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Get Covered America Justine Ceserano NJ State Director November 26, 2013.

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Presentation on theme: "Get Covered America Justine Ceserano NJ State Director November 26, 2013."— Presentation transcript:

1 Get Covered America Justine Ceserano NJ State Director November 26, 2013

2 Who Is Enroll America Enroll America is a non-partisan, not for profit organization that is committed to enrolling a maximum number of people in affordable health coverage through the Marketplace in NJ

3 Introduction to the Affordable Care Act aka as Obamacare The Affordable Care Act was signed into law in March 2010 and ratified by the Supreme Court in June of 2012. It is the law of the land

4 ACA Consumer Protections With the ACA, insurers can no longer charge you more in terms of premiums nor deny you coverage because of: Your gender, occupation or credit history A pre-existing condition – And they cannot cancel your coverage if you become sick There limits on cost adjustments for age and tobacco use

5 Additional Consumer Protections Insurers can no longer put yearly or lifetime limits on coverage Young adults can remain on their parents’ health insurance policy until they rae 26 years of age If insurers don’t spend enough (80%0 to improve and pay for medical services, they must return the money to their customers through rebates

6 ACA is Already Making a Difference in Our Lives Since the passage of the Affordable Care Act: 3.1 million young adults have gained coverage through their parents plans 105 million Americans have had lifetime limits removed from their insurance coverage 6.1 million people with Medicare have received 5.7 billion dollars in drug discounts

7 Benefits That Must Now Be Included in your Health Plan Doctors’ visits Emergency services Hospitalization Maternity and newborn care Mental health and substance abuse services, including behavioral health treatment Prescription drugs

8 Benefits continued Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services, along with chronic disease management Pediatric services including oral and vision screening

9 ACA increases your Access to Affordable Care In many cases, you may get preventive services for free: Cancer screenings such as mammograms and colonoscopies Vaccinations such as flu, mumps and measles Cholesterol screenings Tobacco cessation counseling and interventions

10 Birth control Depression screening For additional included services, visit for a full list

11 Let’s Get Back to Enroll America Our Role: To provide as much educational and outreach throughout the state so that residents are well prepared to enroll

12 Our Focus Outreach and education to consumers Maximizing health coverage enrollment We ARE focused on…… We Are NOT focused on…. Medicaid Expansion voter registration Small Business health coverage In-person assistance

13 Saturation Location of New Jersey’s Uninsured

14 14 As A Result, Enrollment Will Be A Challenge To Overcome Lack of awareness provides opportunity for education with effective messaging Many of the uninsured still don’t know about their options 43% Source: Enroll America, November 2012 of the uninsured don’t know about the new health insurance marketplace options November 2012 August 2013 Source: Kaiser Family Foundation, August 2013 Enroll America still has work to do, but the uninsured are hearing more and more about the new options available to them 78% of the uninsured don’t know about the new health insurance options

15 Awareness of new health coverage options is increasing 15 But many of the uninsured still don’t know Source: Enroll America *Source: Kaiser Family Foundation Still Many Are Unaware

16 Consumers want to know their options 16 Source: Enroll America, November 2012 69% 16% 12%

17 All insurance plans will have to cover doctor visits, hospitalizations, maternity care, emergency room care, and prescriptions. You might be able to get financial help to pay for a health insurance plan. If you have a pre-existing condition, insurance plans cannot deny you coverage. All insurance plans will have to show the costs and what is covered in simple language with no fine print. Four Key Messages to Reach Most Uninsured One of these = top message for 89% of population Source: Enroll America, November 2012

18 State of the State: Who are the Uninsured? Over 900,000 uninsured New Jerseyans The greatest saturation of uninsured is in the northern counties of the state – Essex, Hudson, Bergen and in the central part of the state, Middlesex There are also significant numbers of uninsured in Mercer County (Trenton), Camden (Camden City), Atlantic (Atlantic City)

19 State of the State: Our Marketplace New Jersey has opted for a federally facilitated Marketplace. The Marketplace opened on October 1, 2013 and close on March 31, 2014. Governor Christie has expanded eligibility criteria for Medicaid. It is anticipated that approximately 350,000 residents of the state will qualify for Medicaid with implementation of expansion criteria.

20 Who Qualifies for Enrollment An individual, family or small business not eligible for coverage through someone or someplace else (an employer) All legal citizens and legally present residents of the state Non-incarcerated individuals Members of Congress

21 Financial Assistance Who is Eligible? Income <400% of poverty – 400% of poverty = $44,680 for a single adult, $92,200 for a family of four Are immigrants eligible? – Legal immigrants, yes – Undocumented immigrants, no Refundable, advance-payment federal tax credit (“APTC”) – Do not have to wait until file taxes to get the tax credit – it can be applied to the cost the coverage when they enroll – If taken in advance, tax credit goes directly to health plan consumer chooses – Pays a portion of consumer’s monthly premium 21

22 Enrollment Checklist Before consumers start the enrollment process, they will need to gather: Social Security Numbers (or document numbers for legal immigrants) Employer and income information for every member of your household who needs coverage (for example, from pay stubs or W-2 forms—Wage and Tax Statements) Policy numbers for any current health insurance plans covering members of your household A completed Employer Coverage Tool for every job-based plan you or someone in your household is eligible for. (You’ll need to fill out this form even for coverage you’re eligible for but don’t enroll in.) (see for this complete checklist)

23 4 ways to Enroll Can enroll by phone (800) 318-2596, in person, using paper application or online at Give basic info about self and household  Contact information and who’s applying for coverage  Income/types of income  Number of people in household  Citizenship/immigration status  If have affordable coverage now Process will vary from state to state 23 If applying online or by phone… Enter essential information System pulls existing data about applicant(s) Supplement or correct info, if needed System determines eligibility Pick a plan, amount of tax credit to receive in advance, enroll! Or, enroll in Medicaid or CHIP

24 By phone Official Hotline 1-800-318-2596 24 hours a day 7 days a week 150 languages

25 Online www.

26 Next steps

27 FILL OUT A COMMIT CARD! We’ll provide additional support and information

28 Next steps Get help from an in-person assister

29 Next steps GET ENROLLED

30 Volunteers wanted We need your help! Everyone has a place in this campaign. There is no job too small to make a difference If you care, then you can help! Thank you.

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