Members-only Webinar:
Hospital-based Medicaid Presumptive Eligibility and Enrollment

View the free webinar held March 4.  During this 90-minute session, you will learn the latest implementation news from Medicaid officials with the Centers on Medicare & Medicaid Services.


Health care coverage is an essential component of achieving the AHA’s vision of healthy communities, where all individuals reach their highest potential for health.  The Affordable Care Act (ACA) holds the promise of extending coverage to more than 25 million uninsured Americans through a combination of public programs and private-sector health insurance expansions. 

Beginning Oct. 1, the federal and state governments will launch a six-month open enrollment period to offer affordable health care insurance to eligible individuals through the health insurance Marketplaces, implementing the ACA coverage provisions.  Coverage takes effect Jan. 1, 2014.

But people won’t enroll if they don’t know about the new coverage options.  That’s why it’s critical for all community stakeholders, including hospitals, to help make the enrollment process easy, accessible and widely available. 

Below you’ll find resources to help you navigate the ACA’s insurance Marketplaces and Medicaid and Children’s Health Insurance programs. 

 

Regulatory Advisory: Update on 2015 Regulatory Actions for ACA Marketplace and Medicare Advantage 

HHS/AHA Special Webcast Held Jan. 23

Members-only Webinar Held November 21: Hospital-based Medicaid Presumptive Eligibility and Enrollment

Get Enrolled Case Examples

AHA Member Advisory: Understanding and Monitoring New Insurance Coverage Issues

Special Bulletin: Resources to Help Consumers and Providers with Insurance Coverage Questions

Webcast - Expanding Health Coverage: Working with Community Stakeholders on Health Insurance Enrollment (Held Sept. 16)

Special Bulletin - Medicaid Presumptive Eligibility Hospital Toolkit Available

AHA Member Advisory – Helping People Get Insurance Coverage: Options for Hospitals

Special Bulletin – CMS Rule on ACA provisions Related to Eligibility and Enrollment for Medicaid and CHIP, Presumptive Eligibility and Coordination with the Insurance Marketplaces.

Special Bulletin – CMS Rule on Marketplace Standards for Navigators & Others

Regulatory Advisory – Update on Implementation of ACA Insurance Reforms

Special Bulletin – HHS Rule on Essential Health Benefits & Related Provisions

 

 

Enroll America - Promising State Approaches for Using Hospital Presumptive Eligibility

Rober Wood Johnson Foundation Issue Brief - Implementation of the Affordable Care Act’s Hospital Presumptive Eligibility Option: Considerations for States

Get Covered Calculator: Estimate Your Costs

Enroll America State and Regional Staff Contacts

Alliance for Health Reform - ABCs of the ACA - What You Need to Know

The Center for Consumer Information Insurance Oversight - In-Person Assistance in the Health Insurance Marketplace

Cut the Cost of Health Insurance - Consumers Union State by State Information on New Health Premium Tax Credits

New Chart - State Approaches to Consumer Assistance Training

Enroll America – For help on enrollment and eligibility, visit Best Practices for webinars, maps and state profiles.

Health Insurance Marketplace – Health care providers helping consumers with questions on insurance and enrollment can find training materials, Powerpoint presentations plus other resources on this new CMS website. Some are available in Spanish. 

BusinessUSA - Information for small businesses about new health care changes

Catholic Health Association of the United States - Animated video on Enrollment and Presumptive Eligibility

HealthCare.gov – This consumer site offers a wealth of resources in plain English, such as “What is an Insurance Marketplace?” and live chats.  Plus there’s a Spanish sister site

Get Covered America – This site from Enroll America is directed at consumers with an emphasis on public awareness and grassroots efforts. 

Medicaid Enrollment: Your Guide for Engaging People Experiencing Homelessness

Kaiser Family Foundation – Find health reform facts and tools, including a consumer-friendly video explaining the ACA, to use with your community. 

StateReforum - An online network for health reform implementation.

Click on the map to view state-specific health coverage resources, such as insurance commissioner, Medicaid and CHIP enrollment, Marketplaces and resources from your state hospital association. 

   

Latest News: 

Health Insurance Marketplace - As the start of coverage for Qualified Health Plans approaches, CMS anticipates that some of the newly insured individuals will have questions about how to access healthcare services.  CMS has posted information on Marketplace.cms.gov to address questions that consumers may have with the January 1 start of coverage through their selected health plan.  Individuals who have insurance for the first time or have new plans beginning on January 1 are likely to have many questions related to coverage, premiums payments, co-payments, and other issues and may need to reach their individual insurance plan.    

Information currently available on Marketplace.cms.gov  to assist consumers and providers with plan specific information includes the “Contacting your Health Plan’s Customer Service Phone Number” factsheet ( http://marketplace.cms.gov/getofficialresources/publications-and-articles/contact-health-plan.pdf).  You can use this factsheet which includes instructions about how to contact insurance plans and a link to a database containing the customer service phone numbers for all of the Qualified Health Plans (https://data.healthcare.gov/dataset/QHP-Customer-Service-Phone-Numbers/vryg-tdzf?). 

Consumers who signed up through Healthcare.Gov can also find out information related to their health plan by logging on their HealthCare.gov account or by contacting the Health Insurance Marketplace call center at 1-800-318-2596.

CMS understands that providers will receive additional questions over the coming months from patients or customers.  We are working on getting additional materials published to assist you with additional questions or issues that you may encounter during the transition period.


SAMHSA Offers ACA Enrollment Tool Kit - The Substance Abuse and Mental Health Services Administration (SAMHSA) is now offering an interactive tool kit/webcast to behavioral health and other organizations to help patients and clients to sign up for insurance coverage through the Health Insurance Marketplace (formerly known as the Exchange) under the ACA. The 30-minute long tool kit/webcast explains the health care law and how it helps people with mental and substance use disorders; outlines how to use the Health Insurance Marketplace; and provides communications ideas and materials with a focus on getting the word out to uninsured individuals.

To access the tool kit/webcast, fill out a brief registration form. SAMHSA also has a special health reform webpage

The Centers for Medicare & Medicaid Services has released two new publications for health care providers: Health Insurance Marketplace: 10 Things Providers Need to Know and Health Insurance Marketplace:  10 Things to Tell Your Patients.

CMS has posted the content of the training modules for certified application counselors at: http://marketplace.cms.gov/training/get-training.html.

 

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