Attempt the following work- arounds for online applications

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1 Health Insurance Marketplace Applicatin Tips fr Immigrant, Refugee, and Nnimmigrant Visa Hlders Identity Verificatin Issues Identity prfing must be cmpleted in rder fr a cnsumer t submit an nline applicatin. Because the nline identity verificatin system relies n credit histry, many individuals are nt able t cmplete identity verificatin and cannt submit an applicatin nline. Optins fr Applying fr Peple Wh Can t Verify Identity Online Apply ver the phne Identity verificatin IS NOT REQUIRED with applicatins dne thrugh the Call Center. Cnsumers shuld be able t call the Marketplace Call Center ( ) and cmplete an entire applicatin and enrllment ver the phne. There are Spanish speaking representatives available thrugh the Call Center. Smetimes, individual Call Center Representatives may be hesitant t d an applicatin ver the phne fr cases in which identity cannt be verified. If yu run int this issue, yu can ask t speak t a Call Center Supervisr. In additin, smetimes it is mre effective t simply ask t d an applicatin ver the phne than t attempt t explain the identity verificatin issues. There is n reasn that Call Center representatives cannt cmplete an applicatin ver the phne. If an applicatin is dne ver the phne, the applicant will nt be able t view the health plans thrugh the usual nline enrllment tl. Representatives read the plan infrmatin t the applicant ver the phne. If a cnsumer is selecting a plan ver the phne, yu can use the Brwse Cverage Optins Tl (https://www.healthcare.gv/see- plans/ r https://www.cuidaddesalud.gv/see- plans/) t give the cnsumer a visual guide t their ptins and search prvider directries r frmularies befre enrlling thrugh the Call Center. Attempt the fllwing wrk- arunds fr nline applicatins When creating the new accunt nline, try using the fllwing wrk- arunds: Put cnsumer infrmatin in all CAPS If the cnsumer recently mved, use their last permanent address Leave Scial Security number (ptinal field) blank These tips d nt wrk in all cases, but have been successful fr many cnsumers facing difficulty with identity verificatin n the website. Create accunt nline and uplad r mail dcuments t Marketplace fr manual identity verificatin. Thrugh this methd, cnsumers wuld uplad r mail their identity verificatin dcuments t the This dcument was prepared in December 2014 and tips are subject t change as changes are made t the applicatin prcess. Please reprt updates t Alice Pllard r Brendan Riley

2 Marketplace. After a few days r weeks (depending n methd f submissin), cnsumers can return and attempt t submit an applicatin nline. With this methd, cnsumers cannt cmplete enrllment in ne appintment and must return t see an assister r apply n their wn nce manual identity verificatin is cmplete. This methd is nt recmmended due t the lng delays invlved. Immigratin Status Verificatin Peple wh are seeking health cverage must attest t being a U.S. Citizen r having an eligible immigratin status. The applicatin will ask applicants with eligible immigratin status t list a dcument that prves their status. Cnsumers shuld fill in fields as cmpletely as pssible. The infrmatin is checked with the DHS SAVE system. When helping cmplete an applicatin, it s helpful t use all capital letters fr first and last name f applicants and mit special characters r extra spaces. If verificatin f status des nt wrk, then cnsumers can attest t having an eligible immigratin status and prceed with the rest f the applicatin withut prviding dcument type and numbers. If therwise eligible, the applicant shuld be able t cntinue with enrllment. Applicants will need t uplad r mail prf f status t the Marketplace within 90 days. It s very imprtant that this prf f status is mailed because cverage culd be canceled if the Marketplace des nt receive this infrmatin. If verificatin des nt wrk, assisters shuld be very mindful f immigrants wh d nt qualify fr Medicaid based n their immigratin status (see nte belw). If the immigratin verificatin des nt wrk, the system will assume that the individual meets the immigratin requirements fr Medicaid. Therefre, it wn t recgnize ptential eligibility fr tax credits belw 100% FPL. Citizenship Status Verificatin Attestatins f U.S. citizenship will be checked against Scial Security Administratin (SSA) data, using SSNs. Verificatin may nt be successful fr naturalized r derived citizens thrugh SSA match. If s, they will be asked t prvide: an A#, and either a naturalizatin certificate number r a certificate f citizenship number. If the dcuments are unavailable, they can uplad r mail in ther prf f citizenship, such as a cpy f their U.S. passprt. Tax Dependents with Freign Address The HealthCare.gv applicatin nly accepts U.S. addresses. If a cnsumer has a tax dependent residing at a freign address, the cnsumer s dmestic address shuld be entered fr that dependent. This guidance cmes directly frm CMS. Additinally, the address must be entered identically fr each persn n the applicatin wh lives at the same address. Fr example, d nt enter Street fr ne persn s address and St. fr anther. Ntes abut PTC Eligibility fr Certain Immigrants with Incme belw the Federal Pverty Level Immigrant Eligibility fr Medicaid and Marketplace Medicaid has much stricter eligibility requirements fr immigrants than the Marketplace. Medicaid Eligibility Must have a qualified immigratin status. Qualified immigrants include lawful permanent resident, refugees, asylees, persns granted withhlding f deprtatin, certain victims f dmestic This dcument was prepared in December 2014 and tips are subject t change as changes are made t the applicatin prcess. Please reprt updates t Alice Pllard r Brendan Riley

