the health insurance marketplace:
DESCRIPTION
The Health Insurance Marketplace:. The New Health Care Law and You. Two thirds of the uninsured live in 13 states. Uninsured by State. 67% of uninsured live in 13 states. Number of Uninsured.TRANSCRIPT
The New Health Care Law and You
Two thirds of the uninsured live in 13 states
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Uninsured by State
<230K 230K - 600K
600K - 1.1M
1.1M+
Number of Uninsured
67% of uninsured live in 13 states
Source: Census Bureau, Current Population Survey, March 2011 and 2012
One fifth of the uninsured live in the top 13 counties and half live in the top 114 counties
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Uninsured by County
10% of the uninsured live in just 4 counties (LA, Harris, Cook, Miami)
20% of the uninsured live in top 13 counties(Top 4 + Next 9)
50% live in the top 114 counties (3.8% of total
counties in the US)
Six Months Before Open Enrollment Begins, Many Americans Remain Unaware Of, or Confused About the ACA
As far as you know, which comes closest to describing the current status of the health care law?
KFF Health Tracking Poll, April 2013
Need to Inform, Educate and Assist with EnrollmentNeed to Inform, Educate and Assist with Enrollment
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Looking at the Model by Zip Code(Source: Enroll America)
A new way to get health insurance• Enrollment starts October 1, 2013• Coverage begins January 2014
About 25 million Americans will have access to quality health insurance
• Up to 20 million may qualify for help to make it more affordable
• Working families can get help through the Marketplace
The Health Insurance MarketplaceThe Health Insurance Marketplace
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All Qualified Health Plans Will Cover These Essential Health Benefits
All Qualified Health Plans Will Cover These Essential Health Benefits
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6. Prescription drugs
7. Rehabilitative and habilitative services and devices
8. Laboratory services
9. Preventive and wellness services and chronic disease management
10. Pediatric services, including oral and vision care
1. Ambulatory patient services
2. Emergency services
3. Hospitalization
4. Maternity and newborn care
5. Mental health and substance use disorder services, including behavioral health treatment
Cancer screenings such as mammograms & colonoscopies Vaccinations such as flu, mumps & measles Blood pressure screening Cholesterol screening Tobacco cessation counseling and interventions Birth control Depression screening And more…
Visit www.healthcare.gov/prevention for a full list.
The Law Makes Health Insurance More Affordable
In many cases, you can get preventive services for free:
Marketplace initial open enrollment period starts October 1, 2013 and ends March 31, 2014
Marketplace eligibility requires consumers to• Live in its service area, and• Be a U.S. citizen or national, or• Be a non-citizen who is lawfully present in the U.S. for the
entire period for which enrollment is sought• Not be incarcerated
Eligibility and EnrollmentEligibility and Enrollment
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Application and EligibilityApplication and Eligibility
• Online• Phone• Mail• In Person
Supported by Data Services Hub
Eligible for Marketplace or Medicaid/CHIP
Enroll
(Marketplace)
Screen
(Medicaid/CHIP)
Help will be available in the Marketplace• Toll-free call center - 24/7Federal Call Center is up and running
and the number is: 1-800-318-2596. 150 languages
• Website chat 24/7 (English and Spanish)• Help in-person
Navigators Other trained enrollment assisters
Local Community Health Centers, libraries, hospitals and other locations in local communities
Agents and brokers
Assistance – It’s Available If You Need ItAssistance – It’s Available If You Need It
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Based on family income and size• Premium discount
Family of four with annual income $23,550* – $94,200* or less
And not eligible for certain other insurance coverage like Medicaid
• Lower cost-sharing (like copays) Family of 4 with annual income $58,875*
or less (some other restrictions)
*2013 amounts
Help to Pay Qualified Health Plan CostsHelp to Pay Qualified Health Plan Costs
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www.HealthCare.govwww.HealthCare.gov
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Starting October 1, 2013, you will be able to apply through this site
Now - Sign up for Email and Text Alerts and Get Ready
Marketplace.cms.govMarketplace.cms.gov
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Get the latest resources to help people apply, enroll, and get coverage in 2014
Arizona Provider Website
www.coveraz.org
ACA Requirements for States
New Application and Eligibility System
Health-e-Arizona Plus
Between Arizona and the Federally Facilitated Marketplace, Consumers Have a Wide Range of
Program Options
Many Programs are Accessed Through
Health-e-Arizona Plus
FFMHealth-e-Arizona Plus
SNAP = Supplemental Nutrition Assistance Program (Nutrition Assistance)TANF = Temporary Assistance for Needy Families (Cash Assistance)Clinic SFS = Clinic-based Sliding Fee Scale programsCounty CAP = County-based Community Assistance Programs (CAP)(Pima and Santa Cruz Counties)PTC = Premium Tax Credit ProgramCSR= Cost Sharing Reduction ProgramSHOP = Small Business Health Opportunities Program
Link to FFM
Start Here
Apply for Referral to FFM
Applications Started at the FFM
FFMHealth-e-Arizona Plus
SNAP = Supplemental Nutrition Assistance Program (Nutrition Assistance)TANF = Temporary Assistance for Needy Families (Cash Assistance)Clinic SFS = Clinic-based Sliding Fee Scale programsCounty CAP = County-based Community Assistance Programs (CAP)(Pima and Santa Cruz Counties)PTC = Premium Tax Credit ProgramCSR= Cost Sharing Reduction ProgramSHOP = Small Business Health Opportunities Program
Start Here
No Access Apply forAssessment
Integration with FFM
Arizona Wants to Avoid Consumer Confusion
?HEAplusFederally
FacilitatedMarketplace
??
Upcoming Milestones
What is the MIHS Plan?
Focus on Micro-targeting
Collaborate with VISTA and AmeriCorp Volunteers
Develop Matrix of Leads within Clinics or Areas of the Hospital
Create and/or Distribute Informational Materials
Created [email protected]
Created SharedGroup Folder: ACA 26
What is the MIHS Plan?
Training staff on how to help customers by: • Identify those who will benefit• Inform them of the programs (Medicaid Expansion
and Marketplace)
• Educate patient (Family Learning Centers)
• Refer patients (Consumer Assisters, Brokers, Agents and Navigators)
• Enroll (HEA Plus or FFM) Explore scheduling enrollment events
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For More Information
1. Contact your Medical Provider or Case Manager
2. Visit www.healthcare.gov Visit www.CuidadoDeSalud.gov
3. Health Insurance Marketplace Toll-free Call Center Available 24/7 1-800-318-2596 TTY: 1-855-889-4325
4. Contact our Family Learning Center Staff at 602-344-1352
5. E-mail MIHS at [email protected]
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Acknowledgements
This presentation is a compilation of many sources including:Center for Medicare and Medicaid Services, The Health Insurance Marketplace (July 2013)Census Bureau, Current Population Survey, (March 2011 and 2012)
Enroll AmericaKaiser Family Foundation, Tracking Poll (April 2013)Arizona Health Care Cost Containment System Administration (May 2013)Arizona Alliance for Community Health Centers (July 2013)
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