*************************************************************************** OPEN ENROLLMENT

Size: px
Start display at page:

Download "*************************************************************************** OPEN ENROLLMENT"

Transcription

1 Find answers to commonly asked questions about the Affordable Care Act (ACA), the state and federal marketplaces, Medicaid, Medicare and the Ryan White HIV/AIDS Program below. We have made every effort to provide accurate information, but you should contact the health insurance marketplace or Medicaid agency in your state for guidance on your specific situation. Select A Topic: OPEN ENROLLMENT THE BASICS ABOUT HEALTH INSURANCE MY INSURANCE THE AFFORDABLE CARE ACT THE RYAN WHITE HIV/AIDS PROGRAM AND AIDS DRUG ASSISTANCE PROGRAM (ADAP) EXPANDED COVERAGE THROUGH MEDICAID INSURANCE COVERAGE THROUGH AN EMPLOYER INSURANCE COVERAGE THROUGH NEW STATE MARKETPLACES/EXCHANGES PROBLEMS AND TROUBLESHOOTING INSURANCE COVERAGE WHAT IS *************************************************************************** OPEN ENROLLMENT What does open enrollment mean? The open enrollment period is the three-month period of time when you can purchase a new health plan or switch plans through the marketplace. Generally, you can only enroll in a marketplace or switch plans during the open enrollment period, unless you qualify for a special enrollment period because of special circumstances in your life, such as losing your health insurance because of divorce, a spouse s death, unemployment or a change in income. In these circumstances, you re allowed to enroll in a new plan or switch plans without waiting until the next open enrollment period. If you are eligible for Medicaid or the Children s Health Insurance Program (CHIP), you can enroll at any time of the year. Medicare s open enrollment period for existing policyholders is October 15, 2015-December 7, If you will soon become newly eligible for Medicare because of age, you can sign up during a seven-month period that starts three months before the month you turn 65 and ends three months afterwards. If you are under 65 and

2 disabled, you can sign up for Medicare during the seven-month period that starts three months before your 25th month of getting benefits and ends three months after your 25th month of getting benefits. When is the next open enrollment period? The open enrollment period for coverage in 2016 is November 1, 2015 January 31, What is a special enrollment period? If you or someone in your family experiences a certain major change in your life, called a qualifying life event, you have up to 60 days from the event to enroll in a marketplace health plan, except for persons with coverage through job-based plans, who must act within 30 days of the event. Qualifying life events include for example, the birth or adoption of a child, loss of coverage due to death of a family member or divorce, a move to another part of the country or the loss of a job. A more comprehensive list is available, here. In addition, if an official source such as HealthCare.gov or your state s insurance marketplace gave you incorrect information when you enrolled in a plan, you may be eligible for a special enrollment period during which you can switch plans. By when do I need to enroll to have healthcare coverage in 2016? To receive health insurance for 2016, you must enroll and pay your initial premium between November 1, 2015 January 31, 2016, unless you qualify for a special enrollment period. To have coverage on January 1, 2016 you must enroll by December 15, If I already have coverage, do I need to do anything? If you are happy with your current plan and nothing else in your life has changed, such as your income or family size, your plan will automatically re-enroll you for 2016 if you live in a state using the federally facilitated marketplace. If you live in a state operating its own marketplace, you should check with the marketplace in your state. If you qualified for a premium tax credit in 2015, that will also automatically renew in most cases. You do not have to do anything else. In addition, it s a good idea to review your plan and ask your health insurer if it is making any changes to the plan, which is common from year-to-year. We suggest that you look for changes to the plan s benefits including the premium, deductible, and cost sharing as these changes may impact how much you must pay for your care. We also suggest that you ask about changes to the provider network and confirm that your doctors and other health care providers you may want to consult are still in your plan s network in You should also make sure any prescriptions you currently take will still be covered under your plan s formulary in 2016 and find out what level of cost sharing you will be required to pay. Before the open enrollment period begins, your insurance company will send you information about your plan, including any changes to premiums and benefits. Separately, your state s marketplace will send you information about the amount of subsidy you are receiving. However, you should check with your state s marketplace or consult a navigator or other patient assistor program recognized by your marketplace to find out if it makes sense to update your application for premium tax credits (subsidies) or to consider changing your health plan.

3 If you experience a change in income or household size, you must report this information to your insurance company so that you can get the right premium tax credit. If you don t update this information, you ll get the same premium tax credit you got in 2014, even though you might qualify for a larger credit. Conversely, if you are now eligible for a smaller credit because your income has gone up or your household size has gotten smaller and you haven t reported these changes to your insurance plan, you may owe money when you file your 2015 tax return in For information on how ACA insurance coverage affects your taxes and what you need to know when filing your taxes, click here. Even if your income and family size haven t changed, the amount of subsidy you can get next year may change. For example, the premium for your current plan will probably increase somewhat. If your income hasn t gone up and you reapply through the marketplace, your subsidy may rise to cover that increase. If I have a plan now, will I automatically stay enrolled for next year? If you are in a state using the federally facilitated marketplace, and you are happy with your current plan and want to keep it, your plan will automatically re-enroll you for next year. You do not have to do anything else. If you live in a state operating its own marketplace, you should check with the marketplace. However, you should review your plan and ask your insurance company if it is making any changes to the plan for next year. We suggest that you look for changes to the premium, deductible, cost sharing and copayment rules, as this may impact how much you must pay for your care. We also suggest that you ask about changes to the provider network and confirm that your doctors and other health care providers are still in your plan s network for next year. You should also make sure any prescription drugs you currently take will still be covered under your plan s formulary next year and find out what level of cost sharing you will be required to pay. And if your income or family size have changed, you should review all of your options to see if a new plan might be better for you. Why does my plan cost more this year, or why have my benefits changed and what can I do? Insurance companies are allowed to increase (or reduce) the cost of insurance premiums every year. This happens with all types of private insurance plans, not just those purchased through the federal and state marketplaces. If you purchase your insurance through the health insurance marketplace and are not happy with your plan for any reason, including its cost, you may switch plans during the open enrollment period or during a special enrollment period, if you qualify. Your insurance company may also make other changes to your benefits for next year so it is a good idea during the open enrollment period to look at what benefits your plan will cover next year. Make sure that your doctors are still in the plan s network and that any prescription drugs you are taking are covered and affordable to you. It is also important to make sure that your income and family size information is up-to-date with the marketplace, as that could impact how much you pay for coverage and health services. What do I do if my current plan is not offered next year? Insurance companies sometimes change the plans they offer from one year to the next. This means they could add new plans and eliminate old ones. You may learn that you are in a health plan that your insurance company

4 won t continue to offer next year. If this happens to you, we recommend that you review all the plans available, just as you would if you did not have coverage. If you do nothing, however, your insurance company will automatically enroll you in a similar plan. This will ensure that you continue to have coverage, but the plan it selects may not be the best fit for your needs or have the same benefits as your previous plan. What if I do not like my current plan and want to consider other options? If you do not like your current plan and do not have access to insurance provided through your job or a family member, you have two options: 1. You can look for a different plan offered by the same insurance company with which you are currently enrolled. Or, you can choose a new health plan from a different insurance company through your state s marketplace or on HealthCare.gov. Levels of coverage sold through the marketplaces are categorized by the name of a metal. Plans are labeled bronze, silver, gold or platinum, with the level of benefits and cost typically the lowest for bronze and highest for platinum. Bronze plans offer the least generous benefits whereas platinum plans offer the most generous benefits, with silver and gold falling in between. A person whose income is low enough to qualify for assistance with his or her premiums (also called premium tax credits) can enroll in any level of coverage and still get that help. However, a person whose income is low enough to also make him or her eligible for help with cost sharing (also called cost sharing reductions or CSRs) must select a silver plan to gain access to those subsidies. 2. You can buy a new plan outside the marketplace. This is not a good option for most people. If you buy a plan outside of the marketplace, then you will NOT be eligible for assistance with premiums and cost sharing that makes coverage more affordable for many people. How do I decide if I should switch plans? If you are unhappy with your plan for any reason, you should consider whether a different plan might work better for you. You might consider switching plans if you cannot afford your current plan or if a new plan is offered next year that is even more affordable or provides better coverage. You might also consider changing plans if the doctors you wish to see are not included in your plan or if your plan s formulary does not include medications you need to take. You may also decide to change plans if your cost sharing for services you need, such as medications or lab tests, is too high. While you will likely face some cost sharing in most plans, the amount can vary considerably. If you are considering switching plans, you should contact a navigator, patient assistor, or certified enrollment counselor in your state (or through HealthCare.gov) to help you to select a better plan. In addition, many community-based HIV organizations have staff members trained to help people with HIV navigate the enrollment process, and they may have special insights into the experience of people with HIV with the plans offered in your area.

5 What should I know about the AIDS Drug Assistance Program (ADAP) when selecting a health plan? AIDS Drug Assistance Program (ADAP) is a part of the Ryan White HIV/AIDS Program, which is operated by your state to provide HIV medications and other medications to people living with HIV. For insured people with HIV, ADAP in many states can assist with paying premiums and sometimes cost sharing such as copayments or coinsurance for drugs and other services. Income eligibility requirements and other rules, including what costs are covered, vary by state. ADAP is NOT insurance, and having ADAP without other coverage does NOT satisfy the ACA s requirement to have coverage. Do I have to wait for open enrollment to enroll in Medicaid? No. You can apply for Medicaid at any time, all year long. If you qualify, you can enroll immediately.

