Health Plan Categories
This is typically the lowest priced plans in the Marketplace, with a actuarial value of 60%.
What is the Bronze Metal Level plan?
The amount you can use to lower your monthly premium each month.
What is Premium tax credit?
You would do this if a consumer can not remember their password.
What is resetting a password?
Members of the same household may need to complete separate applications if they won’t file taxes together and they want to apply for help paying for coverage. (T or F)
What is True?
The time a consumer has to start an appeal.
What is 90 days from the date they received an eligibility determination notice?
This plan protect consumers from very high medical costs by only providing coverage when they need a lot of care.
What is Catastrophic Health Insurance Plans?
This let's consumer's answer a few quick questions to review available QHP options in their area and provides estimates prices based on projected income
What is Window Shopping tool?
A us citizen, not incarcerated, and live in a state served by the Marketplace.
What is eligibility to enroll in a qualified health plan?
All individuals and family members in a tax household.
What is Who to Include on an Application?
The consumer must do this before the plan selected takes effect.
What is pay the first month's premium?
With this plan level, insurance will cover 70% of total average costs for covered benefits.
What is the Silver Metal level plan?
Legal documents that serve as written permission to send or receive information among participating parties. *DAILY DOUBLE!*
What is a consent form?
Birth certificate, Social Security card, Marriage certificate, Divorce decree, Employer ID card, High school or college diploma, Property deed or title
What are documents to verify identify?
Individuals who are trained and able to help consumers, look for health coverage options through the Marketplace, including helping them complete eligibility and enrollment forms. Their services are free to consumers.
Who are Assisters?
The effective date of coverage for the consumer.
What is the first day of the month following the plan selection?
Health insurance companies that sell QHPs in an FFM MUST offer at least one Silver and one Gold plan. (T or F)
What is True?
The range for this eligibility is 100%-400% of the federal poverty level.
What is advanced premium tax credit eligibility?
The first time a consumer logs into Healthcare.gov, consumer must answer a few screening questions about their household to begin the application.
What is Identify Verification?
The average time a consumer has to respond to a DMI notice.
What is 90-95 days?
Reasons to appeal the marketplace’s decision from an initial eligibility determination or redetermination.
What is eligibility to enroll in QHP in a Marketplace, denial of a Special Enrollment Period, Denial or their level of premium tax credit or cost sharing reductions, Eligibility for Medicaid or CHIP, Eligibility for an exemption to enroll in a catastrophic plan, failure to provide a timely notice of eligibility determination?
Consumers can use APTC and CSRs to lower the costs of a Catastrophic plan like they can with other health plan categories. (T or F)
What is False?
The range for this eligibility is 100%-250% of the FPL.
What is cost sharing reductions eligibility?
Categories of Essential Health Benefits. (Name at least 4)
What is Ambulatory patient services, Emergency Services, Hospitalization, Maternity and newborn care, mental and behavioral health treatment, prescription drugs, rehabilitative services and devices, laboratory services, preventative services/disease management, and pediatric services?
One way I can file an appeal and next steps.
What is Submitting the Marketplace Eligibility Appeal Request Form at Healthcare.gov online?
OR
What is Writing a letter to: Health Insurance Marketplace Attn:Appeals 465 Industrial Blvd. London, KY 40750-0061?
OR
What is Mailing an appeal request form using the proper form for their states. Appeal request forms are available at HealthCare.gov?
OR
What is Faxing appeal request 1-877-369-0130?
Next steps:
They receive a letter and it says their appeal request was received, it provides a description of the appeals process, it includes instructions for submitting additional material, if applicable.
These things are not counted as income on the application. (Name at least 3)
What are Gifts, Child Support, Supplement Security Income, Veterans’ Disability Payments, Worker’s Compensation, Proceeds from loans( student, home equity or bank), Child Tax Credit checks or deposits (from the IRS), Stimulus Checks?