Though open enrollment into the new health insurance marketplaces is a distant memory and folks are gearing up for round 2 later this year, consumers continue to turn to Navigators and other assisters with questions. JoAnn Volk shares – and provides answers to – a selection of questions we’ve been getting from the field.
One of the key consumer protections in the Affordable Care Act is the requirement that plans must have a limit on out-of-pocket costs. However, there are limits on the limit, and the details matter. Consumers who need a non-formulary drug run smack into one of those limits, but they have options to get the drugs they need as a covered benefit. JoAnn Volk provides a run down.
Now that open enrollment is over, consumers are starting to raise questions about their coverage. One such question from Georgia illustrates one of the challenges consumers may face – a network that changes mid-year. JoAnn Volk takes a look at some options.
How does COBRA fit into coverage options now that people who lose employer-sponsored coverage have other insurance options under the ACA? In this blog post, JoAnn Volk takes up that question and looks at what an offer of COBRA means for special enrollment periods under the ACA.
Navigators have been fielding a range of questions. One that comes up repeatedly is whether an individual who falls into the so-called Medicaid coverage gap and later gets a job with income that would qualify them for premium tax credits can get a special enrollment period. JoAnn Volk takes a look at the options for these individuals.
As we approach the end of open enrollment into new coverage options under the Affordable Care Act, many consumers have questions about their new health plans – what benefits are covered, what doctors are included in their networks, and what to do if there’s a problem. JoAnn Volk has them covered, with a series of frequently asked questions about post-enrollment issues, excerpted from our Navigator Resource Guide.
The ACA established new appeal rights for consumers facing a denial of a benefit or service from their health plan. As consumers start to use their new Marketplace coverage, JoAnn Volk takes a look at the health plan appeals process required of all new plans, and what these new rights mean for patients.
High risk pool enrollees face particular challenges transitioning to new coverage when their coverage ends. But announcements in the past week provide relief to both PCIP enrollees as well as those in state-based high risk pools. JoAnn Volk takes a look at what those announcements mean for consumers.
The start of 2014 marks the transition to new health plans that must meet ACA standards for adequacy and affordability. But, as with any transition, there can be disruptions, particularly for people who are in the middle of treatment or need drugs that may not be on a new plan’s formulary. HHS has recently released fact sheets and an interim final rule to help consumers and health plans make a smooth transition. JoAnn Volk has this overview – and answers some common consumer questions.
Last week the Administration announced plans to extend the Pre-existing Condition Insurance Plans (PCIPs) into 2014 to help ensure enrollees don’t face a gap in coverage. Recently CHIR released a set of frequently asked questions about transitioning out of high risk pool coverage and CHIR’s JoAnn Volk provides an update here.
The opinions expressed here are solely those of the individual blog post authors and do not represent the views of Georgetown University, the Center on Health Insurance Reforms, any organization that the author is affiliated with, or the opinions of any other author who publishes on this blog.