6 THE BASICS ABOUT HEALTH INSURANCE What is health insurance, and how do I know if I have it? Health insurance is a way to pay for health care. Like other types of insurance, such as for your car or home, it protects you against high and sometimes unexpected costs. It also provides you with coverage for medical care and other health-related services, like regular appointments and prescriptions. Many people get health insurance through their jobs or through a family member s job. Others buy their own insurance. Medicaid is the government health program for people with lower incomes. Medicare covers people 65 and older. Former service members may be covered through the Veteran s Health Administration. All of these programs satisfy the legal requirement to have coverage. Be aware that Ryan White and the AIDS Drug Assistance Program (ADAP) does not qualify as insurance. If you have a card that you show at the doctor s office, pharmacy or hospital to pay for health care, you probably have health insurance, as required under the ACA. If you are unsure, check with your state marketplace to see if your coverage qualifies. If it does not, health insurance is offered through the marketplace, and you may be eligible for financial help to purchase it. Am I required to have health insurance? Yes. Most Americans are required to have insurance or pay a fine. If you are uninsured, you should go to your state marketplace and explore new options for coverage, including expanded Medicaid (in some states) and financial help for private health insurance. If you still can t find affordable coverage after exploring these options, you can apply to the marketplace for an exemption from the requirement to have insurance, known as the individual mandate. You may be eligible for an exemption if you: Cannot afford coverage (defined as those who would pay more than 8 percent of their household income for the lowest cost bronze plan available to them through the Marketplace) Are not a U.S. citizen, a U.S. national, or a resident alien lawfully present in the U.S. Had a gap in coverage for less than 3 consecutive months during the year Won t file a tax return because your income is below the tax filing threshold (In 2013, the tax filing threshold is $10,000 for individuals and $20,000 for a couple) Are unable to qualify for Medicaid because your state has chosen not to expand the program Participate in a healthcare sharing ministry or are a member of a recognized religious sect with objections to health insurance Are a member of a federally recognized Indian tribe Are incarcerated

7 Others who do not qualify through these categories but have experienced a hardship that makes it difficult to purchase insurance may apply through the health insurance marketplace for an exemption to the individual responsibility requirement. How do I sign up to get health insurance? To get coverage through the health insurance marketplace or through Medicaid, you can apply online or get assistance in person. You must apply during the open enrollment period. You can apply for and enroll in Medicaid, if eligible, at any time of year. A single application will let you figure out if you are eligible for Medicaid or insurance in the marketplace. For more information, visit You can also call if you need assistance. How much does health insurance cost? The cost of health insurance varies depending upon the type of policy chosen and the benefits it provides. The marketplaces (also called exchanges) created by the Affordable Care Act (ACA) provide a range of new options for coverage, as well as financial assistance for those who qualify. In many states, the expansion of Medicaid makes low- or no-cost coverage available to many more people, including low-income adults without dependent children. For those who meet certain income requirements, the ACA provides financial help in the form of tax credits and cost sharing assistance to make health insurance more affordable. You may be eligible for this help if you are ineligible for other sources of coverage and you earn between $11,490 and $46,680 as a single person (income ranges for eligibility vary depending on your family size). Whether you had insurance before the ACA or are gaining new coverage under the law, you no longer will face annual or lifetime dollar caps on coverage for your HIV care and treatment or for your other care needs. To find out if you are likely to be eligible for subsidies and how much health insurance will cost you in the new marketplace, use the Kaiser Family Foundation subsidy calculator. How do I determine my income? The level of financial assistance available to you is determined by the size of your family and your annual income. The Affordable Care Act (or ACA) uses what s called your modified adjusted gross income (MAGI) to determine how much financial assistance you can receive, generally in the form of a tax credit. When you apply for financial assistance through the marketplace, the application will walk you through the information you need to calculate your income. If you still need help, contact the Marketplace Call Center. Keep in mind that if you estimate your income incorrectly and end up receiving more help than you are eligible for, you may have to pay back some or the entire subsidy that you received when you pay your taxes next year. If you over-estimate your income and end up receiving less help than you are entitled to, the difference will be refunded to you when you file your income taxes.

8 To get an estimate of your eligibility for subsidies and how much health insurance might cost you, use the Kaiser Family Foundation subsidy calculator. What if I can t afford insurance? For people who don t have insurance through their employers or are not employed, the Affordable Care Act (or ACA) establishes new health insurance marketplaces (also called exchanges) in each state where you can compare multiple health plans and buy coverage for yourself and your family or apply for Medicaid. Financial help, in the form of tax credits and other subsidies, is available to make coverage affordable for people with lower incomes. Depending on your income, you may be eligible for financial help to pay the monthly premium for your insurance coverage if you purchase it from a marketplace health plan. You may be eligible for this help if you don t have another source of coverage and you earn between $11,490 and $46,680 a year as a single person (income ranges for eligibility vary depending on your family size). Many people with HIV qualify for Medicaid. (You may already be eligible for Medicaid and not know it.) In most cases, if you enroll in Medicaid, you won t be charged a premium or have to meet a deductible before Medicaid pays. Copayments also are limited. To find out whether you may be eligible for Medicaid or a subsidy for a marketplace plan, as well as how much you would have to spend on health insurance in the marketplace, use the Kaiser Family Foundation subsidy calculator. If you need more help paying for insurance or all the HIV services you need, the Ryan White HIV/AIDS Program and its AIDS Drug Assistance Program (ADAP) may be available in your state to help. As of 2014, the Affordable Care Act (or ACA) requires most people to have insurance (this is called the individual mandate) or pay a penalty, although there are some exemptions from this requirement. The penalty for 2015 is the higher of 2% of income or $325 per adult/$ per child (with a family maximum of $975 using this method). You may be eligible for an exemption if you: Cannot afford coverage (defined as those who would pay more than 8 percent of their household income for the lowest cost bronze plan available to them through the Marketplace) Are not a U.S. citizen, a U.S. national, or a resident alien lawfully present in the U.S. Had a gap in coverage for less than 3 consecutive months during the year Won t file a tax return because your income is below the tax filing threshold (In 2013, the tax filing threshold is $10,000 for individuals and $20,000 for a couple) Are unable to qualify for Medicaid because your state has chosen not to expand the program Participate in a health care sharing ministry or are a member of a recognized religious sect with objections to health insurance Are a member of a federally recognized Indian tribe Are incarcerated

9 Others who do not qualify through these categories but have experienced a hardship that makes it difficult to purchase insurance may apply through the health insurance marketplace for an exemption to the individual responsibility requirement. Will my HIV medications be covered if I sign up for health coverage through the Affordable Care Act? Antiretroviral therapy for HIV will be covered. The Affordable Care Act (or ACA) requires all health plans sold in the new health insurance marketplaces to cover prescription drugs, including antiretrovirals for HIV. All state Medicaid programs cover prescription drugs, regardless of whether the state is expanding Medicaid or not. The different plans available in the marketplace, however, may have different rules about how much cost sharing they charge and which specific drugs they will cover. Not all private health plans will cover all HIV drugs so it is important to learn as much as possible about whether your current medications are covered and with what cost sharing when you are choosing a plan. If you are denied coverage for a drug prescribed by your doctor, you have the right to challenge the denial and present medical evidence to justify your need for the drug. What happens if I lose my coverage or experience other major changes in my life after the open enrollment period has closed? If you lose coverage due to a life-changing event (like a move, job loss or a death in the family) after the open enrollment period ends, you may still be able to enroll in a health plan. Check with your state s marketplace to see whether your experience qualifies you for a special enrollment period.

