Human Arc Blog

  • Presumptive Eligibility: Opportunities and Challenges

    Shanna Hanson - July 30, 2014

    The Affordable Care Act (ACA) requires all states to allow Qualified Hospitals (QHs) to make presumptive eligibility (PE) Medicaid determinations for individuals meeting financial and non-financial eligibility criteria based on self-attestation. Additionally, the ACA gives states the discretion to allow other Qualified Entities (QEs) to make PE decisions. While PE presents the opportunity to make immediate [...]

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  • Patients Will Need Help with Insurance Renewals

    Human Arc - July 17, 2014

    “Enrolling more than 12.8 million Americans in Marketplace coverage [Qualified Health Plans or QHPs], Medicaid, or CHIP during the initial open enrollment period was a monumental achievement, but the true measure of success will be ensuring those gains in coverage are maintained over the long term …” states State of Enrollment: Lesson Learned from Connecting [...]

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  • Looking Ahead to Open Enrollment

    Shanna Hanson - July 8, 2014

    “I didn’t think I could afford insurance so I never applied.” …“I didn’t know financial help to pay for insurance was available to me.” … “I didn’t know I could sign up for coverage.” There is a common theme to these reasons for remaining uninsured: lack of knowledge and understanding. In a survey commissioned by [...]

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  • Coverage Options for Pregnant Women under the ACA

    Shanna Hanson - June 24, 2014

    Under the Affordable Care Act (ACA), pregnant women can get caught in a revolving door between Medicaid or Children’s Health Insurance Program (CHIP) coverage and Qualified Health Plans with premium assistance and cost sharing benefits. Some states are confused by the regulations and may offer inaccurate information. This is partially the result of overlapping eligibility [...]

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  • How Life Changes impact Qualified Health Plan Enrollment

    Shanna Hanson - June 9, 2014

    The Affordable Care Act has provisions to accommodate many kinds of life changes. This blog looks at how life changes impact Qualified Health Plan (QHP) enrollment. Some life changes create an opportunity to enroll in a QHP through the Marketplace outside of an open enrollment period. Other life changes only will impact people if they [...]

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  • Premium and Cost-Sharing Assistance for Marketplace Enrollees

    Human Arc - May 30, 2014

    In a letter last week to the American Hospital Association, HHS Secretary Kathleen Sebelius confirmed that third parties can cover premium and cost-sharing payments for people who enroll in Qualified Health Plans (QHPs)—and stated no further guidance is needed on the issue. As a reminder, third-party payments are acceptable from independent, private, not-for-profit foundations; American [...]

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  • Special Enrollment Period for COBRA-Eligible Individuals and Participants

    Shanna Hanson - May 21, 2014

    In our last blog posting, we informed you about a special enrollment period for federal high-risk pool, called the Pre-Existing Condition Insurance Plan (PCIP), participants. In similar fashion, on May 2, 2014, the Centers for Medicare and Medicaid Services (CMS) announced a special enrollment period for Consolidated Omnibus Budget Reconciliation Act (COBRA) participants. Matter of [...]

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  • Special Enrollment Period for Federal High-Risk Pool Participants

    Human Arc - May 16, 2014

    People participating in the federal high-risk insurance pool who have not yet signed up for new coverage through the Marketplace now qualify for a break: a special enrollment period that runs through June 30. This gives them an extra 60 days to select and enroll in a Qualified Health Plan (QHP). Those who sign up [...]

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  • Victims of Domestic Abuse

    Shanna Hanson - May 5, 2014

    Married couples must file jointly to be eligible for Advanced Payment of Premium Tax Credits (APTC), which reduce the price of purchasing a Qualified Health Plan (QHP) through the marketplace. This eligibility criterion has been documented, published and communicated—no “ifs, ands, or buts.” Or is there? Domestic abuse advocates have claimed persistently that this criterion [...]

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  • The Medicaid Appeals Process

    Shanna Hanson - April 25, 2014

    All state Medicaid agencies have established appeal processes to protect people eligible for coverage. And health insurance Marketplaces, established under the Affordable Care Act (ACA), are required to use the process consistent with each state agency. Providers are advised to know which option is used in their state; with coverage expanding under the ACA, more [...]

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