FOR BREAKING NEWS VISIT WWW.QNS.COM NOVEMBER 2, 2017 • THE QUEENS COURIER 47
health
MEDICARE
AND MEDICAID
ENROLLMENT
Federal exchange now open for enrollment
Th e Federal Health Insurance Exchange
Open Enrollment period runs from Nov.
1 to Dec. 15, with coverage starting on
Jan. 1, 2018.
Th is year the Centers for Medicare
& Medicaid Services (CMS) is taking
a strategic and cost-eff ective approach
to inform individuals about Open
Enrollment. CMS continues to use consumer
feedback to drive improvements.
Consumers can visit HealthCare.gov
and CuidadodeSalud.gov to preview 2018
plans and prices before Open Enrollment
begins.
Key Updates
• New direct enrollment experience:
Under a new streamlined and simplifi
ed direct enrollment process, consumers
applying for coverage through certain
partner websites will now be able
to complete their application using one
website, instead of being redirected to
HealthCare.gov to complete their application.
Th is off ers consumers more
options for ways in which to enroll.
• New “Help On Demand” services for
agents/brokers and consumers: Th e
exchange will off er increased opportunities
for consumers to connect with
agents and brokers.
• For consumers - Th is new service
allows consumers to choose to have
an agent or broker in their area contact
them directly for assistance while
they’re available.
• For registered agents and brokers –
Th is new service allows agents and brokers
to set times when they’re available
and then reach out to a consumer
who expressed interest in needing
help applying and enrolling. For more
information, visit: https://www.cms.
gov/cciio/programs-and-initiatives/
health-insurance-marketplaces/a-b-resources.
html
• Updated help content: Added more
content in plain language to help consumers
navigate income and eligibility
questions.
• Updated provider and prescription
drug search: Added smart search suggestions
for consumers when entering
doctors and prescriptions to help them
quickly fi nd what they are looking for,
including generic and brand drug information.
• Updated eligibility notice: Provided
more streamlined information about
consumer eligibility and next steps
based on consumer feedback.
HealthCare.gov Maintenance
Every major website needs routine
maintenance and updates to keep things
running smoothly and effi ciently. Th is
year, CMS is keeping the potential hours
for planned website and partner maintenance
similar to previous years, and
limiting potential system downtime
to the lowest-traffi c time periods on
HealthCare.gov. CMS also made sure to
share those potential plans in advance of
Open Enrollment with Navigators and
certifi ed application assisters, in response
to their requests, to help them plan their
interactions with consumers.
HealthCare.gov Waiting Rooms
Similar to previous years, CMS may
deploy a “waiting room” when website
traffi c is high for some consumers logging
in or creating an account on HealthCare.
gov. Th e waiting room is one tool we utilize
to optimize a consumers’ experience
because it allows us to control the volume
of users resulting in better performance
of the website. Consumers see a message
asking them to stay on the page. Th e waiting
room will refresh when a consumer
can continue to apply and enroll with a
smooth experience.
Window Shopping
On Oct. 25, CMS launched updates
to window shopping (“See plans & prices”)
which allow consumers to preview
2018 plans and prices before Open
Enrollment begins. As in previous years,
window shopping lets consumers browse
plans without logging in, creating an
account, or fi lling out the offi cial application.
Now, consumers can log in to
HealthCare.gov and CuidadodeSalud.gov
or call 1-800-318-2596 to fi ll out an application
and enroll in a 2018 Exchange
health plan.
Re-enrollment
Consumers who are currently enrolled
in a plan receive notices from the
Marketplace prior to Nov. 1 about the
upcoming the Open Enrollment period.
Th ese notices provide consumers with the
new dates for this year’s Open Enrollment
and the importance of returning during
this time to update their application and
actively re-enroll in a plan for 2018, as
well as customized messaging for their
situation such as if they’re at risk of losing
tax credits. Consumers also receive notices
from their current issuer with important
information about premiums, coverage
and benefi t changes, and plan availability
for 2018.
Consumers whose 2017 plan isn’t available
for 2018 will receive a discontinuation
notice from their current issuer by
the start of Open Enrollment. Th ose consumers
may also receive a letter from the
Marketplace notifying them that they
have been matched them with an alternate
plan from a diff erent issuer to help
avoid a gap in coverage. Consumers are
not under any obligation to stay with
this plan and are encouraged to take
action and choose a plan by December
15. Consumers with discontinued plans
are eligible for a loss of coverage Special
Enrollment Period.
As in previous years, CMS will automatically
re-enroll consumers that don’t
actively re-enroll by December 15, 2017
into their same or similar plan. Th e
Marketplace will send a notice to those
consumers that were automatically
re-enrolled. Similar to Medicare’s Open
Enrollment period, consumers who miss
the deadline to enroll in a plan of their
choice will not be able to make any
plan changes until the next coverage year
unless they qualify for certain Special
Enrollment Periods. Most consumers
whose plan isn’t available in 2018 will
be automatically re-enrolled into a plan
from a diff erent issuer to avoid a gap in
coverage – these consumers will need to
pay their premium for January in order
for this coverage to begin. Consumers
whose issuer isn’t off ering their plan in
2018 are eligible for a Special Enrollment
Period due to losing coverage and have
the opportunity to choose a diff erent
plan.
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