10 MY INSURANCE Why do I need insurance? The Affordable Care Act (ACA) requires most U.S. citizens and legal immigrants to have health insurance. Most people who don t have insurance will be charged a penalty on their tax returns. Having health insurance coverage is vital to staying healthy and accessing proper medical care. This is important both in cases of very serious one-time health issues, such as injuries from a car accident or house fire, or when dealing with minor and major health issues that may arise in your life. People with HIV and other chronic conditions need access to health services and medications to stay healthy, and health insurance helps to ensure this. A key part of the new coverage offered under the ACA is expanded access to preventive services and health screenings so that health issues are identified and treated early before they become more serious. Many recommended health screenings, such as annual physicals and mammograms, are available for free without copays for people with insurance. Certain individuals are exempt from the requirement to have health insurance coverage. For example, those who have incomes below the tax filing threshold and undocumented immigrants are not required to purchase coverage. How does health insurance work? Health insurance is a way of making sure health services are more affordable. By paying a monthly fee (a premium), you are buying protection to help cover future costs of medical care, even if they exceed the value of the premiums you ve paid. In effect, the cost of health care is spread out to make it affordable for everyone; other people s premiums are pooled together to pay for the cost of health care when any one plan enrollee needs it. It is important to understand that insurance does not cover every single health care expense. Before you buy coverage, a review of health plan documents should tell you in advance which services are covered. This information can also be gained by calling your state marketplace or the insurance company directly. However, for you to access these services, they must be medically necessary. This means that a qualified doctor or other medical provider must determine that you need a specific covered medical service to treat a specific health condition. Health plans are permitted to put in place rules and to decide whether they believe a service you or your doctor request is actually needed. If the insurer denies you coverage, however, you have the rights to ask it to reconsider your case and to present medical information to justify your need for a service. In addition to paying the monthly premium, you have to satisfy any annual deductible in your plan, and you may also be required to contribute to the cost of a health service when it is accessed. The amount will depend on the service you need and the plan you select. It is often referred to as a copayment, coinsurance or cost sharing. How can insurance help me to stay healthy? Health insurance is intended to protect you in cases of serious health problems, such as when you need to go to a specialist doctor or when you need to go to the hospital. Health insurance is also important to maintain your health so that you avoid developing serious health problems. Once you get insurance, you should select a doctor

11 who will serve as your main doctor (primary care provider, or PCP). In some health plans, this doctor will be required to give you permission (called a referral) to see other doctors (such as specialists) for your insurance to cover the cost. It is important for people with HIV to choose their main doctor carefully. You want to select someone you like and with whom you can maintain a good relationship, because this person will be responsible for working with you to keep you healthy. It is also important that this person is knowledgeable about HIV. What should I look for when selecting a plan? In selecting a health plan, consider how you use health care. How many times a year do you typically visit your doctors? If you already like your current doctors and other healthcare providers, check with them to see whether they accept the specific health plan you are considering. If you don t already have a doctor that you like, check to see whether the plans you are considering offer enough choices for the kinds of doctors you would like and whether they are conveniently located. You should also make sure that you chose a plan that provides you with enough prescription drug coverage to meet your existing health needs at costs you can afford. For a simple explanation of how to select a plan, watch this video prepared by In sum, things to consider when choosing a plan include: Monthly premiums: The amount you or someone on your behalf pays each month for health insurance. Out-of-pocket costs: The amount a person has to pay towards health care each year in addition to premiums. These expenses include deductibles, coinsurance, and copayments. Provider network: Some plans allow you to see any doctor you wish; other plans only allow you to see doctors in the plan s provider network. Networks are those hospitals, clinics and doctors that have contracted with your plan to provide you with health services. Benefits: Services in addition to the Essential Health Benefits (EHB) covered by a health plan. Deductible: The amount you must pay towards the cost of certain covered services before your health plan begins to pay its share of those costs. In some cases, a deductible can be many thousands of dollars, meaning you would have to pay that out of pocket before your plan kicked-in. What services will I get if I buy insurance? All health plans in the state and federal marketplaces and expanded Medicaid programs are required to cover 10 categories of Essential Health Benefits (EHB), including hospitalization, outpatient medical care, mental health care, and prescription drugs. Health plans have some flexibility within these categories to decide what to cover and not cover so read the plan materials carefully. For example, the health plan s drug benefit may or may not cover all of the drugs you take, or it may reimburse more of the cost of some drugs than others. Look especially for any exclusions (services the plan won t cover at all) and benefit limits (for example, a limit on the number of physical therapy visits a plan will cover in a year). Some plans may offer other services that go beyond the essential health benefits. When choosing a health plan, you should consider if it offers the kinds of services you think you will need. Will all of my doctors take my insurance?

12 Maybe or maybe not. Not all doctors take all insurance coverage. Under some plans, you may be able to see any doctor you choose, but the amount you have to pay for your visits and the services you receive could vary depending on whether the doctor is in the plan s network. You should check with your doctor to see whether he or she takes any insurance plan you are considering. If your doctor does not accept your insurance, some insurance companies will let you submit the bill for reimbursement, but it probably will cover only a fraction of the cost of the visit. Other plans do not cover any costs when you see an out-of-network provider. It is also important to note that care received out-of-network may not count towards your out-of-pocket limit (the highest amount you would have to pay for care in any one year). How will I find doctors who take my insurance? When you compare different plans in the marketplace, you will find a link to each plan s provider network. Some health plan websites offer a provider search tool so that you can easily find out if your doctor is in its network. Before enrolling, however, it is strongly recommended that you call each of your doctors to double check whether they are in a specific health plan s provider network. It is also a good idea to double check this information with any new doctor you might want to see and to ensure that they are accepting new patients. Will my HIV medications be covered by my insurance? There are two critical questions you need to ask about your medications. Are the drugs covered on the health plan s formulary, which is the approved list of covered drugs? And how much will you be charged as a copayment or for cost sharing? Under the Affordable Care Act, every insurance plan is required to cover at least one prescription drug in each category or class of drugs. This means that every plan will cover HIV medications, but not necessarily the specific drugs your doctor prescribes for you. All of the drugs that your plan covers are supposed to be listed by brand name and/or generic equivalent on your insurance company s formulary or preferred-drug list. It is important to ensure you are looking at a complete (rather than a partial) formulary. Most health plans in the marketplaces cover many HIV medications. The medications most often excluded are single-tablet-regimen combination therapies. Many plans have placed all or nearly all HIV drugs on the highest cost sharing tier, which means that the amount they would charge you may be a big barrier to care. Some plans require that you pay coinsurance (or a percentage of a drug s cost), while others require a copayment (a fixed amount). In most cases, you will pay less toward the cost of HIV medicines with a plan charging copays than with than a plan charging coinsurance. Keep in mind that there is an annual out-of-pocket limit (the total amount you will have to contribute to healthcare costs each year) on spending for all people in marketplace health plans, excluding premiums. For 2015, this amount is $6,600 for individual coverage and $13,200 for a family policy. If ineligible for other coverage, people with incomes between 100 percent of the federal poverty level ($11,670 a year for a single person) and 250 percent ($29,175 for a single person) are eligible for cost sharing reductions (or CSRs) if they are eligible for a premium tax credit and purchase a silver plan through the health insurance marketplace in their

13 state. Also, your state s AIDS Drug Assistance Program (ADAP) may provide supplemental assistance for costs associated with prescription drugs and drugs not covered by a plan. Before enrolling in a health plan, try to determine how much you will be expected to pay for the medications you are currently taking. Why are the drugs I need not covered? Insurance companies try to control costs for health care by limiting the drugs they cover. In some cases, if they do not cover all drugs in a class of drugs, they are able to get a bigger discount on those drugs they choose to cover. Every insurer must cover at least one brand of drug per class, but this does not necessarily mean it will be the drug that your doctor prescribes. Every insurance company has an appeals process in which you can challenge your insurer s decision not to cover the drug you need. The process varies by company, but you can expect to need to give your insurer a letter from your doctor to justify your need for a specific medication. In urgent cases, your doctor can submit an expedited appeal. Check with your health plan to learn more about its appeals process. If an insurer denies an appeal, it is required to provide you with information about how to request an external review by someone who is independent of your health plan. Every state also has an independent appeals process through which your doctor can ask for an exception based on your medical need. Click here for more information about appeals. For people who are HIV negative, will my insurance pay for Truvada as pre-exposure prophylaxis (PrEP)? Pre-exposure prophylaxis, or PrEP, is a once daily pill to help those who are HIV negative stay negative. PrEP is currently available under the brand Truvada. Most insurance companies and state Medicaid programs are covering Truvada as a way to prevent people from getting with HIV. The Centers for Disease Control and Prevention (CDC) has issued criteria to health care providers determine about who would benefit from PrEP. If you meet these criteria or believe you would benefit from PrEP, discuss your options with your healthcare provider. Your insurance company may require prior authorization before covering the drug. If you plan on taking PrEP, check to make sure Truvada is listed on your plan s formulary. Also, as with any medication, it is important to examine your cost sharing obligations before starting a regimen or when selecting a health plan, if you are already taking PrEP. Cost sharing for HIV medications, including Truvada, can be very high under some plans and, if you have not met a deductible, you could be responsible for the full price of this drug. I can t find a drug on the formulary of my health plan. Does that mean I can t get it? Not necessarily. First, if you don t see the drug you take on a plan s formulary, ask the company whether it has a separate list of specialty pharmaceuticals that it covers or if the list you are looking at is a complete formulary. If the drug is still not listed, you can appeal the denial of coverage. Every insurance company has an appeals process in which you can challenge your insurer s decision not to cover the drug you need. The process varies by company, but you can expect to have to give your insurer a letter from your doctor to justify your need for a specific medication. In urgent cases, your doctor can submit an expedited appeal. Check with your health plan to learn more about its appeals process. If an insurer denies an appeal, it is required to provide you with information about how to request an external review by someone who is

