.com.

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