Updated Navigator Resource Guide

Open Enrollment_Section3 (1)This week, CHIR is pleased to release an updated online version of the Navigator Resource Guide on Private Health Insurance and Health Insurance Marketplaces with searchable frequently asked questions (FAQs) and easy-to-read background information on key health insurance and marketplace issues. The Guide is a result of a project funded by the Robert Wood Johnson Foundation and in collaboration with Georgetown’s Center for Children and Families.

The Guide is a hands-on, practical resource for navigators and anyone who needs to communicate with consumers about private health insurance and the Affordable Care Act.  It’s organized into four sections: (1) People without coverage, (2) People with coverage, (3) Employers offering coverage, and (4) Post-enrollment problems with coverage. The (FAQs) reflect a wide range of situations that consumers may face as they navigate our changing health coverage system. In each case, CHIR experts provide helpful background on the topic with accompanying FAQs, culled from common consumer situations. Examples of the questions answered in the Guide include:

  • Are there exemptions to the individual mandate penalty? What are they?
  • I received a notice telling me it’s time to renew my marketplace plan. What do I need to do?
  • My son goes to college in another state, but we want to enroll him on our family plan. Can we do that?
  • I own my own business and have no employees. What are my options?
  • I have an offer of coverage through my employer, but the premiums are too expensive. Can I get financial help to buy a marketplace plan?
  • Does pregnancy trigger a special enrollment opportunity?
  • I’m eligible for COBRA but haven’t elected it yet. Does that affect my eligibility for marketplace subsidies?
  • I was denied coverage for a service my doctor said I need. How can I appeal the decision?

The Guide has also been updated with recent guidance clarifying coverage on preventive services like contraception, a preventive screening colonoscopy, and other required benefits like mental health and behavioral health services. It also updates available exemptions and qualifying life events for a special enrollment period as well as the federal marketplace approach to renewing 2016 coverage.

Throughout the coming months, we will feature a FAQ of the week on either a question we’ve been asked by assisters or another timely topic during open enrollment on https://chirblog.org/. The upcoming open enrollment period promises to generate many more questions – such as how to renew or change plans, obtain premium tax credits, and file for exemptions from the individual mandate. As more questions come in and new federal guidance comes out, we’ll update the Guide in real time so that Navigators and assisters can provide accurate, up-to-date advice to consumers.


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