14 independent of your health plan. Every state also has an independent appeals process through which your doctor can ask for an exception based on your medical need. Click here for more information about appeals. Will ADAP help me pay my prescription drug copays? Maybe. Depending on your income and your state s rules, AIDS Drug Assistance Program (ADAP) may be able to help you cover the cost of copays and even deductibles for your prescription medications. Can the Ryan White HIV/AIDS Program assist me with copays for doctor visits? Maybe. Depending on your state and local Ryan White programs and your income, you may be eligible for Ryan White assistance with copays for your doctor visits. How do I communicate with an insurance company? Most insurance companies can be reached by phone, , online or by regular mail. Look at a company s website or paper materials for its contact information. The toll-free customer service line is usually printed on the back of your insurance card. Communicating with an insurance company requires patience and sometimes multiple follow-up communication efforts to reach the right person who can help you. It might be helpful to keep a record of communication with your insurance company. What kinds of information does an insurance company need about me? To sign you up for insurance, a company will ask for your name, date of birth, marital status, Social Security number, proof of citizenship or legal resident status and proof of residence. No insurance company can deny you coverage or charge you more for coverage based on health status. The cost of insurance varies across the country, and plans are permitted to charge people higher premiums if they smoke or use tobacco products. Premiums also can vary based on a person s age. But you cannot be denied coverage or charged a higher premium because you have HIV or any other health condition. If something changes in my life, like my job, marital status or family size, do I need to notify my insurance company? Yes. If you experience a qualifying life event, like a change in income, marital status or household size, you need to report this information to the marketplace so that your premium can be adjusted (for example, if you no longer have a spouse) and you can get the right premium tax credit, if you qualify for one. If you don t update this information, you ll get the same premium tax credit you got in 2014, even if you might qualify for a larger credit. Conversely, if you are now eligible for a smaller credit because your income has gone up or your household size has changed, you may owe money when you file your 2015 tax return in If you want to add coverage for a new baby or drop coverage for a divorced spouse, you must also get in touch with your health plan. Why is it important to find doctors who are in network for my health plan? Insurance companies often limit the doctors in their health plan networks and require you to pay more to see a doctor who is out of network. Before selecting a plan, you should determine if your current doctor is in its

15 network if you want to stay with that doctor. If you are already enrolled in a health plan and need to select a doctor, you should make sure that the doctor you select is in network for your specific plan. That means that the doctor and the plan have prearranged to work together. Sometimes doctors are in the network of some of an insurance company s health plans, but not all. You should ask any doctors you are considering seeing whether they are in network for the specific health plan (not just insurance company) and metal level (such as bronze or silver, etc.) in which you have enrolled. It is also important to find out if your doctor is your plan s primary care or specialist category. Sometimes doctors specializing in HIV are in the specialist category, and it may be more expensive to see them or require a referral from your primary care physician. Some doctors are considered specialists for other patients, but health plans will allow them to be the primary care doctor for patients with HIV. In many cases it will save you money to sign up for a plan in which your doctor is categorized as a primary care provider. You should also ask your doctor to perform needed health screenings and preventive measures, including vaccinations such as flu shots to prevent certain illnesses. Remember, health insurance can only help you stay healthy if you use it. When can I sign up for health coverage under the Affordable Care Act (or ACA)? You can sign up for new private health insurance coverage in your state during the open enrollment period. An open enrollment period occurs once a year so individuals can enroll in a marketplace health plan or switch health plans. You may also qualify for a special enrollment period if you experience certain events, which are called qualifying life events. If you are eligible for Medicaid, you may apply for it at any time. By when do I have to sign up? You can sign up for new private health insurance coverage in your state during the open enrollment period. An open enrollment period occurs once a year so individuals can enroll in a marketplace health plan or switch health plans. The open enrollment period for 2016 coverage is November 1, 2015 January 31, You may also qualify for a special enrollment period if you experience certain events, which are called qualifying life events. If you are eligible for Medicaid, you may apply for it at any time. Once I have enrolled, when does my new coverage begin? During the open enrollment period, if you enroll in the first half of a month (between the 1st and 15th day of the month) and pay your premium by the due date, your coverage begins the first day of the next month. So if you enroll on February 10, 2016, your coverage begins March 1, If you enroll in the second half of the month (between the 16th and the last day of the month) and pay your premium by the due date, your coverage begins the first day of the second following month. So if you enroll on November 1, 2015, your coverage starts on January 1, 2016.

16 THE AFFORDABLE CARE ACT If I don t currently have insurance, what are my options through the Affordable Care Act? If you are not offered health insurance through your or a family member s job, or if you aren t working, you can buy your own coverage from online insurance marketplaces (also known as exchanges) set up in each state as part of the Affordable Care Act (ACA). The purpose of these marketplaces is to make health insurance easier to get and more affordable. You can no longer be denied coverage or be charged more because of your HIV status. And insurers can no longer limit how much they ll spend on your medical care over a year or your lifetime. These are important changes for someone with HIV. If you are buying your own coverage in a marketplace, financial assistance may be available to reduce how much you pay for monthly premiums and for your out of pocket costs for medical care. In general, you may be eligible for financial help in the marketplace if you are ineligible for another source of coverage and you earn between $11,490 and $46,680 as a single person (income ranges for eligibility vary depending on your family size). Another possible option for coverage is Medicaid. As part of the Affordable Care Act, states can choose to expand Medicaid to cover more people. This means you may now be eligible for Medicaid even if you were not before. If you live in a state that is expanding Medicaid and you earn about $16,000 a year or less as a single person (or $21,000 or less as couple), you likely can get coverage under the program. Also important for someone with HIV is that you no longer need an AIDS diagnosis or to be very sick or disabled to get coverage under these expanded programs. Not all states are expanding Medicaid, but even if yours is not you may still be eligible. Even if you are currently receiving financial assistance from the Ryan White HIV/AIDS Program or the AIDS Drug Assistance Program (ADAP), you are still required to have health insurance, if you are eligible. Ryan White and ADAP will continue to be available, but some of the services they currently cover might have to be replaced by insurance. If you still need help paying for your coverage or care, even if you are buying insurance through the marketplace or qualify for Medicaid, Ryan White and/or ADAP may be able to help. If I already have insurance (including through Medicaid or Medicare), do I need to do anything or will anything change for me? If you have Medicare, Medicaid or employer-based insurance, you don t have to do anything, unless your situation changes and you no longer have this coverage. If you currently buy your own insurance, you may now have new options that could meet your needs better than your current coverage. You may be newly eligible for Medicaid, or you could qualify for financial assistance through the new state and federal marketplaces (also known as exchanges), programs set up in each state to make it easier to buy insurance on your own. Before you change plans, though, you should compare benefits and costs to see if a new plan would really be better for you and your situation.

17 If you currently get health insurance from your own job or a family member s job and do not expect that to change next year, you don t need to do anything. But if your circumstances change or you are not satisfied with your coverage or feel you are paying too much you can buy your own coverage from online health insurance marketplaces. However, if you chose to give up your employer-based insurance, you are giving up the share of costs your employer pays which can be a large amount. And if you make that choice, in many situations you will not be eligible for a tax credit. Only if your employer-based coverage is unaffordable and doesn t reach a certain standard under the law will there be an option for financial assistance to help you buy your own coverage in the marketplace. In those cases, depending on your income, a tax credit could be available to reduce the amount you pay each month for your premium and for medical costs paid from your own pocket. Are my insurance options different because I am a person living with HIV? No. The Affordable Care Act (or ACA) requires insurers to provide coverage to everyone regardless of preexisting health conditions, such as HIV, and you cannot be charged more for insurance because of your health status. If I have Medicare, does the Affordable Care Act provide any support for prescription medications? The Affordable Care Act (or ACA) makes prescription drug coverage more affordable for Medicare beneficiaries. Prescription drug coverage through Medicare currently includes a drug coverage gap, sometimes called the donut hole. This means that people lose their coverage after their drug spending each year reaches a certain level. Because HIV medications are costly, many people with HIV have fallen into the Medicare coverage gap. Under the ACA, the Medicare coverage gap will be phased out by Until then, the costs of drugs in the coverage gap are being discounted; the discount will increase each year until there is no gap in drug coverage. In 2015, individuals who fall into the coverage gap must pay 45 percent of the costs of brand name drugs. Can my wife/husband/partner/children get the same insurance as me? In most cases, yes. As part of the Affordable Care Act (ACA), health insurance marketplaces (also called exchanges) provide insurance options to individuals and families, which should make it easy to enroll in the same plan. In addition, the ACA allows young adults under age 26 to obtain insurance from a parent s health plan. Young adults may also be eligible for Medicaid, for a marketplace plan or for an employer-based health plan coverage that may be better than that available through their parents. Children 18 and younger may be eligible for Medicaid, even if their parents are not, or for CHIP, a federal program that provides health coverage to children in families with incomes too high to qualify for Medicaid. Some parents enroll their children in Medicaid or CHIP, but apply for private coverage for themselves.

