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, open to anyone with or without insurance coverage

State-wide Reach Arizona’s largest primary care network; serving rural, urban and tribal areas

If Arizona Had 100 People Employer sponsored Insurance: 46 Medicaid (AHCCCS): 18 Medicare: 13 Other Public Private Insurance : 4 Uninsured: 18

Who Has the Most to Gain? Uninsured: 18 1,000,000 Under the age of 65 AHCCCS Marketplace 45% 55% Apprx. 450,000 Apprx. 550,000

AHCCCS or Marketplace 400% FPL Marketplace & 250% FPL Financial Assistance 138% FPL AHCCCS 0

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

Application Four Steps

Connecting to Coverage  Navigators  Certified Application Counselors (CAC)  Health-e-Arizona Plus Assisters  Insurance Brokers

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 Marketplace AHCCCS  healthearizonaplus.gov  Healthcare.gov  1-855-HEAplus  Marketplace hotline: (1-855-432-7587) (800) 318-2596 or TTY: (855) 889-4325  DES Offices  Paper Applications  Paper Applications

Where to Find Help AHCCCS & Marketplace  Navigators and Application Counselors 211 (By December 1)  Online directories at:  Healthcare.gov  Coveraz.org  AACHC.org

Key Dates Marketplace  Oct. 1 – March 31: Open enrollment; sign-up and pay 1 st premium by 3/31/14 and no “penalty” Coverage begins January 1, 2014   B e “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