Summing Up Questions from Navigators: A Grab Bag of Consumer Queries

We at CHIR continue to field questions from Navigators and assisters as part of our Robert Wood Johnson Foundation-funded project to provide technical assistance and resources to assisters of all stripes. Though Open Enrollment is a distant memory and folks are gearing up for round 2 later this year, consumers continue to turn to Navigators with questions about special enrollment opportunities for the Marketplace, year-round-enrollment for Medicaid, and issues with their premiums, benefits and coverage. A recent survey of assisters found 90 percent have been re-contacted by consumers with post-enrollment questions.

We are working on updating our Navigator Resource Guide, which includes 270 FAQs covering eligibility and enrollment issues as well as post-enrollment questions. Stay tuned for an online version later this year that will incorporate many of the questions we’ve received. In the meantime, we’ve put together a compilation of some of the questions we’ve been getting from the field, chosen because assisters in other states are likely to receive similar questions. In it, we provide answers on:

  • Student health insurance and premium tax credits
  • Non-ACA-compliant plans that fall short on benefits
  • The 90 day grace period for payment of premiums
  • Accessing providers in border counties and states
  • Medicaid residency rules
  • Counting Social Security benefits in household income
  • Same-sex couples and eligibility for premium tax credits

Throughout this project, we’ve learned there is no shortage of rules and considerations for families to work through in figuring out how to obtain and use health insurance coverage. Assisters are doing yeoman’s work to help families sort it all out, and we’re fortunate to be able to contribute to the resources available to assisters.

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