In this Beyond the Basics webinar presented by the Center on Budget and Policy Priorities, in partnership with Foundation Communities, on October 5, 2021, Arianna Anaya covers strategies to help consumers understand how insurance works, evaluate and compare marketplace plans, and select the plan that best meets their families’ needs.

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Part I: Using the Enrollment Process to Explain Exchange Plans

• The Marketplace Enrollment Checklist
• Estimating Total Annual Cost
• Choosing the Amount of PTC to Use
• Checking Network & Rx Coverage
• Choosing a Health Plan

Part II: Plan Comparison Strategy

• Talking About Cost & Network
• Essential Health Benefits
• Comparing Plans Based on Cost
• Comparing Plans Based on Network
• Narrowing Plan Selection
• Cost-Sharing & Metal Tiers

Part III: Plan Selection Tips & Tools for Assisters

• Building a Network Overview Cheat Sheet

Additional Resources

OE9 Webinar: Part V Health Insurance Plan Design

Plan Comparison Worksheet

Key Facts About Cost-Sharing Reductions

Key Facts About Cost-Sharing Charges

In this Health Reform: Beyond the Basics webinar presented on October 6, 2020, Dave Chandrasekaran, a health policy consultant and volunteer Certified Application Counselor, provided strategies to support consumers in understanding how commercial insurance works, evaluating and comparing marketplace plans, and selecting the plan that best meets their families’ needs.

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Overview of Marketplace Plans

• Elements of Marketplace Health Plans
• Overview of Cost Sharing
• First Dollar Coverage
• Health Savings Accounts
• Carrier Negotiated Rates
• Health Plan Types

Trends in Marketplace Plans

• Partial Exemptions from the Deductible
• Deductible-only Plans
• Prescription Drug Tiers
• Tiered Provider Networks
• Inaccurate Provider Directories

Strategies to Help Consumers

• Preparing for Open Enrollment
• Tailoring Search Based on Consumer Needs
• Understanding Consumers Tradeoffs

Live Plan Selection Demonstration on HealthCare.gov

• Example Scenarios

Additional Resources

OE8 Webinar Part V: Plan Design

Key Facts About Cost-Sharing Charges

Key Facts About Cost-Sharing Reductions

In this Health Reform: Beyond the Basics webinar presented by the Center on Budget and Policy Priorities on October 17, 2019, Dave Chandrasekaran, a health policy consultant and volunteer Certified Application Counselor, joins us to provide strategies to support consumers in understanding how commercial insurance works, evaluating and comparing marketplace plans, and selecting the plan that best meets their families’ needs.

↓ View Presentation Slides (PDF)

Watch the Webinar

Additional Resources

Worksheet: Marketplace Plan Comparison Worksheet

Key Facts:

• Cost-Sharing Charges
• Cost-Sharing Reductions

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts

Tools and Resources | View all tools and resources

Frequently Asked Questions | View FAQs

In this special Health Reform: Beyond the Basics webinar presented on September 18, 2018, Karl Cooper, Director of Public Health Programs at the American Association on Health and Disability (AAHD), addresses disability etiquette and basic accessibility considerations for anyone doing enrollment work, as well as provides an overview of questions a person with a disability needs to think about when considering their health care options in the marketplace. In addition, he provides an overview of the resources available through the National Disability Navigator Resource Collaborative (NDNRC).

Presentation Slides

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Overview of What’s Covered

Overview of AAHD

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• AAHD mission
• Health disparities for people with disabilities

Disability Etiquette

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• People with all types of disabilities
• People with mobility disabilities
• People who are blind or low vision
• People who are deaf or hard of hearing
• People with speech and language disorders
• People with cognitive or intellectual disabilities
• People with mental health or behavioral health disabilities
• Disability accessibility and accommodations

National Disability Navigator Resource Collaborative (NDNRC)

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• Overview of the Affordable Care Act’s impact on people with disabilities
• Overview of NDNRC and enrollment resources
• Resource: Guide to Disability for Health Insurance Navigators
• Resource: Topical and population-specific fact sheets
• Needs by disability category
• Resource: Community Outreach Collaboratives

Considerations When Assessing Health Plan Options

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Health Insurance Jeopardy: It’s not about the answer. It’s about asking the right question!

• Topical questions
• Population specific questions
• Accessibility and disability etiquette
• Resource: Health Insurance Jeopardy Series | View NDNRC YouTube channel

Ongoing Challenges

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• Limited provider networks
• Limited formularies
• Discriminatory pharmacy design
• Plan transparency
• High out-of-pocket costs
• Confusion on the definition of “rehabilitation” and “habilitation” services and supports
• Confusion on the coverage of prosthetic devices and durable medical equipment
• Confusion about coordinating exchange coverage with Medicare and Medicaid
• Delays in getting plan information once they are enrolled
• Communication issues for deaf and hard of hearing

Additional Resources

Resources | View resources links

American Association on Health and Disability (AAHD) | Find out more

AAHD | National Disability Navigator Resource Collaborative (NDNRC)

• Guide to Disability for Health Insurance Navigators
• Topical and population-specific fact sheets
• Community Outreach Collaboratives

AAHD | NDNRC: Health Insurance Jeopardy Series | NDNRC YouTube channel

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts

Tools and Resources | View all tools and resources

Frequently Asked Questions | View FAQs

In a special Health Reform: Beyond the Basics webinar presented by Dave Chandrasekaran, a training consultant and certified application counselor, on September 25, 2018, Part IV provides an in-depth lesson on effective strategies to support consumers with understanding how commercial insurance works, evaluating and comparing Marketplace plans, and selecting the plan that best meets their families’ needs.

