We are in our eleventh year of open enrollments made possible by the Patient Protection and Affordable Care Act , commonly known as the ACA. This post is for the enrollment assisters around the country doing the important work of outreach and enrollment. At Transform Health, we believe outreach and enrollment work is central to health systems change because we know that accessing affordable, quality health coverage is the first step to addressing health care inequities and driving systems change to create healthy communities.
Resources in Heavy Rotation
We’ve curated a list of our favorite resources in heavy rotation. Make sure to bookmark these links on your browser and please share with others.
The Center on Budget and Policy Priorities Beyond the Basics webinar series is a must-have to learn about:
- Determining household income
- Data matching errors and what to do about them
- Plan selection strategies, and more.
Some of our all-time faves to accompany your consumer appointments include CPBB’s plan comparison worksheet and the quite popular yearly income guidelines and thresholds reference sheet. The plan comparison worksheet is available in eight languages and helps to organize plan details so that consumers can compare plans side by side before enrolling. The yearly income guidelines and thresholds document provides a quick reference to assist in assessing a client’s income for potential eligibility for premium tax credits through the Marketplace.
The Georgetown Center on Health Insurance Reforms Navigator Resource Guide. This is a must-have for everyday life as an enrollment professional helping consumers with qualified health plan selection on the marketplace. Check out their state-based fact sheets and FAQs about health coverage.
- People without any coverage
- People with coverage
- Information for small business employers
- Post-enrollment issues to look out for
Understanding Coverage Embedded in Your Enrollment Appointment
Did you know that healthcare.gov, managed by the Department of Health and Human Services (HHS), is more than just a place to select a qualified health coverage plan? On healthcare.gov you can also find quick answers to common questions and some gold nuggets for your consumer appointments in multiple languages— without applying for coverage. If you need more detailed information, CMS.gov is the official home of the Marketplace information for assisters and outreach partners. And if you are looking for a state that has its own marketplace, you can find those here.
The annual healthcare.gov Window Shopping Tool provides a preview of the plan benefits and coverage available to consumers and can be used if a consumer isn’t quite ready to enroll but wants a general sense of their options. It is available now with 2024 plan information, including plan directories of in-network providers, formularies of covered medications, and detailed information on deductibles, out-of-pocket maximums, copays, and co-insurance. Assisters interested in a full walkthrough of the tool can view this step-by-step video below.
Coverage to Care Materials for Educating Consumers
We would be remiss to not mention the partner toolkits and Coverage to Care materials produced by the Centers for Medicare and Medicaid Services (CMS). The C2C materials can be used to follow-up with consumers, explain the value of having health insurance coverage, and facilitate meaningful conversations about confusing terms at events and appointments. We are big proponents of the C2C library and highly encourage incorporating these tools into your workflows. We specifically like:
- FAQ for Accessing Care
- Partner Toolkit, which can be used to educate community partners and increase referrals to your enrollment services
- Roadmap to accessing care and services, the basics of using coverage
Enrollment Assistance for Lawfully Present Immigrants
Do you provide enrollment assistance to clients who are immigrants? If so, you will want to have the resources available through Protecting Immigrant Families (PIF) on hand. PIF provides information in multiple languages, presented clearly for both assisters and consumers. The chilling effect on enrollment due to Public Charge concerns is still with us, and consumers may be hesitant to apply for health coverage. The Herlinda Letter is an enrollment tool aimed at supporting assisters to relay facts in a way that consumers can take action.
Not only are they home to The Connector, an appointment setting tool for outreach, but Young Invincibles also has a national Get Covered Coalition, where assisters can compare notes and best practices, as well as media kits targeting Medicaid Unwinding populations and shareable graphics tailored for outreach during and outside of the Open Enrollment Period.
Kaiser Family Foundation
Navigators all over the country know that Medicaid Unwinding is still underway during open enrollment. Kaiser Family Foundation’s resource is tracking Medicaid Unwinding data and trends happening around the country.
We hope you are able to take advantage of all of these free resources during this open enrollment, and beyond. Happy Open Enrollment!
Transform Health is a nationally certified women and minority led health care consulting firm. As a small business, we support enrollment programs around the country with strategy and planning activities large and small. Reach out to us today if you would like to work together. Contact Heather Bates, COO, and VP of Stakeholder Engagement at firstname.lastname@example.org We would love to hear from you!