18 What if I am lesbian, gay, bisexual, or transgender (LGBT)? Will that affect my health insurance coverage and options? The Affordable Care Act (ACA), as well as some new federal policies, put in place important new protections for lesbian, gay, bisexual, and transgender (LGBT) individuals and their families. Health insurance marketplaces, which are new organizations, set up in every state to create more organized and competitive markets for buying coverage, are prohibited from discriminating on the basis of sexual orientation and gender identity. You cannot be turned away or charged more for being lesbian, gay, bisexual or transgendered. You also can t be denied coverage or charged more because of any pre-existing health condition, such as HIV. And insurers can t limit how much they ll spend on your medical care over a year or over a lifetime. Under the ACA, these protections extend to the plans sold through the marketplace. They cannot discriminate based on sexual orientation, gender identity or health status in how they design their essential health benefits. In addition, the ACA prohibits discrimination based on gender identity in all health programs that receive federal funding. Further, federal rules require most health plans offered outside of the marketplaces such as a jobbased or a private plan that you purchased on your own (unless it is grandfathered) to offer coverage to married same sex spouses if they offer coverage to opposite sex spouses. This protection applies even in states where state laws do not recognize same sex marriages. The Supreme Court s Ruling on the Defense of Marriage Act and What It Means for Your Insurance Options Beyond the new protections in the ACA, the Supreme Court s June 2013 ruling overturning part of the Defense of Marriage Act (DOMA) means that same sex marriages are now recognized under federal law. They are treated the same as heterosexual marriages, and in many cases, this recognition exists whether or not you live in a state that recognizes same sex marriage. This has implications for the new healthcare marketplaces as well as for Medicaid and CHIP: Marketplace: Because of the DOMA decision, legally married same sex couples can apply jointly for tax credits in the marketplace. These tax credits help you pay the costs of your health plan and are available even if you live in a state that does not recognize same sex marriage. Tax credits are calculated based on your federal income tax filing, so if you are legally married to someone of the same sex, you can claim credits jointly with your spouse. If you are not legally married if you are in a domestic partnership, a civil union or another relationship you ll still be able to get these credits, but will need to apply for them as individuals instead of as a couple. Depending on your state marketplace, you may be able to use your individual credits to buy a family policy rather than two individual policies. Medicaid and CHIP: States may now choose to recognize same sex marriages when determining whether or not you meet your state s income eligibility requirement for Medicaid and CHIP. There are also other new federal policies designed to protect you and your family. Hospitals must now allow visitation by a same sex partner, and same sex partners may be afforded the same treatment as other spouses for long-term care, such as nursing home care, under Medicaid. In addition, same sex couples now have the same rights as others to name a representative to make medical decisions on a patient s behalf.

19 Can I be denied health insurance because I have HIV (or another pre-existing health condition)? No. As of 2014, the Affordable Care Act (or ACA) prohibits health insurance companies from denying coverage, dropping coverage or charging higher premiums to someone with HIV or any other pre-existing health condition. This is a very important change for people living with HIV who, prior to the ACA, often could not obtain affordable coverage. Will I be charged more for insurance because I have HIV (or another health condition)? No. The Affordable Care Act (or ACA) prohibits health insurance companies from discriminating based on HIV status or any other pre-existing health condition. This means you cannot be charged more for insurance, denied coverage or dropped from coverage because you have HIV or any other health condition. This is a very important change for people with HIV who, prior to the ACA, often could not obtain affordable coverage. Is dental coverage available when I sign up for health coverage under the Affordable Care Act? While the Affordable Care Act (or ACA) may offer new opportunities for you to purchase dental coverage, dental coverage for adults is not considered an Essential Health Benefits (EHB). Medicaid, Medicare and all private plans, including insurance bought in the new marketplaces, are not required to offer it. But dental care is critically important for people with HIV. It can provide early notice of other developing health problems, and mouth pain or other dental problems can make it difficult to take medications regularly and stay on a treatment regimen. What are your options for dental coverage? Some Medicaid programs may elect to provide dental benefits, and some marketplace health plans may provide dental services as a covered benefit. When choosing a health plan, you may want to look for options that include dental coverage. If you have HIV, the Ryan White HIV/AIDS Program may be able to provide you with access to dental care, depending on your state, whether or not you have Medicaid, Medicare or job-related insurance or you enroll in new coverage through a marketplace health plan. If I sign up for health insurance coverage will my HIV status be kept confidential? Your health information is kept confidential and protected under the law. Federal laws limit the collection, use and disclosure of your personal health information, including information about your HIV status. You have the right to obtain your own personal health records, to ask health plans to control access to your records and to limit certain disclosures of your personal health information. However, if you are a dependent or on another person s coverage, including if you are on a parent s or partner s coverage, they may receive some information about the services you use because they are the principal policy holder. This typically happens when they receive, in the mail, a list of services provided and costs incurred, sometimes called an Explanation of Benefits or EOB.

20 THE RYAN WHITE HIV/AIDS PROGRAM AND AIDS DRUG ASSISTANCE PROGRAM (ADAP) If I receive services from Ryan White or AIDS Drug Assistance Program (ADAP), do I still need insurance? Yes. The Ryan White HIV/AIDS Program pays health service fees for some people with HIV. Some HIV patients receive services from an arm of Ryan White called the AIDS Drug Assistance Program (ADAP). Ryan White and ADAP are NOT health insurance and do NOT meet the requirement to have insurance, known as the individual mandate. Ryan White or ADAP may purchase insurance coverage for you or provide you with services today. But if you will be eligible for new coverage through the Affordable Care Act (or ACA) in the health insurance marketplace or through Medicaid, the services or financial support you receive from Ryan White or ADAP may change or be replaced by insurance. If you are receiving help from Ryan White or ADAP, it s important that you contact the program to find out about new options. If your insurance plan has limits or gaps in what it covers or charges cost sharing or copayments when you access services or fill a prescription, Ryan White or ADAP may be able to help you cover those costs. Ryan White may also be able to help connect you to new health coverage in your state. If you are a person with HIV and you are ineligible for Medicaid or a marketplace health plan, Ryan White or ADAP may be able to help you as well. If I currently receive financial support from the Ryan White Program or AIDS Drug Assistance Program (ADAP), will that support still be available? The Ryan White HIV/AIDS Program or the AIDS Drug Assistance Program (ADAP) may still be able to help you. But they do not qualify as insurance under the Affordable Care Act (ACA). To continue to get help from Ryan White or ADAP, you must either obtain Medicaid (if you are eligible); enroll in a health plan in the health insurance marketplace in your state or sign up for other qualifying coverage. If you are unable to afford insurance or qualify for Medicaid, or if your insurance has limits or gaps in its coverage, then Ryan White or ADAP may be able to help you. Can I still see my Ryan White/ADAP services provider under the Affordable Care Act? It depends. If staying with your current doctor is important to you, check to see if s/he is included in a health plan s network before choosing a marketplace plan or when enrolling in Medicaid coverage. Most health plans offered in the marketplace and many Medicaid programs give beneficiaries a choice of health plans that have networks of hospitals, doctors, specialists, pharmacies, and other health care providers. Depending on the type of policy you buy, care may be covered only when you get it from a network provider. Each plan sold in the Marketplace must provide a link on the Marketplace web site to its health provider directory so you can find out if your doctor is included. If staying with your doctor is important to you, you should also check directly with your doctor to confirm that s/he is in the network of the plan you are considering.

This glossary provides simple and straightforward definitions of key terms that are part of the health reform law.

This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. A Affordable Care Act Also known as the ACA. A law that creates new options for people

More information

Health Insurance Marketplace Frequently Asked Questions

Health Insurance Marketplace Frequently Asked Questions Health Insurance Marketplace Frequently Asked Questions Q & A SPECIFIC TO THE HEALTH INSURANCE MARKETPLACE & ASSISTANCE Q1: Why is health insurance important? A: No one plans to get sick or hurt, but at

More information

A Consumer s Guide to the Affordable Care Act

A Consumer s Guide to the Affordable Care Act A Consumer s Guide to the Affordable Care Act The Affordable Care Act was designed to help make health care affordable for everyone. This guide will help you understand how the ACA affects individuals

More information

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace

Understanding the ObamaCare Health Insurance Plans in North Carolina Understanding Insurance and Affordable Care Act Terminology: ACA- Marketplace Understanding the ObamaCare Health Insurance Plans in North Carolina As a result of the Affordable Care Act (a.k.a. ObamaCare) the following provisions are now in place for health insurance policies with

More information

Frequently Asked Questions

Frequently Asked Questions Frequently Asked Questions What is Covered California? What is Obamacare? Are they the same? What is the Medi-Cal program? Who can buy health insurance through Covered California? When will I be able to

More information

Section 2: INDIVIDUALS WHO CURRENTLY HAVE

Section 2: INDIVIDUALS WHO CURRENTLY HAVE Section 2: INDIVIDUALS WHO CURRENTLY HAVE COVERAGE OR AN OFFER OF COVERAGE FROM THEIR EMPLOYER Section 2 covers enrollment issues for individuals who have coverage or an offer of coverage whether through

More information

Understanding Health Insurance. Your Guide to the Affordable Care Act

Understanding Health Insurance. Your Guide to the Affordable Care Act Understanding Health Insurance Your Guide to the Affordable Care Act Summary Health insurance may seem like a luxury if you are on a tight budget. But protecting your health and your family is one of the

More information

AFFORDABLE CARE ACT FAQ

AFFORDABLE CARE ACT FAQ AFFORDABLE CARE ACT FAQ What is the Healthcare Insurance Marketplace? The Marketplace is a new way to find quality health coverage. It can help if you don t have coverage now or if you have it but want

More information

List of Insurance Terms and Definitions for Uniform Translation

List of Insurance Terms and Definitions for Uniform Translation Term actuarial value Affordable Care Act allowed charge Definition The percentage of total average costs for covered benefits that a plan will cover. For example, if a plan has an actuarial value of 70%,

More information

Copayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service.