This is Part IV in a 4-part series on core elements of eligibility and enrollment.

Presentation Slides

↓ View presentation slides (PDF) 

Watch the Webinar

Overview of What’s Covered

Overview of Marketplace Plans

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Overview of cost sharing

• Explaining cost-sharing terms
• First dollar coverage
• No cost sharing for preventive services
• Negotiated rates for services

Overview of covered benefits

• Other covered services
• Prescription drugs cost sharing and formularies

Provider networks

• Types of provider networks
• Searching for a provider

Trends in Marketplace Plans

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Partial exemptions from the deductible

Deductible-only plans

Additional prescription drug tiers

Narrow and/or tiered provider networks

• Inaccurate provider directories

Strategies to Help Consumers

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Preparing for open enrollment

• Tracking changes in the lowest-cost plan options
• Comparing differences in provider networks
• Studying all plans in your area

Tailoring search based on consumer needs

• Renewal or new applicant?
• Prescription drugs or current doctors?
• Major health needs or anticipated procedures?
• Finding options for first dollar coverage

Understanding consumer tradeoffs

• Bronze vs. silver plans
• Paying more to preserve access to providers or prescriptions
• Bronze plan + community-based coverage or other alternate sources of care
• Benefits of coverage vs. going uninsured

Live Plan Selection Demonstration via Healthcare.gov

Please note that this section of the webinar features a live web-browsing demonstration that is not reflected in the static slides.

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Scenario 1: General plan comparison (single adult)

Scenario 2: Weighing in-network doctors and current prescriptions (married couple)

Scenario 3: Comparing out-of-pocket costs (family of three)

Q&A

Additional Resources

Resources | View resources links

Worksheet: Marketplace Plan Comparison Worksheet

Webinar OE6: Plan Design

Key Facts:

• Cost-Sharing Charges
• Cost-Sharing Reductions

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts

Tools and Resources | View all tools and resources

Frequently Asked Questions | View FAQs

In this special webinar presented on October 24, 2017, Karl Cooper, Director of Public Health Programs at the American Association on Health and Disability (AAHD), helps you think about what questions a person with a disability needs to think about when they are considering their health care options in the Marketplace and provides an introduction to the resources available through the National Disability Navigator Resource Collaborative (NDNRC). Additionally, it addresses disability etiquette and basic accessibility considerations for anyone doing enrollment work.

Presentation Slides

↓ View presentation slides (PDF)

Watch the Webinar

Overview

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• AAHD mission
• Health disparities for people with disabilities
• Disability law and the Affordable Care Act

National Disability Navigator Resource Collaborative (NDNRC)

Jump to video section, View slides | Find out more

• Overview of resources available through NDNRC
• Resource: Guide to Disability for Health Insurance Navigators
• Resource: Topical and population-specific fact sheets
• Community Outreach Collaboratives

Considerations When Assessing Health Options

Jump to video section, View slides 

Health Insurance Jeopardy: It’s not about the answer. It’s about asking the right question!

• Topical questions
• Population specific questions
• Disability etiquette
• Resource: Health Insurance Jeopardy Series | View NDNRC YouTube channel

Ongoing Challenges

Jump to video section, View slides 

• Limited provider networks
• Limited formularies
• Discriminatory pharmacy design
• Plan transparency
• High out-of-pocket costs
• Confusion on the definition of “rehabilitation” and “habilitation” services and supports
• Confusion on the coverage of prosthetic devices and durable medical equipment
• Confusion about coordinating exchange coverage with Medicare and Medicaid
• Delays in getting plan information once they are enrolled
• Communication Issues for deaf and hard of hearing

Disability Etiquette

Jump to video section, View slides 

• People with all types of disabilities
• People with mobility disabilities
• People who are blind or low vision
• People who are deaf or hard of hearing
• People with speech and language disorders
• People with cognitive or intellectual disabilities
• People with mental health or behavioral health disabilities
• Disability accessibility and accommodations

Q&A

Additional Resources

Resources links | View resource links

American Association on Health and Disability (AAHD) | Find out more

AAHD | National Disability Navigator Resource Collaborative (NDNRC) | Find out more

AAHD | NDNRC: Guide to Disability for Health Insurance Navigators | View guide

AAHD | NDNRC: Topical and population-specific fact sheets | View fact sheets

AAHD | NDNRC: Health Insurance Jeopardy Series | View NDNRC YouTube channel

Beyond the Basics Webinar Series | View all webinars

Key Facts About Health Reform | View all key facts

We have updated our tool for in-person consumer assistance staff to use when helping consumers evaluate and select a plan, called the Marketplace Plan Comparison Worksheet [Spanish Version].

After consumers obtain a tax credit determination, their health plan search tends to narrow down to a handful of plans that fall into a target price range (often three to five plans). This worksheet is intended for assisters to use with consumers to note the differences between several plans, compare and contrast them, and identify which plan best meets their needs.

Click here for the worksheet. (Click here for the Spanish version)