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Please note that this newsletter corrects the links that were included in the newsletter that was sent on December 31.
This week’s newsletter includes updates and tips to help assisters facilitate enrollment and help consumers begin using their new health insurance.
Since the beginning of open enrollment, millions of Americans are gaining access to health coverage–many for the very first time—thanks to the Affordable Care Act. The most recent data indicate that more than 2.1 million people have enrolled in a private health insurance plan through the Federal and State-based Marketplaces since October 1.
Both states and the federal government have seen a surge in enrollment in December. Our HealthCare.gov enrollment nearly doubled in days before the January 1 coverage deadline compared to the first weeks of the month. Nationwide, including state and federal marketplaces, December enrollment so far is nearly 6 times that of October and November combined.
We expect these numbers to continue to grow through the end of March when open enrollment ends.
Thanks for all of your efforts to make these first three months of open enrollment so successful!
This Friday, January 3rd we will have our weekly assister call where will we discuss the latest information to help assisters reach consumers and facilitate enrollment, as well as tips for helping consumers understand their health insurance coverage.
The deadline to sign up for coverage to start January 1st was December 23rd. Since we experienced high demand and consumers enrolled from multiple time zones, we took steps to make sure that those who tried to enroll, but had delays due to high traffic to HealthCare.gov, maintenance periods, or other issues with our systems had a fail-safe. We programmed our systems to support January 1 coverage for those who attempt to complete their enrollment through the end of December 24, 2013. This is similar in concept to Election Day: if you are in line when the polls close, you still get to vote. In addition, as noted in our listserv message on December 26, consumers who were unable to complete their application because of these types of circumstances should call the Call Center (1-800-318-2596, available 24/7), preferably before December 31st. The consumer should tell the Call Center customer service representative that they tried to enroll and explain why they couldn’t finish by the December 23rd deadline, and ask if they can get covered by 1/1. The call center representative can explain to the consumer what they can do to finish their enrollment and still get covered for 2014.
We want to remind assisters that consumers who successfully enrolled in a health plan need to pay their premium directly to the insurance company in order to have coverage by January 1, 2014. Consumers can pay when invoiced by the plan, call the issuer to make payment, or pay online if the plan accepts online payment. All consumers have until at least December 31, 2013 to pay for coverage effective January 1, 2014 although some insurance companies have extended this deadline. Consumers should check with their insurance company to find out when their first premium is due in order for coverage to be effective January 1. Consumers should also confirm with the issuer that their first month’s premium has been received and that enrollment is complete.
Please note that once a consumer selects a plan through the Marketplace, it may take the health plan 48-72 hours to receive and process the enrollment, so please encourage consumers to continue to periodically check back with their selected health plan. The insurance company will also send plan information and an insurance card to consumers who have completed enrollment including payment of the premium.
While December 24th was a significant date for Americans looking to secure coverage beginning January 1st, it is important to remember that we are about halfway through the full six month open enrollment period. Consumers have until March 31, 2014 to enroll for coverage through the Marketplace during this open enrollment period. We will continue to work to ensure that HealthCare.gov and our other enrollment channels continue to improve and are available for consumers looking to sign up for affordable coverage by the end of March and will continue to keep you updated with the latest information. Consumers that enroll in coverage by March 31, 2014 will not have to pay the individual responsibility payment for the time that they are without health insurance coverage in 2014.
The majority of consumers who are experiencing technical difficulties with their online application should try starting the process again by removing and restarting an application. This way, consumers can start with a fresh slate and take full advantage of the recent fixes we’ve made to the system. In addition, a helpful best practice is to recommend that the consumer save and print a screenshot of any error message s/he may receive on the website.
If a consumer’s effort to remove and start over with a new application still leads to the same issue we recommend that the consumer call the Call Center for assistance. The Call Center will work to assist the consumer to successfully move the consumer through the enrollment process.
Many consumers will have new health insurance coverage starting on January 1, 2014. Some of these consumers may be new to private health insurance coverage or may be reentering the health insurance market after a long gap in coverage and may have questions about how to use their new health insurance coverage.