3 vilence and trafficking in humans, certain Cuban and Haitian entrants, and persns parled int the U.S. fr ne year r mre. Many qualified immigrants are subject t a five- year waiting perid fr Medicaid and CHIP cverage. After the 5- year disqualificatin perid expires, qualified immigrants must meet ther Medicaid eligibility rules (incme and categry) t qualify. The fllwing immigrants are exempt frm the five- year bar n federal means- tested public benefits, and may start cllecting benefits as sn as they receive legal status. Children under age 19 and pregnant wmen wh are therwise eligible Qualified immigrants wh entered the US befre August 22, 1996 Refugees, asylees, Cuban and Haitian entrants, Amerasian immigrants, persns granted withhlding f deprtatin, victims f trafficking, veterans and active duty military persnnel and their spuses and children, as well as certain Native Americans. Marketplace Eligibility Any lawful immigratin status- Full list available at Examples: Lawful Permanent Resident (LPR/Green Card hlder) Anyne with wrk authrizatin wh: is a registry applicant, has an Asylee rder f supervisin, has applied fr Refugee cancellatin f remval, r is an Wrker visas (including H- 2A, H- 2B, H- 1B, etc.) applicant fr legalizatin under IRCA r the LIFE Act Student Visas U visas Temprary prtected status (TPS) Deferred Enfrced Departure (DED) Deferred Actin Status (But nt DACA hlders). Anyne with wrk authrizatin wh: is a registry applicant, has an rder f supervisin, has applied fr cancellatin f remval, r is an applicant fr legalizatin under IRCA r the LIFE Act If ineligible fr Medicaid based n immigratin status, Lawfully present immigrants with husehld incmes f less than 100% FPL may qualify fr financial assistance in the marketplace. Why are sme immigrants belw the pverty line eligible fr tax credits when US citizens are nt? The architects f the ACA designed the law this way with the assumptin that all states wuld have expanded Medicaid eligibility frm 0% FPL t 138% FPL; hwever, that alne wuld have shut ut sme immigrants frm affrdable cverage, as Medicaid is nly available fr certain types f immigrants and may require a waiting perid. Lawfully present immigrants wh are nt barred frm Medicaid due t their immigratin status are treated like US citizens and aren t eligible fr premium tax credits if their incmes are belw 100% f pverty. (This is because under the law s riginal intent, these individuals wuld ve been eligible fr expanded Medicaid.) This dcument was prepared in December 2014 and tips are subject t change as changes are made t the applicatin prcess. Please reprt updates t Alice Pllard r Brendan Riley