Copayment: The amount you must pay for each medical visit to a participating doctor or other healthcare provider, usually at this time service. Basic Terms How to calculate Out of Pocket Costs on a Hospital Stay: If you have a $2000 deductible and 30% coinsurance health insurance plan. If you have a $10,000 emergency room or hospital stay your

More information

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE

State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Scott Walker, Governor Theodore K. Nickel, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone:

More information

Understanding the New Health Insurance

Understanding the New Health Insurance Get Covered Guide Understanding the New Health Insurance Written by: Lucy Berrington and Jessica Kendall at Enroll America with input and support from: Kimberly Bemberis, Kathryn Bicego, Barbara DiPietro,

More information

What Healthcare Providers Need to Know about the Affordable Care Act (ACA)

What Healthcare Providers Need to Know about the Affordable Care Act (ACA) What Healthcare Providers Need to Know about the Affordable Care Act (ACA) General Housekeeping If you experience any technical difficulties during the webinar, please contact GoToMeeting.com Corporate

More information

Insurance. how insurance works

Insurance. how insurance works Insurance how insurance works why health insurance is important Health insurance is one of the best ways you can protect yourself and your family in case you get sick or injured and need medical care.

More information

MODULE 16: MEDICARE AND THE HEALTH INSURANCE MARKETPLACES

MODULE 16: MEDICARE AND THE HEALTH INSURANCE MARKETPLACES MODULE 16: MEDICARE AND THE HEALTH INSURANCE MARKETPLACES Objective This module will educate HIICAP counselors about how Medicare is affected (and not affected) by the health insurance Marketplaces. What

More information

Guide to Health Care Reform

Guide to Health Care Reform Guide to Health Care Reform 2 0 1 5 Navigating the changing landscape The first year of health care reform may be over but it may have left you with more questions than ever. You probably want to know

More information

Federal Health Reform FAQs

Federal Health Reform FAQs Federal Health Reform FAQs Individuals 1. What is an exchange? An exchange, as created under the Affordable Care Act (ACA), is a place where consumers can purchase subsidized health insurance coverage.

More information

Currently, for the very low-income, Medicaid is available for children, parents, and individuals who are disabled, elderly, or pregnant.

Currently, for the very low-income, Medicaid is available for children, parents, and individuals who are disabled, elderly, or pregnant. 0 Currently, for the very low-income, Medicaid is available for children, parents, and individuals who are disabled, elderly, or pregnant. Parents are typically covered at very low income levels, and most

More information

EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS

EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS The EMPLOYEE S GUIDE TO HEALTH CARE REFORM S TAX CREDITS Calculate Your Health Insurance Tax Credit 2 Introduction Beginning in 2014, massive tax credits will become available to help individuals buy health

More information

A Quick Guide to. Health Insurance

A Quick Guide to. Health Insurance A Quick Guide to Health Insurance Contents How health insurance helps you... 3 Find the health insurance that s right for you.... 4 Know your health insurance costs.... 6 Compare Marketplace health plan

More information

NAVIGATOR RESOURCE GUIDE ON PRIVATE HEALTH INSURANCE COVERAGE & THE HEALTH INSURANCE MARKETPLACE

NAVIGATOR RESOURCE GUIDE ON PRIVATE HEALTH INSURANCE COVERAGE & THE HEALTH INSURANCE MARKETPLACE NAVIGATOR RESOURCE GUIDE ON PRIVATE HEALTH INSURANCE COVERAGE & THE HEALTH INSURANCE MARKETPLACE The Center on Health Insurance Reforms Georgetown University Health Policy Institute Acknowledgements This

More information

H I V. and Insurance YOUR LEGAL RIGHTS HIV AND INSURANCE 1

H I V. and Insurance YOUR LEGAL RIGHTS HIV AND INSURANCE 1 HIV AND INSURANCE 1 H I V and Insurance YOUR LEGAL RIGHTS UPDATED MARCH 2014 published by: AIDS Legal Council of Chicago 180 North Michigan Avenue, Suite 2110 Chicago, Illinois 60601 (312) 427.8990 2 AIDS

More information

Your Guide to Getting Health Insurance

Your Guide to Getting Health Insurance Your Guide to Getting Health Insurance Getting Health Insurance: KEY QUESTIONS The following is a list of key questions and things to think about when selecting health insurance to best meet your needs

More information

How to choose a health plan in Covered California: Do it before February 15, 2015!

How to choose a health plan in Covered California: Do it before February 15, 2015! For people with HIV and/or hepatitis C and those seeking PrEP How to choose a health plan in Covered California: Do it before February 15, 2015! CONTRIBUTORS: Project Inform, APLA Health & Wellness, San

More information

How to choose a health plan in Covered California: Do it before February 15, 2015!

How to choose a health plan in Covered California: Do it before February 15, 2015! For people with HIV and/or hepatitis C and those seeking PrEP How to choose a health plan in Covered California: Do it before February 15, 2015! CONTRIBUTORS: Project Inform, APLA Health & Wellness, San

More information

Ambulatory patient services (outpatient care you get without being admitted to a hospital)

Ambulatory patient services (outpatient care you get without being admitted to a hospital) What is the Affordable Health Care Act (ObamaCare)? Whether you need health coverage or have it already, the health care law offers new rights and protections that make coverage fairer and easier to understand.

More information

How the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1

How the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1 How the Affordable Care Act Affects Medical Support Orders in Oklahoma Frequently Asked Questions Spring, 2014 1 General 1. Did Oklahoma expand Medicaid? No, Oklahoma did not expand Medicaid. 2. Who is

More information

Shopping for a health care plan can be confusing. Let us help.

Shopping for a health care plan can be confusing. Let us help. We re here to help Shopping for a health care plan can be confusing. Let us help. Thank you for trusting Anthem Blue Cross and Blue Shield for your health coverage. We re here to protect you from the high

More information

You can usually only shop for insurance during a specific timeframe that occurs once a year called open enrollment.

You can usually only shop for insurance during a specific timeframe that occurs once a year called open enrollment. Getting Started So many of us forget about health insurance until we need to use it. Even when we have insurance, sometimes we forget about the routine and preventive services that help us to get and stay

More information

The Affordable Care Act and the Health Insurance Marketplace

The Affordable Care Act and the Health Insurance Marketplace The Affordable Care Act and the Health Insurance Marketplace Are You Ready? The Affordable Care Act is here! In March 2010, President Obama signed into law the Affordable Care Act (ACA), putting comprehensive

More information

A Roadmap to Better Care and a Healthier You

A Roadmap to Better Care and a Healthier You FROM COVERAGE TO CARE A Roadmap to Better Care and a Healthier You Step 2 Understand your health coverage Your ROADMAP to health 2 Understand your health coverage Check with your insurance plan or state

More information

FAQ: PARTICIPANTS ON EARNED COVERAGE

FAQ: PARTICIPANTS ON EARNED COVERAGE FAQ: PARTICIPANTS ON EARNED COVERAGE What should I do when the Health Insurance Marketplace goes into effect on January 1? You don t need to do anything if you have earned coverage through the DGA Producer

More information

A,B,C s of Obama Care What do you need to know? How will it affect you and your family?

A,B,C s of Obama Care What do you need to know? How will it affect you and your family? Elephant in the Room A,B,C s of Obama Care What do you need to know? How will it affect you and your family? Confused? What will you learn in this webinar? O What is Obamacare? O What has it done so far?

More information

Exchanges and the ACA What You Need to Know for 2014

Exchanges and the ACA What You Need to Know for 2014 Exchanges and the ACA What You Need to Know for 2014 How the Affordable Care Act affects the Individual Health Insurance Market This presentation is for informational purposes only and does not constitute

More information

Presented by South Dakota Community Action Partnership

Presented by South Dakota Community Action Partnership Presented by South Dakota Community Action Partnership The project described was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S Department of Health and Human Services, Centers for

More information

Premium Tax Credits: Answers to Frequently Asked Questions

Premium Tax Credits: Answers to Frequently Asked Questions Updated July 2013 Premium Tax Credits: Answers to Frequently Asked Questions Beginning in 2014, millions of Americans will become eligible for a new premium tax credit that will help them pay for health

More information

Health Insurance A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. HL-14-001 Rev. 08/2015

Health Insurance A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. HL-14-001 Rev. 08/2015 A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE The of Health Insurance wahealthplanfinder.org 1-855-WAFINDER 1-855-923-4633 HL-14-001 Rev. 08/2015 THE ABC S OF HEALTH INSURANCE: WHY IS HEALTH

More information

Medicare Made Clear. Helping your employees and volunteers understand Medicare.

