First, start by cooking sausage on medium heat, in a large skillet until the meat is brown. Drain off fat. Then, add diced bell peppers: Next, add dried elbow macaroni, marinara sauce, and water: Bring to boil; reduce heat to simmer. Simmer, covered, for about 20 minutes until macaroni is tender, occasionally stirring.
Add half and half, sprinkle with cheese, and mix everything well. Remove from heat, cover and let it sit for about 2 minutes or until the cheese melts: Your pasta is ready to serve: only 45 minutes from start to finish!