4 Examples: Raul is a HH f 1, earning $5,000 per year. Raul has been a lawful permanent resident fr 3 years. Nt eligible fr Medicaid (due t 5 year bar) Eligible fr premium tax credits (because ineligible fr Medicaid due t 5 year bar) Raul is a HH f 1, earning $5,000 per year. Raul has been a lawful permanent resident fr 6 years. Nt eligible fr Medicaid (because nt disabled and n children) Nt eligible fr premium tax credits (because nt barred frm Medicaid due t immigratin status) Lupe lives with her 4 year ld daughter Ana. Ana is a US Citizen and Lupe recently btained a U visa. Their incme is $10,000 per year. Ana is eligible fr Medicaid. Lupe is eligible fr PTCs in the Marketplace because she is ineligible fr Medicaid as an adult U visa hlder. Marketplace Applicatin System Issues with Recgnizing PTC Eligibility Belw 100% FPL During the first pen enrllment perid ( ), the system did nt d a gd jb f recgnizing eligibility fr immigrants wh were eligible fr tax credits belw 100% FPL. Assisters shuld duble- check eligibility determinatins t be sure that the system is wrking prperly. If the system is nt able t verify an applicant s immigratin status r if the cnsumer des nt include their immigratin dcument numbers, the system will assume that the individual meets the immigratin requirements fr Medicaid. Therefre, it wn t recgnize ptential eligibility fr tax credits belw 100% FPL. If the cnsumer has applied fr Medicaid since 11/15/2014 and been denied based n immigratin status, yu can indicate that n the applicatin. This is the third checkbx n the page f the applicatin which asks abut disability. Checking this bx will generally help t flag the applicatin and btain crrect eligibility results. If the cnsumer has nt received a Medicaid denial since 11/15/2014, thinks they are ineligible fr Medicaid due t their immigratin status, and is having truble getting a crrect eligibility result thrugh the Marketplace, yu can help them apply fr Medicaid again. Once they receive the new denial, they can update the Marketplace applicatin and check this bx. The new Medicaid denial is ften a faster way t get crrect results than waiting n an appeal. Hwever, requesting an appeal is still imprtant because it prtects the initial date f applicatin fr retractive cverage if needed. Incrrect Eligibility Determinatins In the case f incrrect eligibility determinatins, assisters can help a cnsumer with a few ptins: 1) Call the Marketplace Call Center t see whether the issue can be slved infrmally. 2) Re- apply and be sure t prvide all necessary dcumentatin. G back t the applicatin and click n reprt life change review all infrmatin in the applicatin, t make sure that nthing was checked which may be triggering an incrrect eligibility result. Cmmn examples f questins which result in n APTC include: a. Married but filing taxes separately This dcument was prepared in December 2014 and tips are subject t change as changes are made t the applicatin prcess. Please reprt updates t Alice Pllard r Brendan Riley

5 b. Nt planning t file taxes c. Has an ffer f affrdable emplyer based cverage r clicked "I dn't knw" d. Incme just ver the pverty line and indicated a disability 3) File an appeal and refer t legal services. Appeal frms fr NC can be fund at this link: https://www.healthcare.gv/dwnlads/marketplace- appeal- request- frm- a.pdf. It s strngly advised that a cnsumer seek assistance frm legal services with an appeal. T facilitate a referral, assiters can fill ut this appeal referral frm with sme brief infrmatin abut the situatin and have the cnsumer sign the frm t authrize sharing f their infrmatin. The assisters can fax the frm t the apprpriate cntact listed at the bttm f the sheet. The frm des nt guarantee representatin but it will help a legal services agency make the cnnectin t the cnsumer. If the assister des nt fill ut the appeal referral frm, they can help cnsumers access legal services by calling the fllwing phne numbers: Pisgah Legal Services: (Buncmbe, Hendersn, Madisn, Plk, Rutherfrd, and Transylvania Cunties) Legal Services f Suthern Piedmnt: (Mecklenburg Cunty) Legal Aid f NC: (All 100 Cunties) Frequently Asked Questins Abut Mixed Status Families The Natinal Immigratin Law Center (NILC) has develped this helpful dcument with answers t frequently asked questins abut mixed immigratin status families access t ACA prgrams. This 7- page FAQ explains, fr example, wh is eligible fr cverage in the health insurance marketplaces created by the ACA, and wh in a mixed- status family is an applicant and wh a nnapplicant. And it lists six Key pints t remember abut mixed- status families. Reprt Enrllment Barriers NILC has develped a Ggle frm (http://nilc.rg/acaprblems.html) that in- persn assisters shuld fill ut anytime immigrant cnsumers that they assist encunter prblems with the applicatin prcess. NILC is using this infrmatin t cntinue its effrts t mnitr the applicatin and enrllment barriers t immigrant cnsumers and advcate fr a less burdensme applicatin prcess fr the immigrant ppulatin. References and Resurces Natinal Immigratin Law Center, Health Refrm Beynd the Basics, Applicatin Prcess fr Families that Include Immigrants training- webinar- applicatin- prcess- fr- health- cverage- fr- families- that- include- immigrants/ Maine Equal Justice Partners & Prtland Cmmunity Health Centers, Tips fr Immigrant/Refugee applicatins in the Health Insurance Marketplace In the Lp Assister Cmmunity Nrth Carlina Justice Center HealthCare.gv Resurces n Immigratin: https://www.healthcare.gv/immigrants/immigratin- status/ This dcument was prepared in December 2014 and tips are subject t change as changes are made t the applicatin prcess. Please reprt updates t Alice Pllard r Brendan Riley

6 Cmmn Immigratin Dcuments (Frm 2015 Marketplace Assister Training) Prepared by NC Cmmunity Health Center Assciatin

7 Prepared by NC Cmmunity Health Center Assciatin

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