Medicare Made Clear. Helping your employees and volunteers understand Medicare. Medicare Made Clear Quick Reference Guide Helping your employees and volunteers understand Medicare. Medicare helps nearly 50 million older and disabled Americans save on their health care expenses. But

More information

Consumer Guide to. Health Insurance. Oregon Insurance Division

Consumer Guide to. Health Insurance. Oregon Insurance Division Consumer Guide to Health Insurance Oregon Insurance Division The Department of Consumer and Business Services, Oregon s largest business regulatory and consumer protection agency, produced this guide.

More information

Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion

Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion Table of Contents Expanded Coverage... 2 Health Insurance Exchanges... 3 Medicaid Expansion... 8 Novartis Pharmaceuticals Corporation

More information

Welcome to the KASA webinar series!

Welcome to the KASA webinar series! Welcome to the KASA webinar series! Today s topic: What Youth Leaders and Millennials Need to Know about Health Insurance and the Affordable Care Act Presenter: Erin Hemlin, Young Invincibles Hosted by:

More information

Why the Affordable Care Act Matters for Women: Health Insurance 101

Why the Affordable Care Act Matters for Women: Health Insurance 101 Why the Affordable Care Act Matters for Women: Health Insurance 101 APRIL 2014 Women are the health care decision makers in our country they make approximately 80 percent of the health care decisions in

More information

NEW YORK STATE HEALTH INSURANCE EXCHANGE

NEW YORK STATE HEALTH INSURANCE EXCHANGE NEW YORK STATE HEALTH INSURANCE EXCHANGE INFORMATIONAL GUIDE Vista Health Solutions www.nyhealthinsurer.com 1 Table of Contents What is the New York State Health Insurance Exchange?...3 Essential Benefits...3

More information

1Will my Medicare Part D plan be

1Will my Medicare Part D plan be 2014 Medicare Prescription Drug Annual Open Enrollment Questions & Answers The Annual Open Enrollment for Medicare prescription drug (Part D) is October 15, 2013 December 7, 2013. Certain people with Medicare

More information

The Instant Insurance Guide: Federal Health Care Reform

The Instant Insurance Guide: Federal Health Care Reform The Instant Insurance Guide: Federal Health Care Reform From Karen Weldin Stewart, CIR-ML Delaware Insurance Commissioner 1-800-282-8611 www.delawareinsurance.gov A Message From The Delaware Department

More information

HEALTH INSURANCE PLANS

HEALTH INSURANCE PLANS 2016 HEALTH INSURANCE PLANS FOR YOU & YOUR FAMILY An Independent Licensee of the Blue Cross and Blue Shield Association MPI 4162 10/15 Access to more doctors, hospitals and top specialists * Coverage that

More information

Health plans for individuals and families

Health plans for individuals and families 2015 Health Plan Information Health plans for individuals and families + Choosing the right plan for you + Subsidy eligibility information + Plan comparison charts + Terms and definitions + How to enroll

More information

Health Insurance and HIV

Health Insurance and HIV Health Insurance and HIV Use this guide to find out how you can get help paying for your HIV care and other health needs, including the answers to these questions: Why do I need health insurance? How can

More information

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions.

Informational Series. Community TM. Glossary of Health Insurance & Medical Terminology. (855) 624-6463 HealthOptions. Informational Series Glossary of Health Insurance & Medical Terminology How to use this glossary This glossary has many commonly used terms, but isn t a full list. These glossary terms and definitions

More information

Medigap Insurance 54110-0306

Medigap Insurance 54110-0306 Medigap Insurance Overview A summary of the insurance policies to supplement and fill gaps in Medicare coverage. How to be a smart shopper for Medigap insurance Medigap policies Medigap and Medicare prescription

More information

Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange

Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange Choosing the Best Plan for You: A Tool for Purchasing Coverage in the Health Insurance Exchange The Affordable Care Act (ACA) makes health insurance available to nearly all Americans and the law requires

More information

Health Care Reform Overview How Will People with Hepatitis Benefit?

Health Care Reform Overview How Will People with Hepatitis Benefit? Health Care Reform Overview How Will People with Hepatitis Benefit? A N N E D O N N E L L Y, H E A L T H C A R E P O L I C Y, P R O J E C T I N F O R M R A C H E L M C L E A N, A D U L T V I R A L H E

More information

A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. Health Insurance

A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. Health Insurance A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE The of Health Insurance THE ABC S OF HEALTH INSURANCE: WHY IS HEALTH INSURANCE IMPORTANT? Even if you are in GOOD HEALTH, you will need to

More information

A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. Health Insurance

A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE. The. Health Insurance A GUIDE TO UNDERSTANDING, GETTING AND USING HEALTH INSURANCE The of Health Insurance THE ABC S OF HEALTH INSURANCE: WHY IS HEALTH INSURANCE IMPORTANT? Even if you are in GOOD HEALTH, you will need to

More information

Health Care Reform: Health Insurance Marketplace FAQs

Health Care Reform: Health Insurance Marketplace FAQs From Filice Insurance Health Care Reform: Health Insurance Marketplace FAQs What is a Health Insurance Marketplace? The Health Insurance Marketplace (Marketplace) is a way to find health coverage that

More information

Healthcare Exchanges / Marketplaces Frequently Asked Questions For Students & Campus Administrators

Healthcare Exchanges / Marketplaces Frequently Asked Questions For Students & Campus Administrators Healthcare Exchanges / Marketplaces Frequently Asked Questions For Students & Campus Administrators This FAQ is intended to provide our clients and customers with information about Healthcare Exchanges,

More information

Find health care options that meet your needs and fit your budget. ctober 2014

Find health care options that meet your needs and fit your budget. ctober 2014 O Health Insurance Find health care options that meet your needs and fit your budget. ctober 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law generally requiring

More information

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget.

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. March 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law

More information

5Want to know more about the health

5Want to know more about the health www. WHAT S INSIDE STEPS TO UNDERSTANDING OBAMACARE Introduction 4 Step 1 Does your current health insurance plan need to change? 6 Step 2 How will you pay for health insurance in 2014? 10 Step 3 What

More information

The Affordable Care Act: What it Means for Seniors

The Affordable Care Act: What it Means for Seniors December 12, 2013 The Affordable Care Act: What it Means for Seniors Amber Cutler, Staff Attorney National Senior Citizens Law Center www.nsclc.org 1 The National Senior Citizens Law Center is a non-profit

More information

Programs. Summary of State Programs and Laws Highlighted in Faces of Maryland s Newly Insured. Medical Assistance for Families (SB 6)

Programs. Summary of State Programs and Laws Highlighted in Faces of Maryland s Newly Insured. Medical Assistance for Families (SB 6) Programs Summary of State Programs and Laws Highlighted in Faces of Maryland s Newly Insured Medical Assistance for Families (SB 6) Medical Assistance for Families provides full health care insurance to

More information

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS

GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS The Affordable Care Act: A Working Guide for MCH Professionals Module 2 GLOSSARY OF KEY HEALTH INSURANCE CONCEPTS Overview A fundamental first step in accessing health care in the United States is having

More information

Health Insurance Marketplaces

Health Insurance Marketplaces Health Insurance Marketplaces 2013 Zywave, Inc. All rights reserved. Presented by Employer Flexible What is Health Care Reform? The Affordable Care Act (ACA) was enacted in March 2010. Biggest overhaul

More information

INDIVIDUAL HEALTH INSURANCE GUIDE. Introduction. What is the Health Insurance Marketplace?

INDIVIDUAL HEALTH INSURANCE GUIDE. Introduction. What is the Health Insurance Marketplace? INDIVIDUAL HEALTH INSURANCE GUIDE Introduction On November 15th, 2014, the second annual Open Enrollment Period for Individual Health Insurance begins. The Affordable Care Act (ACA) requires all US citizens

More information

Coinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy.

Coinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy. Glossary of Health Insurance Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should

More information

Consumer Health Coalition

Consumer Health Coalition Consumer Health Coalition An overview of the Affordable Care Act and how to get health insurance through the marketplace Presented by Leslie Bachurski 412-456-1877 x200 lbachurski@consumerhealthcoalition.org

More information

A Guide to Health Insurance

A Guide to Health Insurance A Guide to Health Insurance Your health matters. A healthier you makes a healthier Cleveland! Healthy Cleveland Insurance Guide Dial Dial Acknowledgements On behalf of the City of Cleveland Department

More information

Affordable Care Act Employee Education Packet

Affordable Care Act Employee Education Packet Affordable Care Act Employee Education Packet Your Health Plan Options under the Affordable Care Act The Affordable Care Act (ACA) requires that most Americans be covered under a health plan by January

More information

HealtH insurance 101

HealtH insurance 101 Health insurance 101 Know the facts. Knowing the facts can make all the difference when it comes to health insurance. To make the most of new choices, protections and financial help, you need good information.

More information

On the next page are answers to some important questions that can help you during the Annual Open Enrollment.

On the next page are answers to some important questions that can help you during the Annual Open Enrollment. QA 2015 Medicare Prescription Drug Annual Open Enrollment The Annual Open Enrollment for Medicare prescription drug coverage (Part D) is October 15, 2014 December 7, 2014. Certain people with Medicare

More information

Health Care Reform: General Q&A for Employees

Health Care Reform: General Q&A for Employees From Baugher Financial & Associates, Inc. Health Care Reform: General Q&A for Employees Common questions answered I ve heard a lot about the health care reform law. When do the reforms become effective?

