NEW CMS AND HHS RESOURCES

1. NEW CMS RESOURCE: 2016 Federally-facilitated Marketplace Assister Training Content

The content of Navigator Training Courses and Certified Application Counselor Training Courses are now available online. Click here to view the Navigator course modules, click here to view the CAC course modules, and click here to view links to both, along with other technical assistance resources for the 2016 assister training.  

2. NEW Blogs on Preventive Care and Understanding Financial Help

Click here to view a recent, consumer-friendly blog on HealthCare.gov about qualifying for savings to purchase Marketplace coverage, and click here to view another HealthCare.gov blog about preventive care and staying healthy during flu season! 

3. NEW Resources: Supporting Enrollment Needs for People Living with HIV

Many external organizations have developed tools, tips, materials, or training sessions that assisters can use.  We are sharing those resources through this weekly newsletter and by posting them on Marketplace.cms.gov. If you would like to recommend other helpful resources, please email CACQuestions@cms.hhs.gov. We will be limited to sharing resources that are (1) applicable to assisters facilitating enrollment in the Federally-facilitated Marketplaces (including State Partnership Marketplaces); and (2) open and accessible to the public.

What do you need to know to help people living with HIV find an affordable plan that covers their critical medications and care? The Health Resources and Services Administration (HRSA) has a variety of resources to help you answer this question. Watch this short animated video from the HRSA-supported TARGET Center, and download this 1 page fact sheet to better understand the enrollment needs of people living with HIV. Also, download this slide deck of HRSA’s HIV/AIDS Bureau’s 2014 presentation to CMS assisters for more information about assisting people living with HIV in the Health Insurance Marketplace.

DECEMBER 7 IS LGBT WEEK OF ACTION

During the week of December 7, the Department of Health and Human Services will celebrate an OE3 Lesbian, Gay, Bisexual, and Transgender (LGBT) Week of Action. HHS will take the opportunity this week to discuss LGBT health and health disparities, highlight health resources available to LGBT consumers, and promote Open Enrollment while doing targeted outreach to LGBT communities. In honor of LGBT Week of Action and to help you get ideas for  reaching and assisting these communities, please see the following resources dedicated to outreach, education, and enrollment assistance for LGBT communities.

Assister Webinar on Reaching and Assisting Lesbian, Gay, Bisexual, and Transgender Communities (in collaboration with Out2Enroll):

On HealthCare.gov:

Other Resources:

Strong Families: Where to Start, What to Ask: A Guide for LGBT People Choosing Health Care Plans

RURAL HEALTH WEEK OF ACTION AND NATIONAL RURAL HEALTH DAY

Many external organizations have developed tools, tips, materials, or training sessions that assisters can use.  We are sharing those resources through this weekly newsletter and by posting them on Marketplace.cms.gov. If you would like to recommend other helpful resources, please email CACQuestions@cms.hhs.gov. We will be limited to sharing resources that are (1) applicable to assisters facilitating enrollment in the Federally-facilitated Marketplaces (including State Partnership Marketplaces); and (2) open and accessible to the public.

This week is the National Rural Health Week of Action, and Thursday, November 19, is National Rural Health Day. Rural communities are great places to live and work, which is why 16 percent of the population, or nearly one in five Americans, call them home. With populations that are disproportionately older, less educated, and more likely to have chronic disease, these rural communities have unique healthcare needs. Rural Americans are more likely to be uninsured than residents in urban areas, have lower income levels, are more likely to be on food stamps, and have access to fewer health resources. Additionally, fewer rural states have expanded Medicaid and the majority of rural residents live in a state without plans to expand Medicaid.

The National Organization of State Offices of Rural Health (NOSORH) was established in 1995 to assist State Offices of Rural Health (SORHs) in their efforts to improve access to, and quality of health care for Rural Americans. For more information on National Rural Health Day, resources, and ideas on how to celebrate, click here. For additional information and resources:

CMS Announces $32 Million to Help Get Eligible Children Enrolled in Health Coverage

On Monday, November 16, CMS announced $32 million in available funds to support efforts to reach out to families with children eligible for Medicaid and the Children’s Health Insurance Program (CHIP) and help them get covered. The funds will support efforts to reach out to families with children eligible for Medicaid and CHIP, and help get them covered and stay covered for as long as they qualify. CMS expects to award approximately 30 cooperative agreements, ranging in size from $250,000 to $1 million over a two-year period. Proposals are due January 20, 2016.CMS will host two conference calls for prospective applicants:

  • Thursday, November 19; 3:00 pm-4:00 p.m. EST | Call-in: 1-877-267-1577; Passcode: 992 099 111
  • Monday, November 30th, 3:00 pm-4:00 pm EST | Call-in: 1-877-267-1577; Passcode: 998 168 839; Password: Meeting1

Please send questions regarding this information to: CMS_TA@grantreview.org, and click here to view more information.

