Get Covered Illinois offers guidance to federal website applicants who have been referred to the state for Medicaid eligibility

Applicants advised to restart process by using the GCI screening tool after some express concern that they were incorrectly denied private coverage

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[December 20, 2013]  CHICAGO Get Covered Illinois is advising people who have applied for coverage on the federal website HealthCare.gov and who believe they may have been incorrectly referred to the state for Medicaid coverage, to restart the process by using the screening tool at GetCoveredIllinois.gov.

State officials are offering this guidance because some of the people who have been flagged by the federal website as not eligible for private health plans through the Illinois Health Insurance Marketplace believe they have been incorrectly referred to the Medicaid program. Federal officials have said they expect to transfer applications to the state from more than 30,000 people who are potentially eligible for Medicaid, although the final Medicaid determination rests with the state.

The GCI screening tool asks users several simple questions about their income, household size and if anyone in the family is currently on Medicaid. It uses this information to determine whether the applicant likely meets the income levels for Medicaid, or is eligible to purchase coverage through the Illinois Health Insurance Marketplace.

  • If the screening tool refers them back to the federal website and they are unable to remove the application within their existing account, GCI recommends they create a new account with a different email address and submit a new application to www.healthcare.gov.

  • If the screening tool refers them to the state's Medicaid application site, ABE.illinois.gov, they can choose to submit an application there.

  • To obtain additional assistance, applicants are also encouraged to call the GCI Help Desk at 866-311-1119, with hours between 8 a.m. and 8 p.m. every day.

Under the federal Affordable Care Act, individuals and families with income from 138 percent up to 400 percent of the federal poverty level $15,860 to $45,960 for individuals and from $32,500 up to $94,200 for a family of four are eligible for subsidies on a sliding scale if they obtain coverage through the Health Insurance Marketplace and don't have an alternative source of affordable, quality coverage. GCI is delivering this guidance through its statewide system of more than 1,500 navigators and in-person counselors and is also contacting applicants directly via email and phone.

The state is offering the advice to applicants ahead of Dec. 23, the first of a series of key enrollment dates under the federal Affordable Care Act. Consumers must enroll in a health plan by Dec. 23 and have paid a premium by Dec. 31 in order to have coverage on Jan. 1 through the plans offered on the Health Insurance Marketplace, which is accessed through www.healthcare.gov. The full open enrollment period runs through March 31.

There is no final date to apply for Medicaid eligibility, for which applications are accepted throughout the year.

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The U.S. Department of Health and Human Services released numbers last week for the first two months of enrollment under the Affordable Care Act that indicate 67,936 applications on behalf of 124,252 individual people were completed from Illinois and that 7,043 people have selected a private health care plan through the www.healthcare.gov website since Oct. 1.

The numbers released by HHS show that of the completed applications, 73,949 people are eligible to enroll in a health plan through the Health Insurance Marketplace, and 28,689 of them qualify for federal financial subsidies. In addition, 30,446 people were going to be transferred to the state for potential eligibility for Medicaid, although the final Medicaid determination rests with the state.

Illinois officials said traffic on the GetCoveredIllinois.gov website has remained steady, with more than 595,000 website visits since Oct. 1 and more than 270,000 users of the screening tool.

The ABE site has received more than 99,000 applications.

Anyone seeking assistance in applying for health coverage in Illinois is encouraged to do so through any of the following methods:

  • Visit the website at www.getcoveredillinois.gov. There is also a Spanish-language version of the website.

  • Sit with a specially trained navigator at one of the hundreds of partner sites across the state. Find a navigator nearby through the website by entering a ZIP code. Bilingual navigators are available.

  • Call the help desk at 866-311-1119. Operators are available to help each day from 8 a.m. to 8 p.m. Spanish-language assistance is available on the phone.

[Text from file received from Get Covered Illinois]

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