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Many questions about how health reform is affecting us have already been answered. Perhaps yours is one of them. If you do not find the answer you need below, please send us your own question.


YOUR QUESTIONS ANSWERED

 Q:   How can someone sign up for CountyCare?

 A:   In order to enroll in CountyCare, an adult must be eligible and enroll in Medicaid for ACA Adults first (ages 19-64 and below 138% FPL). After successful enrollment into Medicaid through ABE or a local DHS office, that individual  will receive a letter with Medicaid health plans options. CountyCare, which started out as a pilot program, could be one of those options, depending on the area where the individual lives. The letter will instruct the individual to call the client enrollment broker to choose a Medicaid Health Plan. If CountyCare is an option for that individual, they may sign up through the client enrollment broker.

 Q:   Can Insurance Agents & Brokers sell inside the Illinois health insurance marketplace and get a commission?

 A:   Yes, agents and brokers may sell (and receive commission on) Marketplace Qualified Health Plans using either the Marketplace website or individual issuer websites. To do this, they must be licensed in good standing in the state they wish to sell in, and are required to register with the federal Center for Medicare and Medicaid Services (CMS) in order to sell individual plans; CMS also encourages agents and brokers exclusively working in the small group (SHOP) market to register. The commission for the enrollments will be received directly from the issuer – enrollees will pay the same premium if they work with a broker, navigator or on their own. For more information about how agents and brokers can participate in the Illinois Marketplace (and other Federally Facilitated and State Partnership Marketplaces), visit "Resources for Agents and Brokers in the Marketplace" on CMS.gov.

 Q:   When is the increase in Medicaid payments to primary care physicians?

 A:   On March 4, 2013, the Illinois Department of Health & Family Services (HFS)  published this notice about the increase in fees for primary care physicians. It says, "For dates of service January 1, 2013 through December 31, 2014, the department will apply an increased payment rate to enrolled practitioners for primary care services delivered by a primary care physician with a specialty designation of family medicine, general internal medicine, or pediatric medicine. The increased payments will apply to services reimbursed by Medicaid fee-for-service, Voluntary Managed Care Organizations and Integrated Care Program Health Plans."  In order to receive the increased payments, physicians must self attest that they meet certain criteria. Interested primary care providers should read the notice for more information.

 Q:   How can Illinois state legislators help uninsured constituents?

 A:   Many consumers need individualized help to figure out if there is a public health or private insurance program that might fit their specific needs. There are options such as Medicaid and Medicare which require that consumers meet very specific requirements on income level, family status, disability and age. There are also new options -- such as for people with special health care needs to buy insurance through a high risk insurance pool, young adults under age 26 (even if they are not in college) and others. You can refer an individual constituent for assistance finding coverage to: GetCoveredIllinois.govHealthCare.gov; the Illinois Department of Insurance, Office of Consumer Health Insurance (877) 527-9431; or the Campaign for Better Health Care's toll-free hotline at 1-888-544-8271.


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