Additional Resources:

Read the entire press release by clicking here. CMS invites all eligible entities to apply. Proposals are due January 20, 2016. For more information, including application requirements, visit http://www.grants.gov. Information on past Connecting Kids to Coverage grant awards can be found here.

Reminder: Assister Help Resource Center (AHRC)

Have you used the AHRC yet? As mentioned in the November 12th assister newsletter, CMS recently launched the Assister Help Resource Center for the 2016 Open Enrollment period. The AHRC is a dedicated call center for assisters in states using the Healthcare.gov platform. The AHRC focuses on policy issues; the customer service representatives will not have access to the consumer’s application. See our questions and answers here for more about this resource for assisters. Some common questions the AHRC is fielding include determining income and identity verification. Assisters can access the AHRC by calling 855-811-7299. The AHRC is open Monday through Friday from 9am to 9pm EST and Saturday from 9am to 5pm EST during Open Enrollment for the individual market.

NEW CMS RESOURCE: MARKETPLACE HEALTH COVERAGE RIGHTS AND PROTECTIONS

To help consumers better understand their rights when they enroll in a Marketplace health plan, CMS released a new fact sheet, Health Insurance Marketplace: Know your rights. This resource offers information on rights and protections that consumers have when they enroll in a Marketplace plan.

These rights include:

  • Getting easy-to-understand information about what a plan covers, what consumers will pay for services out-of-pocket, what drugs a plan covers, and what providers are in its network
  • Getting coverage for emergency services
  • Requesting coverage for a prescription drug that’s not normally covered by a plan
  • Appealing a health plan’s decision not to pay a claim

Click here to view this new, consumer-directed fact sheet. You can also use the HealthCare.gov section on “Health coverage rights and protections” section of HealthCare.gov to help consumers learn more about their rights when they enroll in a Marketplace plan.

CORRECTED LINK: CONSUMER GUIDE FOR ANNUAL HOUSEHOLD INCOME DATA MATCHING ISSUES

Last week’s newsletter included information on a new resource guide from CMS which assisters can use to help consumers through the eligibility and enrollment process and to resolve annual household income data matching issues. However, the link included in last week’s newsletter was incorrect; please use this link to access the Consumer Guide for Annual Household Income Data Matching Issues. This guide will:

  • Help consumers understand how the Marketplace uses annual household income to decide whether a consumer qualifies for help paying for health coverage through the Marketplace.
  • Explain how a consumer should send the Marketplace proof of income if his or her information wasn’t verified by our data sources when the consumer applied, also known as an income data matching issue.
  • Click here to view this consumer guide for annual household income data matching issues

For more information on data matching issues below are some additional resources:

  • How do I Resolve an Inconsistency?
  • Tips to Resolve Data Matching Issues
  • Tips for Submitting Supporting Documents to the Marketplace

Reminder: Assister Help Resource Center (AHRC) Launched for the 2016 Open Enrollment Period

Have you used the AHRC yet? As mentioned in the October 28th assister newsletter, CMS recently launched the Assister Help Resource Center for the 2016 Open Enrollment period. The AHRC is a dedicated call center for assisters in states using the Healthcare.gov platform. The AHRC focuses on policy issues; the customer service representatives will not have access to the consumer’s application. See our questions and answers here for more about this resource for assisters. Some common questions the AHRC is fielding include determining income and identity verification. Contact your program point of contact to learn more on who should use the AHRC and for the phone number.  

November is Lung Cancer Awareness Month & Nov. 19th is the Great American Smokeout!

November is Lung Cancer Awareness Month.  The American Cancer Society is sponsoring the Great American Smokeout on November 19th.  This year’s theme is Quit Like a Champion.

