March 31 is the deadline for everyone to enroll in the Affordable Healthcare Act. At Arab American Family Services, we have In-Person Counselors who are trained to educate and enroll clients into the new Affordable Healthcare Program. Our caseworkers are trained to handle questions. Screening is required to determine if clients qualify for Medicaid or the Illinois Health Insurance Marketplace. The application generally takes 2 to 3 hours for seniors, and 1 to 2 hours for non-seniors. There is a 90 day wait period to determine whether a client is approved by the state. For an appointment to assist in the ACA application process, please call (708) 599-2237.
What is the Affordable Care Act:
As part of the implementation of the Affordable Care Act, the State of Illinois is launching a new self-service website for new customers to apply for Medicaid, SNAP, and cash assistance. The website is called ABE (Application for Benefits Eligibility). ABE will replace the current application for Medicaid, All Kids, the Medicare Savings Program, SNAP and cash assistance. It will make it easy and more convenient to apply and will allow for electronic signatures and document upload. ABE will also support community partners and medical providers who are assisting clients or applying on their behalf.
Uninsured customers in need of health coverage will go to a “landing page” website currently under development. By answering a few simple screening questions, customers will be directed to the best health coverage option given their household size and income – to ABE for Medicaid coverage or to the Illinois Health Insurance Marketplace. At the Illinois Health Insurance Marketplace website, customers can compare policies and prices and buy private insurance, potentially qualifying for financial help with premiums and cost-sharing.
What Changes come with the Affordable Care Act:
If you already have Medicaid (also known as medical assistance or public aid) you do not need to reapply. If you have Medicare, these options do not affect you.
It is estimated that nearly 300,000 Illinois residents will select coverage by commercial insurers that will be offered in a newly created Illinois Health Benefits Marketplace. Cost will be on a sliding fee basis according to income, and some individuals or households may be eligible to receive assistance with paying their premiums through federally-subsidized tax credits. About 500,000 to 800,000 residents will be covered under the restructured Medicaid program, at little or no cost to individuals.
The ACA prohibits health plans from applying preexisting condition exclusions to children up to age 19, and all health plans must provide for both an internal appeals and external review process for denied health insurance claims.
Uninsured individuals with pre-existing conditions might be eligible for the high-risk pool, set up by Illinois with federal funds and currently in effect. More information for people who are uninsured because they have a previous medical problem is available at the Illinois Pre-Existing Condition Insurance Plan website.
Current Illinois law limits annual out-of-pocket costs for HMO plans, but non-HMO plans can include deductible, co-pay and other cost-shifts to consumers without regard to the financial burden shifted to a family. Beginning in 2014, the ACA will limit out-of-pocket costs for policies sold on in the Health Insurance Marketplace. The most an individual can pay out-of-pocket each year will be $6,350 and the most a family can pay will be $12,700.
(708) 599-2237
