The ACA in Arizona Connecting To Coverage Who is Impacted - - PowerPoint PPT Presentation

The ACA in Arizona Connecting To Coverage

• Who is Impacted
• AHCCCS or Marketplace
• Do It Yourself
• Enrollment Assistance

Provider of Choice

Nonprofit, comprehensive primary care, located in underserved areas,

• pen to anyone with or without

insurance coverage

Arizona’s largest primary care network; serving rural, urban and tribal areas

State-wide Reach

Employer sponsored Insurance: 46 Uninsured: 18 Medicaid (AHCCCS): 18 Medicare: 13 Private Insurance: 4 Other Public

If Arizona Had 100 People

Uninsured: 18 1,000,000

Under the age of 65

Who Has the Most to Gain?

AHCCCS 45%

• Apprx. 450,000

Marketplace 55%

• Apprx. 550,000

Marketplace & Financial Assistance AHCCCS AHCCCS or Marketplace 400% FPL 250% FPL 138% FPL

AHCCCS or Marketplace

Household Size Income

1 2 3 4 5 6 7 8

$0 - $11,499 $11,500 - $15,999 $16,000 - $19,999 $20,000 - $23,999 $24,000 - $27,999 $28,000 - $31,999 $32,000 - $45,999 $46,000 - $62,499 $62,500 - $78,499 $78,500 - $94,499 $95,000 - $110,499 $110,500 - $126,499 $126,500 - $142,499 $142,500 - $158,999 $159,000+

Easy as One, Two, Three

• 1. Do you have health insurance?
• 2. How many in your family (IRS dependents)
• 3. What is your estimated 2013 and

2014 income?

No Wrong Door, Maybe a “Better” Door

Best door if earn too much for AHCCCS Best door if most likely eligible for AHCCCS and interested in SNAP (Food Stamps) or Cash Assistance

Marketplace “Mechanics”

Create an Account Apply Pick a Plan Enroll

Determination Notice APTC and RCS Routed to Ins. Co. to Enroll & Pay

Application Four Steps

• Navigators
• Certified

Application Counselors (CAC)

• Health-e-Arizona

Plus Assisters

• Insurance Brokers

Connecting to Coverage

Navigators Entities

• Arizona Alliance for Community Health Centers,

Statewide

• Arizona Board of Regents, University of Arizona

The Center for Rural Health, Tucson

• Campesinos Sin Fronteras, Inc., Yuma County
• Greater Phoenix Urban League, Inc., Maricopa,

Pinal and Pima Counties

Navigators & Application Counselors

• Unbiased FACILITATORS
• Can assist with AHCCCS or Marketplace
• Strict conflict of interest and privacy

requirements

• Must show all Marketplace options
• Will assist in multiple languages

Insurance Brokers

• Represent multiple insurance companies;

not necessarily all Marketplace plans

• Sell group and individual, off and on

the Marketplace

• Paid commission by insurance company
• Motivated to retain customers
• Not trained to assist with AHCCCS

BEWARE

Legitimate Brokers, Navigators and Certified Application Counselors don’t charge fees to consumers for their services.

• www. Helathcare.com

Levels of Coverage

The lower the premium the higher the deductible and co-pays The higher the premium the lower the deductible and co-pays

Do It Yourself

• healthearizonaplus.gov
• 1-855-HEAplus

(1-855-432-7587)

• DES Offices
• Paper Applications

AHCCCS Marketplace

• Healthcare.gov
• Marketplace hotline:

(800) 318-2596 or TTY: (855) 889-4325

• Paper Applications

Where to Find Help

• Navigators and Application Counselors

211 (By December 1)

• Online directories at:
• Healthcare.gov
• Coveraz.org
• AACHC.org

AHCCCS & Marketplace

Key Dates Marketplace

• Oct. 1 – March 31: Open enrollment; sign-up and pay 1st

premium by 3/31/14 and no “penalty”

• Coverage begins January 1, 2014
• Be “safe” enroll by December 1 if you want

coverage to begin in January

AHCCCS

• No open enrollment period
• Expanded AHCCCS coverage, scheduled to begin January 1

Do You Want to be Contacted?

Yes, please contact me so we can schedule an appointment. Name: Email: Phone: ZIP:

Allen Gjersvig Director Healthcare Innovation marketplace@aachc.org 602.218.3900