Smokers who quit – and stay quit – are champions to us, their families, and their friends. Make sure to check out Great American Smokeout Event Tools and Resources for downloadable flyers, posters, and table tents as well as ready-to-use web and social media graphics for your workplace, community, and school.

You can also visit the The Great American Smokeout page on cancer.org to get more information/resources on quitting, including the below:

-What are the Benefits of Quitting?

-QUIZ: Do You Need Help Quitting?

-Desktop Helpers

-Expert Voices Blogs on Tobacco and Smoking

-Latest News About Tobacco and Smoking

-Fight Back Against Tobacco

-Get the new Quit For Life Mobile app from Alere Wellbeing, available for iPhone and Android

 

ACS flyers you can print to utilize for GASO and lung cancer awareness are listed on the website as well:

-Tobacco and Cancer

-GASO one pager

-GASO Recovery Infographic

-Lung cancer research flyer

-Lung cancer fact sheet

 

ACS brochures that you can order for FREE are listed below  and come in packs of 25:  

Tobacco and the LGBT Community – This awareness brochure written specifically for the lesbian, gay, bisexual, and transgender community, addresses the issue of smoking in this community. It has a stop smoking message.

The Decision is Yours (also available in Spanish) -This graphic pamphlet will certainly help young people make the decision not to start smoking. With medical photos of a healthy lung, emphysema, and lung cancer, this pamphlet gives graphic and detailed information on the harmful effects of smoking.

Set Yourself Free: A Smoker’s Guide (also available in Spanish) – This booklet was created to help smokers quit. It describes the various methods and resources that can be used by smokers who want to quit.

The Smoke Around You (also available in Spanish) – A pamphlet that outlines the dangers of secondhand smoke is always useful for our nonsmokers (especially during Smokeout). Includes sections on “Who’s Taking Action” and “What You Can Do.”

Smart Move! A Stop Smoking Guide – This popular booklet is designed to help the smoker quit by teaching about smoking, helping the smoker plan to stop, and letting the smoker know what to expect after stopping. It also contains the advice of other smokers who have given up cigarettes. Includes ACS toll-free number and web site address.

The Cold Hard Facts About Dip – This piece is designed to help heavy users quit their habit. It provides important information on the dangers of smokeless tobacco. The full-color brochure, which includes graphic illustrations of what can happen with continued use of oral tobacco, is aimed at an adult male audience.

Living Smoke Free – for You and Your Baby (also available in Spanish) – Simply stated, smoking hurts your baby before it’s born, after it’s born, and it hurts you. Following all three statements are detailed facts supporting the dangers of smoking during pregnancy, including harm to the baby, an increased chance of infant mortality, and harm to the mother’s health.

When Smokers Quit – This pamphlet for adults highlights the immediate (and long-term) positive benefits of quitting smoking from the first 20 minutes after quitting through the first 15 years after quitting.

12 Things to Do Instead of Smoking poster (16×24) (also available in Spanish) – these are ordered individually – Targeted for a young audience, this classic poster, by renowned graphic artist Seymour Chwast shows fun activities to do instead of smoking, including riding a bike, playing, or even doing nothing at all!

REMINDER: HELP CONSUMERS ENSURE TIMELY FORMS 1095-A

As noted in the October 14, 2015 assister newsletter, assisters can help consumers reduce Form 1095-A errors and ensure timely delivery of the form by:

  • Encouraging consumers who had 2015 Marketplace coverage to update their mailing address by November 15, 2015 if their mailing address changed during 2015 so that their Form 1095-A will be sent to the correct address.
  • Suggesting to consumers enrolling in coverage through the Marketplace for the first time, or who have not previously used an online account, to create their online account before January 1, 2016.

Background: Taxpayers who enrolled in coverage through the Health Insurance Marketplaces and received advance payments of the premium tax credit (APTC) must reconcile the total APTC they received during the year with the amount of premium tax credit (PTC) for which they are eligible based on their income using a tax statement from their Marketplace called a Form 1095-A. Specifically, consumers should use information from their Form 1095-A to complete Form 8962—Premium Tax Credit.

Click here to read more about health coverage and federal income taxes on HealthCare.gov, and use the following tips to help consumers make sure that they receive an up to date Form 1095-A at the correct address, as soon as it’s available.

Thank you for your hard work helping consumers understand these important updates; we look forward to providing additional information and tips for helping consumers through the newsletter’s “TIPS on Filing Taxes” section in the coming months.