Health Insurance Marketplace

Reform

For information on taxes, please see our Health Coverage and Taxes Page…http://projectaccesseasttn.org/latest-news/community-interest/health-care-reform/taxes/

Third ANNUAL OPEN ENROLLMENT FOR

HEALTH INSURANCE PLANS

THROUGH THE MARKETPLACE Has CLOSED

[IMPORTANT DATES]

After January 31st, you must have a qualifying life event which will start a Special Enrollment Period in order to sign-up for a Marketplace Plan.

TennCare Applications can be done AT ANY TIME.

Remember: Project Access can help with applications during Open Enrollment, applications during Special Enrollment Periods, Appeals, Exemptions, and new TennCare applications.  Our Navigators can assist residents of Carter, Greene, Hancock, Hawkins, Johnson, Sullivan, Unicoi, and Washington counties in Tennessee.  423.232.6700 or 423.676.3457.

[FLYERS]

Already Enrolled in a Marketplace Plan?
See the CMS Flyer 
5-Steps-to-Staying-Covered

[ENROLLMENT EVENTS]

SEE OUR SITE’s CALENDAR for PROJECT ACCESS’S UPCOMING EVENTS  http://projectaccesseasttn.org/events/

For all GET Covered Tennessee Events visit
http://www.getcoveredtenn.org/

[TennCare – Tennessee’s Medicaid Program]

Redetermination
If you are CURRENTLY ENROLLED IN TENNCARE, the Tennessee Health Connection will be handling your recertifications/re-enrollments.  If you have any questions, or have not heard anything about your TennCare coverage, call their toll free number at 1-855-259-0701.

Important: the Department of Human Services no longer has a contract with the State of Tennessee to do TennCare applications – this means that when you apply for Food Stamps you are NOT being screened for TennCare coverage – ALL NEW TennCare applications must go through the Health Insurance Marketplace.

If you NEED TO SIGN-UP for TennCare, Project Access can help.  Call us at 423.232.6700. We have a main office location in Johnson City and a traveling Navigator who can help you in-person in any of our 8 service counties in TN: Carter, Greene, Hancock, Hawkins, Johnson, Sullivan, Unicoi, and Washington.

  • You can APPLY AT ANY TIME for Medicaid/TennCare.
  • In all states, Medicaid provides free or low-cost care for some low-income people, families and children, pregnant women, the elderly, and people with disabilities.
  • Medicaid programs must follow federal guidelines, but coverage and costs may be different from state to state. Some Medicaid programs pay for your care directly. Others use private insurance companies to provide Medicaid coverage.

Services Typically Covered by TennCare

Specialists, Wellness/Preventive Services, Dental (those 20 or younger), Mental Health, Transportation, Children’s Healthcare, Pharmacy Benefit, Prescription Medications

Please see http://www.tenncareadvocacy.com/index.php/what-services-are-covered for more information

[CoverKids – Tennessee’s CHIP – Children’s Health Insurance Program]

  • You can APPLY AT ANY TIME for CHIP Coverage.
  • CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers parents and pregnant women. Each state offers CHIP coverage, and works closely with its state Medicaid program.

https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/
http://www.coverkids.com/WebForms/StaticContent1.aspx

CoverKids Benefits http://www.covertn.gov/web/coverkids_benefits.html

[Medicaid Expansion and the Coverage Gap]

The Affordable Care Act provides states with additional federal funding to expand their Medicaid programs to cover adults under 65 with income up to 133% of the federal poverty level. (Because of the way this is calculated, it’s effectively 138% of the federal poverty level.) Children (18 and under) are eligible up to that income level or higher in all states.

This means that in states that have expanded Medicaid, free or low-cost health coverage is available to people with incomes below a certain level regardless of disability, family status, financial resources, and other factors that are usually taken into account in Medicaid eligibility decisions.

If you live in a state that hasn’t expanded its Medicaid program (Tennessee has not expanded its Medicaid program as of 02.03.2016) and you have limited income, you may not have many options for health coverage. It will depend on where your income falls.

Medicaid Gap

[VISUAL INFORMATION]

 


[IN-PERSON ASSISTANCE]

Anyone in Tennesse can find local assistance by going to http://www.getcoveredtenn.org/ or by calling 1-844-644-5443.

Get Covered

Navigators – In the State of Tennessee, 2 Grants are given by the U.S. Department of Health & Human Services to fund Navigation efforts.

For Year 1: 2013-2014, one grant was awarded to SeedCo [Structured Employment Economic Development Corporation http://www.seedco.org/healthcare-access/tennessee/] and the other to the Tennessee Primary Care Association.  AMPA/Project Access was funded for 2 Navigators and served as part of a state-wide collaboration under SeedCo.  TPCA dedicated one Navigator to the Northeast TN Region, who worked out of Nashville, and oversaw the Federally Qualified Health Centers (such as the Johnson City Community Health Clinic and the Rural Health Consortium).

For Year 2: 2014-2015, SeedCo was again awarded funds and continued to serve as the lead Grantee for a state-wide collaborative of non-profit organizations.  Project Access continues as a subcontractor, responsible for the eight county region of Northeast TN, plus the four additional counties added for the 2014-2015 Grant Year: Claiborne, Cocke, Grainger, and Hamblen.  APA (Advanced Patient Advocacy http://www.enrollapa.com/navigator-locations/tennessee) was the other group awarded Navigator funding.  They had Navigators available at Mountain States Health Alliance hospitals in TN (specifically, Johnson City Medical Center in Johnson City, Indian Path Medical Center in Kingsport, and Sycamore Shoals Hospital in Elizabethton).

For Year 3: 2015-2016, Family & Children Services out of Nashville and The Wellmont Foundation were awarded the two Navigation grants in the State of TN.  AMPA/Project Access continues with a state-wide collaboration of non-profits under the direction of Family & Children Services.  We continue with funding for 2 full time Navigators with the rest of our staff trained as either Certified Application Counselors or Assisters.  Navigators are not allowed to charge for services.  Please call Project Access at 423.232.6700 for assistance.

For Virginia Residents, please contact Enroll Virginia http://enroll-virginia.com/ev.  Navigator, Marcie Barnes, Marcie@Enroll-Virginia.com, 1.855.207.5636.

Certified Application Counselors – In the State of TN, the Health Resources and Services Administration provided funding to Federally Qualified Health Centers for Certified Application Counselors.  There are also some CACs at Non Profit Organizations (for example, Project Access has CACs as well; we do not receive any funding for providing thise service) and Program Specific CACs (such as at the Health Department for the Ryan White and the Breast & Cervical Cancer Programs).  CACs are not allowed to charge for services.  Please call Project Access at 423.232.6700 for assistance.

For Virginia Residents, please contact Enroll Virginia (1.855.207.5636).

[Articles and Publications]

A Checkup for Obamacare Reveals a Positive Prognosis
Washington Post Article, 01.07.2016

“Between the year that the Affordable Care Act passed (2010) and the first half of 2015, the share of Americans younger than 65 who were uninsured was nearly halved, falling from 18.2 percent to 10.5 percent”

Surveys show that Americans are pretty keen on almost all of Obamacare’s specific provisions, such as guaranteeing coverage for people with preexisting conditions, the Medicaid expansion, no out-of-pocket costs for preventive care, and letting children stay on their parents’ health plans until age 26″.

For the full article: https://www.washingtonpost.com/opinions/a-checkup-for-obamacare-reveals-a-positive-prognosis/2016/01/07/f3e13c10-b582-11e5-9388-466021d971de_story.html