Federal Health Insurance Marketplace
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3.5 Consumer Plan Selection PowerPoint PPT Presentation


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Federal Health Insurance Marketplace. 1. Consumer Entry – Initiate Application. 1.3 MAGI - Is Income >138% FPL. Consumer Receives Insurance Card. 1.5 – Consumer Plan Selection- Referred to Carrier for Payment. 1.1 Consumer Sign In & Initiate Application .

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3.5 Consumer Plan Selection

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3 5 consumer plan selection

Federal Health Insurance Marketplace

1

Consumer Entry – Initiate Application

1.3 MAGI - Is Income

>138% FPL

Consumer Receives Insurance Card

1.5 – Consumer Plan Selection- Referred to Carrier for Payment

1.1 Consumer Sign In & Initiate Application

1.2 Complete MAGI and Provide Results to Consumer

1.4 – Select Premium Tax Credit

YES

NO

C - Carriers

A -Federal Data Services Hub verifies key application data

Marketplace sends data to AR Medicaid

Arkansas Eligibility & Enrollment Framework ACCESS Arkansas

AR Medicaid provides notice to consumer and sends data to Marketplace

NO

Health Care Independence Plan

2

Consumer Entry – Initiate Application

2.3 MAGI - Is Income

≤ 138% FPL

2.4 Medicaid Eligible – Notice Provided to Consumer to go to insureark.org

2.2 Complete MAGI

2.1 Consumer Sign In & Initiate Application

YES

B - MMIS

Arkansas Health Care Independence – insureark.org

Traditional Medicaid

Traditional Medicaid

YES

Health Care Independence Plan

3

3.4 Special Healthcare Needs??

Consumer Entry – Entry only after receipt of Medicaid eligibility notice

3.1 - Consumer Sign In

3.2 - Medicaid Eligibility Verification

3.3- Health Care Needs Assessment

3.5 Consumer Plan Selection

NO

Consumer Receives Medicaid Card


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