Assisters - Be Counted!
The Health Insurance Marketplace application includes a section where consumers indicate if they received assistance with their application from a Navigator or Certified Application Counselor (CAC). Be sure to add your name, health center information and CAC or Navigator ID in the designated section. Applications from 2017 did not auto-populate this information and it must be re-entered for consumers who are reenrolling and new consumers. These identification numbers are collected by CMS and may be used for Navigator funding determinations in the upcoming years.
Mark Your Calendar - Upcoming Webinars
PACHC will host two informative webinars for Navigators and Certified Application Counselors (CACs). Get your most complex issues answered on Medicaid eligibility and immigrant coverage options.
Medicaid Eligibility - A Refresher Tuesday, Dec.19 from 10:00 am - 11:30 am
- This webinar will provide an overview of Medicaid eligibility for children, pregnant women and adults (with or without disabilities). It will highlight who is and is not covered under Medicaid expansion and briefly review Medicaid's tax-based rules for defining income and household. We'll also discuss the Medical Assistance for Workers with Disabilities program.
Immigrant Coverage Options - Tuesday, Jan. 2 from 10:00 am to 11:30 am
- What does it mean to be a "qualified" immigrant? What is the five-year bar? What state-funded Medical Assistance categories are available to very low-income immigrants? This webinar will cover the Medicaid immigration status requirements in depth. We'll also discuss the option of Marketplace coverage and subsidies for certain immigrants who do not qualify for Medicaid.
Grace Period Knowledge Check
Q: John, who's eligible for advance premium tax credit (APTC), selects his plan during Open Enrollment. John makes his binder payments on time to effectuate his coverage. John does not make a premium payment for May. By the end of the three-month grace period, John has not paid all outstanding premium owed (within the tolerance of any applicable premium payment threshold). When does John's grace period expire?
A: The answer is July 31.
Individual Mandate Penalty Calculator
This week, the Kaiser Family Foundation posted a new Individual Mandate Penalty Calculator. This tool assists with estimating whether consumers qualify for any exemptions from the individual mandate penalty, where consumers are on the federal poverty level (FPL) chart, if the Marketplace coverage is unaffordable or if they are eligible for Medicaid. This tool can be used in conjunction with www.Healthcare.gov and PA.Checkbookhealth.org.