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Affordable Care Act Certified Application Counselors Frequently Asked Questions

Why do I need to participate in the Marketplace?
In March 2010, Congress passed the Affordable Care Act, which specifies that starting in January 2014 all individuals must obtain basic health coverage, obtain an exemption, or make a payment on their taxes. The Marketplace offers basic health coverage to eligible individuals.

What if I do not want to participate in the Marketplace?
If you already have basic health coverage, or can get it through an employer or a public program like Medicare, you doncoverage in the Marketplace. If you doncoverage, you may opt to complete an exemption application, or you may pay a fee if you do not want to complete the exemption request.

Will you keep all my information confidential?
Yes, your information will remain confidential and only those individuals you deem appropriate will have access to your information.

Who, outside of the Marketplace, has access to my account information?
You may assign authorized representatives and account holders to have access to your account information. They will only have access to your account information with your permission. Navigators and other assistance personnel may access your account only when you are present.

When is the deadline for applying for health coverage?
You can set up your online Marketplace account whenever you want; however, the periods of time during which you can enroll and obtain coverage through the Marketplace are limited. The current enrollment period for coverage in 2015 starts November 15, 2014 and will end on February 15, 2015. For health coverage to start January 1, 2015, you must enroll in a plan by December 15, 2014. If you want to change 2015 plans after December 15, 2014, you can do that any time during the Open Enrollment, which continues through February 15, 2015. If you make updates and enroll in a new health plan after December 15, 2014, your coverage won’t start on January 1st. Read the notice from your health plan to check when your coverage will start.

When can I complete an application?
You may complete an application during the open enrollment period (Nov. 15, 2014 – Feb. 15, 2015). You must select a plan by the 15th of the month for coverage to start on the 1st of the following month and make any premium payment by the date specified by your plan. If you choose your health plan after the 15th of the current month, and pay your premium on time, your coverage will start on the first day of the next following month. For example, if you select a plan on Dec. 18, 2014, your coverage will not start until Feb. 1, 2015.

How do I get an application?
You may obtain an electronic application on the Marketplace website once you have created an account. If you would rather complete a paper application, you can get one by calling the Marketplace toll-free call center. Applications can also be completed over the phone with a Marketplace representative. You may reach the Marketplace by calling 1-800-318-2596.

Why do I need an online account?
An account allows you to electronically submit your application, compare and select Qualified Health Plans (QHP), view the status of your application, and complete other Marketplace-related activities.

Can I set up multiple accounts?
No, you are only able to create one account.

What if I do not have an email?
You may create an email with an internet or email service provider of your choice (CACs can assist with creating an email account) or choose to submit a paper application to participate in the Marketplace. Applications can be completed over the phone at 1-800-318-2596. An Application ID will be provided so that when/if an online account is created, the application can be linked to the account.

What if my password is not accepted?
If you are still unable to create a password after confirming you have followed the field requirements, contact the call center for further assistance. That phone number is 1-800-318-2596.

What if my username is not accepted?
You cannot select a username if it is already in use by another applicant. You should try another username, or contact the call center for further help. That phone number is 1-800-318-2596.

Do I have to enter my Social Security Number to create an account?
No, you do not need to enter your Social Security Number if you are not applying to the Marketplace. If you want health coverage and have a Social Security Number, you must supply it to apply for health coverage.

What information do I need to provide on the eligibility application?
The application will request only information necessary to make an eligibility decision. Thus, the exact questions will vary depending on each consumerYou may be asked to provide information on the following topics:

  • Household contact information (contact information for the individual submitting an application on behalf of a household or family)
  • Household structure
  • Social Security Number
  • Citizenship and immigration status
  • Household information
  • Personal identification (residence and contact information)
  • Current health coverage status
  • American Indian/Alaska Native status 

Why do I need to submit supporting documentation?
The Marketplace may request supporting documentation to verify the information you provided on your application. The Marketplace verifies information to ensure that only eligible individuals obtain coverage and qualify for options to lower their health plan costs.

When can I select my health plan?
You may select an insurance plan after you have completed an eligibility application and received eligibility results.

Can I browse health plans in the Marketplace without creating an account?
Yes, you may browse and compare plans in Shopper mode. It is important to note, however, that you may not see all details of Qualified Health Plans (e.g., all benefits and costs) and are encouraged to create an account and submit an application to see the full details of various QHPs.

Who decides which health plans are Qualified Health Plans (QHPs)?
The Marketplace, with help from some states, determines which plans are Qualified Health Plans.

When do I see the cost of the health plans?
You can see estimated costs of health plans before you apply. If you are determined eligible for a QHPs through the Marketplace, you will be able to view your exact plan costs after you apply your premium tax credit or cost-sharing reductions (if you qualify).

What is difference between getting a plan in the Marketplace and getting another private plan?
QHP's in the Marketplace must meet a certain level of coverage, quality, and assistance as determined by the federal government.

How do I look at the different plans and compare them?
You may view and compare plans two waysand your account.

Are all Qualified Health Plan benefits the same despite different QHP costs?
No, you will see differences in coverage levels. However, all QHPs meet the Minimum Essential Coverage (MEC) requirements determined by the Federal Government. A CAC can assist you in the process of determining which plan best fits your needs.

May I enroll in more than one plan?
No, you may not enroll in more than one plan.

Can you enroll me in a Medicaid or CHIP plan?
No, CACs are unable to enroll consumers in Medicaid/CHIP. CACs should refer consumers to the state Medicaid/CHIP agency (Appendix C) to provide contact information to consumers to inquire about the enrollment process.

How do I select a Medicaid or CHIP plan?
If you are determined eligible or assessed eligible for Medicaid or CHIP by the Marketplace, you will be contacted by your local Medicaid or CHIP office for more instructions on selecting and enrolling in either program.

How do I contact my state Medicaid or CHIP agency?
If your eligibility results refer you to your local state Medicaid or CHIP agency, contact information will be included in the notice.

I want a QHP instead of Medicaid. How do I change programs?
You may reject your Medicaid/CHIP determination and apply for QHP eligibility; however, you will not be eligible for premium tax credits and cost-sharing reductions to reduce the cost of the QHPs.

How long does it take for my state Medicaid or CHIP agency to make a final eligibility determination? And how will the agency notify me?
Determination periods vary from state to state. You should contact your local state Medicaid or CHIP agency for detailed information.

Do I have to go to my state Medicaid or CHIP agency in person to receive assistance?
No, you can contact your local state Medicaid or CHIP agency office via phone and request assistance. 

Medicaid/CHIP agencies
Health Connection (Medicaid & CHIP): 1-855-259-0701
Right from the Start Medicaid Outreach Project: 1-800-809-7276
Insure Kids Now (CHIP): 1-877-543-7669
Medicaid Agency: 1-800-362-1504
All Kids (CHIP): 1-888-373-5437