AETC Blog: Gearing Up for Open Enrollment in ACA Marketplaces

AETC Blog: Gearing Up for Open Enrollment in ACA Marketplaces

Wednesday, June 12, 2013
AETC National Coordinating Resource Center (NCRC)

This edition of the AETC ShareSpot Blog provides tips for HIV/AIDS programs to help clients navigate and make choices when selecting health plans in the Affordable Care Act Marketplaces, once the open enrollment season begins October 1, 2013. The blog, titled "Gearing up for Open Enrollment: Accessing HIV/AIDS Care & Treatment through the ACA Marketplaces," is by NASTAD's Amy Killilea and covers these points:

  • Consumers will review plans using a single streamlined application--online or paper formats. Income eligibility (for the Medicaid expansion population and tax credits/subsidies) will be based on Modified Adjusted Gross Income.
  • Coverage dates for Medicaid and individual health insurance coverage will begin fairly promptly but merits attention to ensure that clients experience no gaps in care.
  • Ideas for what a client should look for when picking a plan: coverage of needed medications, inclusion of chosen providers (including a client's current clinic if that's the client's wish), costs (including information about what costs ADAPs can help cover), and plan coverage limitations.  (Additional considerations might include: geographic location of providers in the plan, assistance with costs that other Ryan White providers can help cover [e.g., Local Pharmacy Assistance Plans], and care coordination services like Patient Centered Medical Homes or Medicaid Health Homes that can help support clients in remaining in care.)

See Consumer Readiness Materials for additional tips and resources on helping clients prepare for ACA. 

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