After the open enrollment season, people may encounter a variety of issues that could affect their ability to stay enrolled in health coverage. They might have data matching issues (DMIs) they need to address to finalize their enrollment, or they might need to file an appeal to resolve an enrollment issue.
During the year, an enrollee might need to update their application to reflect changes to their income or household size.
Toward the end of the year, enrollees may need help understanding the re-enrollment process for the following year.
In this Beyond the Basics webinar presented May 16, 2023, in partnership with the National Health Law Program (NHeLP), Skyler Rosellini, Senior Attorney (CA Office) at NHeLP, provides an overview of the Medicaid eligibility appeals process, including what can be appealed, how to file an appeal, and what to know…
Updated October 2022 Under a recent Department of Health and Human Services (HHS) rule, insurers can no longer collect any past-due premiums from the last 12 months before allowing someone to enroll in a plan with the same carrier. The following FAQ explain what happens now if a person misses…
Este novedoso seminario web en español proporciona herramientas para facilitar el acceso a cobertura de salud para consumidores hispanos, como son: conceptos básicos sobre seguro médico, comparación de planes de salud, y cómo resolver los errores más comunes de elegibilidad que afectan a inmigrantes y familias de estatus mixto. Un…
In Part VIII of this Beyond the Basics OE10 webinar series presented on October 13, 2022, Claire Heyison, Senior Policy Analyst for Health Insurance & Marketplace Policy, and Jenny Sullivan, Director of Health Coverage Access, bring together all of the policies covered in the Beyond the Basics webinar series by…
In Part VII of this Beyond the Basics OE10 webinar series presented on October 6, 2022, Jenny Sullivan, Director of Health Coverage Access, provides an in-depth review of the HealthCare.gov renewal process for 2023 coverage, including redetermination of premium tax credit eligibility and plan enrollment. Webinar Resources ↓ Presentation Slides (PDF)
In Part VI of this Beyond the Basics OE10 webinar series presented on October 4, 2022, Shelby Gonzales, Vice President for Immigration Policy, and Jenny Sullivan, Director of Health Coverage Access, provide guidance on how to help applicants complete the marketplace documentation requirements and explain how to prevent data matching…
Updated October 2022 Each open enrollment period, people receiving advance premium tax credits (APTC) to help them pay for health coverage have to renew their eligibility. The following FAQ provides information about how the Federally-Facilitated Marketplace (FFM) will renew eligibility for APTC and will briefly explain how HealthCare.gov will assign…
Updated September 2022 People who enroll in coverage through a health insurance marketplace must pay a monthly premium in order to effectuate and maintain their coverage. The following FAQ explains marketplace policies for plan year 2023 on premium payments, grace periods for people who do not pay premiums on time,…
This Beyond the Basics webinar was presented in partnership with the National Health Law Program on April 28, 2022. Mara Youdelman, Managing Attorney at the National Health Law Program, provided information on marketplace appeals, detailing what decisions can be appealed, how to file an appeal, and ways to expedite the…
Starting in 2022, there is a new law, the No Surprises Act, that protects people from “surprise medical bills.” These protections apply to anyone enrolled in a private health insurance plan, including employer plans or a plan purchased on or off the marketplace. Even though surprise bills are now banned…