More information

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform.

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform. WHAT IS HEALTHCARE REFORM? Healthcare Reform (HCR) is a law passed by Congress that provides many different requirements. A very important aspect of the law is that it is designed to provide individuals

More information

Do you have health insurance?

Do you have health insurance? Do you have health insurance? We will help you understand how to get, pay for, and use health insurance This presentation will help you understand how to get health insurance, how to pay for health insurance,

More information

your guide to health INSURANCE reform

your guide to health INSURANCE reform CURRENT LOGO your guide to health INSURANCE reform for This guide explains how Health Reform will affect Individual and Family health plans, helps you understand different types of health insurance and

More information

FOR YOU & YOUR FAMILY LOOK INSIDE! MPI 3124 10/14. You may qualify for low-cost insurance.

FOR YOU & YOUR FAMILY LOOK INSIDE! MPI 3124 10/14. You may qualify for low-cost insurance. LOOK INSIDE! You may qualify for low-cost insurance. 2015 healthinsurance PLANS FOR YOU & YOUR FAMILY An Independent Licensee of the Blue Cross and Blue Shield Association MPI 3124 10/14 Can a card give

More information

Optimum HealthCare Sales Video Script - H5594_14SalesVideo_CMS Approved

Optimum HealthCare Sales Video Script - H5594_14SalesVideo_CMS Approved Optimum HealthCare Sales Video Script - H5594_14SalesVideo_CMS Approved Thank you for joining us for this special presentation on Optimum HealthCare s Medicare Advantage Plans. Today we will explain the

More information

HEALTH CARE REFORM CHECKLIST

HEALTH CARE REFORM CHECKLIST HEALTH CARE REFORM CHECKLIST As a small employer, you need to be aware of the new regulations tied to the Affordable Care Act. Refer to this checklist to ensure you understand each one and that you re

More information

Health Care Reform: What s in the Law

Health Care Reform: What s in the Law Health Care Reform: What s in the Law Professor Sidney D. Watson March 2013 On June 28, 2012, the United States Supreme Court upheld the Affordable Care Act, also known as ObamaCare. The Supreme Court

More information

Health Care Reform Update

Health Care Reform Update Small Businesses No Financial Requirements for Small Businesses: The ACA imposes no financial requirements for small businesses to contribute to their employees health insurance. However, beginning in

More information

Virginia. A guide for individuals and families. The health insurance benefits you want, at a cost you can afford

Virginia. A guide for individuals and families. The health insurance benefits you want, at a cost you can afford Virginia A guide for individuals and families CoventryOne is an individual product (for individuals and families) offered by Coventry Health Care, an Aetna company. The health insurance benefits you want,

More information

Your complimentary Medicare Guidebook

Your complimentary Medicare Guidebook Learn Protect Assess Enroll Your complimentary Medicare Guidebook About this Guidebook If you or someone you care for is new to Medicare or will be soon, this Guidebook will help make Medicare easier to

More information

Your Health Insurance: Questions and Answers

Your Health Insurance: Questions and Answers Your Health Insurance: Questions and Answers This simple guide will help you understand how to use and keep your health insurance Meet four people with questions about their health insurance: George is

More information

Hospitals and the Affordable Care Act (ACA)

Hospitals and the Affordable Care Act (ACA) Hospitals and the Affordable Care Act (ACA) General Housekeeping If you experience any technical difficulties during the webinar, please contact GoToMeeting.com Corporate Account Customer Support at: 1-888-259-8414

More information

The Affordable Care Act and American Indian and Alaska Natives. Frequently Asked Questions

The Affordable Care Act and American Indian and Alaska Natives. Frequently Asked Questions The Affordable Care Act and American Indian and Alaska Natives Frequently Asked Questions 1. Is IHS coverage going away under the Affordable Care Act? No. The IHS, Tribal and urban Indian health programs

More information

GUIDE. Your. To Public Health Insurance Marketplaces. Find Coverage for You and Your Family

GUIDE. Your. To Public Health Insurance Marketplaces. Find Coverage for You and Your Family GUIDE Your To Public Health Insurance Marketplaces Find Coverage for You and Your Family We are Towers Watson s OneExchange We help you shop for a health plan. We hire and train licensed benefit advisors

More information

Health plans for individuals and families

Health plans for individuals and families 2015 Health Plan Information Health plans for individuals and families + Choosing the right plan for you + Subsidy eligibility information + Plan comparison charts + Terms and definitions + How to enroll

More information

The Affordable Care Act. What does it mean for you and how we advocate for it?

The Affordable Care Act. What does it mean for you and how we advocate for it? The Affordable Care Act What does it mean for you and how we advocate for it? Who are Young Invincibles? Agenda Overview of the ACA How does health insurance work? What s included in a health insurance

More information

INDIVIDUAL HEALTH INSURANCE In Maine

INDIVIDUAL HEALTH INSURANCE In Maine A Consumer s Guide To... INDIVIDUAL HEALTH INSURANCE In Maine Published by: The Maine Bureau of Insurance September 2015 Paul R. LePage Governor Eric A. Cioppa Superintendent Basics of Individual Health

More information

Frequently Asked Questions: The Affordable Care Act and You

Frequently Asked Questions: The Affordable Care Act and You Frequently Asked Questions: The Affordable Care Act and You This document provides answers to the common questions we receive regarding the Affordable Care Act and Health Insurance Marketplaces. If you

More information

Affordable Care Act: Impact on People with Disabilities

Affordable Care Act: Impact on People with Disabilities Affordable Care Act: Impact on People with Disabilities Stephanie Altman, Assistant Director of Healthcare Justice stephaniealtman@povertylaw.org October 2014 About Us: The Shriver Center The Sargent Shriver

More information

presents The New Insurance Marketplace and MS Live Webinar November 19, 2013 8 pm Eastern

presents The New Insurance Marketplace and MS Live Webinar November 19, 2013 8 pm Eastern presents The New Insurance Marketplace and MS Live Webinar November 19, 2013 8 pm Eastern Guest Presenters Kent Rogers, MBA Principal Consultant Blue Fin Group and Margaret Weisser, LSW Manager of Client

More information

Your complimentary Medicare Guidebook

Your complimentary Medicare Guidebook Learn Protect Assess Enroll Your complimentary Medicare Guidebook Learn Original Medicare... 4 Medicare Prescription Drug Coverage.............. 6 Medicare Supplement Insurance... 8 Medicare Advantage...

More information

Ohio Health Benefits LLC. Your health insurance partner!!

Ohio Health Benefits LLC. Your health insurance partner!! December 16, 2014 Presented by Steve Clark & Scott Prior Patient Protection and Affordable Care Act of 2010 Obamacare or ACA or PPACA or Health Care Reform (HCR) Signed in to law on March 23, 2010 The

More information

Medicare and Your Mental Health Benefits CENTERS FOR MEDICARE & MEDICAID SERVICES

Medicare and Your Mental Health Benefits CENTERS FOR MEDICARE & MEDICAID SERVICES CENTERS FOR MEDICARE & MEDICAID SERVICES Medicare and Your Mental Health Benefits This is the official government booklet about Medicare mental health benefits for people in the Original Medicare Plan.

More information

artist Understanding Health Care Reform The Artists Health Insurance Resource Center www.ahirc.org {1}

artist Understanding Health Care Reform The Artists Health Insurance Resource Center www.ahirc.org {1} Every artist Insured Understanding Health Care Reform The Artists Health Insurance Resource Center www.ahirc.org {1} The Artists Health Insurance Resource Center AHIRC, a program of The Actors Fund, was

More information

Q. My company already offers employee health coverage, how does the law impact me?

Q. My company already offers employee health coverage, how does the law impact me? Frequently Asked Questions Q. Will my business be required to provide employee health insurance under the health care law? A. The law does not mandate employers provide employees health care coverage.

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update Overview of the Affordable Care Act and the Federally Facilitated marketplace. September 2014 AFFORDABLE CARE ACT» The Affordable Care Act: Establishes a Health

More information

LEARN. Your guide to health insurance. How to choose the best plan for you and your family

LEARN. Your guide to health insurance. How to choose the best plan for you and your family LEARN Your guide to health insurance How to choose the best plan for you and your family Table of Contents Understanding health insurance...1 Health care law and you...2 Health insurance basics...4 Why

More information

I Have Health Insurance! Now What?

I Have Health Insurance! Now What? I Have Health Insurance! Now What? A Guide to Using Your Private Health Insurance Plan Brought to you by: Congratulations on Your New Health Plan! This guide is an overview of private insurance plans and

More information

WELCOME TO A NEW ERA IN HEALTH CARE COVERAGE FOR TENNESSEE.

WELCOME TO A NEW ERA IN HEALTH CARE COVERAGE FOR TENNESSEE. WELCOME TO A NEW ERA IN HEALTH CARE COVERAGE FOR TENNESSEE. Quality Health Plans for Individuals and Families in Tennessee. TABLE OF CONTENTS INTRODUCTION...1 Who are we?... 1 What is a CO-OP?...1 Our

More information