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
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