Although the Affordable Care Act is a federal law, state policymakers like the governor, state agencies, stakeholders, and the legislature are responsible for decision making. They are also tasked with the execution of certain provisions, such as Medicaid expansion, or creating a state-run marketplace. In Illinois, as in several other states, Medicaid expansion was successfully enacted, but legislation to create a state-run marketplace stalled, leaving residents to use the federal healthcare.gov site to enroll. Stay with us to stay informed:
YOUR QUESTIONS ANSWERED
Q: How can someone sign up for CountyCare?
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?
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.
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RESOURCES FOR YOU
Managed Long Term Services and Supports
Starting July, 2016 managed care organizations will be responsible for coordinating long-term services and supports for people who live in a nursing facility or receive home and community-based services through a Medicaid waiver program. This April 2016 fact sheet from Health & Disability Advocates informs consumers about the change.
Engaging African Americans
In this January 2016 blog post for the Social Security Administration, a Minister details proven outreach and enrollment strategies with the Black community— a group which is still more likely to be uninsured.
Food is Medicine
This January 2016 fact sheet from the Shriver Center provides guidance to Enrollment Assisters looking to connect their clients with SNAP, formerly called food stamps.