Depending on when a consumer enrolled in coverage and paid the premium, he or she may not receive an enrollment package and insurance card by January 1. Even if a consumer has not received their enrollment package and insurance coverage, their coverage may be effective and they may be able to begin using their insurance. If a consumer has not received these documents, the consumers should call the health insurance company’s consumer assistance line to confirm enrollment and to ask any questions they may have about when they should receive their enrollment package or about using their new health insurance and covered benefits. Consumers can find this contact information on Plan Compare and on the health plan’s Summary of Benefits and Coverage.
If a consumer has questions about eligibility for coverage or subsidies the consumer should call the Call Center for assistance.
The following links on HealthCare.gov should be helpful if there are questions about using new health insurance coverage:
- What You Should Know About Seeing Your Doctor
- What You Should Know About Getting Your Prescription Medications
- Appealing Your Insurer’s Decision Not to Pay
- I Signed Up, But Don’t have Health Coverage. What Should I Do?
- Getting Emergency Care
- What You Should Know about Early Renewal of Health Coverage
- What You Should Know about Provider Networks
We are excited to announce a new story collection tool that allows Assisters and consumers to share their stories about enrolling in the Marketplace or about how consumers are benefiting from the many other protections under the Affordable Care Act. Stories submitted may be featured on Health and Human Services blogs and other social media postings.
Assisters and other partners can use the “Got Covered” widgets and badges internet page to submit their own stories or to direct consumers to this new tool so consumers can share their stories about enrolling in and using their new coverage. Consumers and assisters may also submit stories to My Story.
1Q: Do permanent residents holding a "green card" qualify for government subsidies in the form of premium tax credits for the purchase of a qualified health plan (QHP) through the Marketplace?
1A: Yes. Lawfully present non-citizens, including permanent residents ("green card holders"), are eligible to apply for and enroll in a qualified health plan (QHP) through the Marketplace. Permanent residents may also qualify for premium tax credits and/or lower out-of-pocket costs based on their income.
2Q: Do "dreamers" qualify for Marketplace coverage?
2A: Individuals who are lawfully present (including those under Temporary Protected Status, or under Deferred Enforced Departure or Deferred Action status) are eligible to apply for and enroll in Marketplace coverage. Individuals who are lawfully present may also be eligible for advance payments of tax credits or cost-sharing reductions. There is a specific exception in the definition of lawful presence, in that individuals with deferred action under the Department of Homeland Security’s Deferred Action for Childhood Arrivals (DACA) process are not considered to be lawfully present, and are not eligible for Marketplace coverage.
3Q: How should assisters help consumers fill in the dependent questions if they only claim a child every other year?
3A: Consumers should add the dependent to the initial application if they will be claiming them as a dependent for tax year 2014. The consumer is required to notify the Marketplace of any status changes that occur during the year. And, the consumer is required to update application information on a yearly basis.
4Q: Does an applicant have to have an email account to apply for coverage through the Marketplace?
4A: To apply through the Marketplace online, an email account is required. To most expeditiously apply and enroll in coverage, consumers are encouraged to utilize the online application process. Consumers may create email accounts free-of-charge. However, if the consumer applies over the phone or submits a paper application, an email account is not required.
5Q: If a consumer gets a mailed eligibility notice, how can I make sure it is not fraudulent?
5A: The eligibility letter that is mailed to the consumer will be on distinctive Health Insurance Marketplace letterhead. In addition, there will be two pages that have information about how to get assistance in several different languages; and the last page of the letter will have a barcode on it.
We have posted some new FAQs to the Assister Resource page: Helping Consumers With Applications and Helping Consumers With Eligibility.
If you are a Navigator grantee and have specific questions or issues you’d like to see us highlight in our weekly webinar/conference call, or here in this newsletter, please get in touch with your Navigator project officer. If you are a CAC designated organization, please send an email to CACQuestions@cms.hhs.gov.
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