Marketplace Coverage

Basics and Eligibility 

• Health Insurance Literacy Basics
  This resource is a self-paced, interactive course designed to build the health insurance literacy of RWHAP program staff. Participants will learn how to: define health insurance literacy, use key health insurance terms correctly in conversations with clients, help clients understand their health coverage options, and help clients use and keep their health coverage. 

• Plain Language Glossary
  The Plain Language Glossary is a quick guide to common health insurance terms in plain language intended for both RWHAP program staff and clients. The glossary is also available in Spanish, Haitian Creole, and as an English/Spanish Comparison Table.

• 8 Things to Know to Help Support People with HIV to Enroll in Health Coverage
  This resource provides enrollment assisters, navigators, and certified application counselors, especially those who may be new to helping enroll people with HIV, with tips to help people with HIV find health plans that cover their unique health care needs.

• Video for Enrollment Assisters
  This video provides essential tips to enrollment assisters, navigators, and certified application counselors who may be new to supporting people with HIV. 

• Transitioning from Marketplace to Medicare Health Coverage
  Learn how to help RWHAP clients navigate the transition from Marketplace to Medicare smoothly and efficiently using this helpful guide. The resource includes answers to frequently asked questions about this process.

• Best and Promising Practices for Engaging, Enrolling, and Retaining People with HIV in Health Coverage
  The ACE TA Center has identified best and promising practices for engaging, enrolling, and retaining people with HIV in health coverage. Though the current list is most relevant to enrollment in Marketplace health insurance, many of the best practices can also apply to Medicare and Medicaid enrollment work.

Engaging Clients in Conversations About Coverage

• Common Questions and Suggested Responses for Engaging Clients in Health Coverage
  This guide is a training tool to help RWHAP providers start a conversation with their clients about their health coverage and how to address possible concerns, including sample questions and responses. This resource is also available in Spanish. 

• Pre-enrollment Appointment Checklist
  This pre-enrollment appointment checklist can be used by HIV case managers and enrollment staff to help individual clients choose the health care plan that best fits their health and financial needs.

• Get Covered for a Healthy Life - Consumer Q&A
  This Q&A is a plain language guide to common questions that RWHAP clients might have about enrolling in health coverage, such as: “Why do I need health insurance?”, “Will insurance pay for my HIV medications?” and “Can I still get services from RWHAP and ADAP?” This resource is also available in Spanish and Haitian Creole. 

• My Health Insurance Works For Me - Enrollment Poster Series
  This poster series is designed to spark conversations about the benefits of enrolling in health insurance. The poster series is also available in Spanish.

• My Health Insurance Works For Me - Renewals Poster Series
  This poster series is designed to spark conversations about the benefits of renewing health insurance. The poster series is also available in Spanish. 

• Tracking Your Efforts to Engage Clients Who Experience Barriers to Enrollment
  This resource includes best practices and resources for engaging hard-to-enroll clients and tracking your efforts in four easy steps. 

• Open Enrollment Twitter Toolkit
  This toolkit compiles adaptable tweets and graphics to promote key Open Enrollment messages and ACE TA Center materials with consumers on Twitter. This resource is updated annually before Marketplace Open Enrollment. 

Enrolling Clients in Marketplace Coverage

These resources are updated annually before Open Enrollment for Marketplace Coverage.

• Preparing for Open Enrollment eLearning Module
  This eLearning module is a self-paced, interactive learning tool designed to help RWHAP program staff and enrollment assisters prepare for an efficient and successful Open Enrollment Period.

• Account Tune-Ups: Getting Ready for Marketplace Open Enrollment
  This resource provides guidance on conducting Account Tune-Ups to help make sure eligible clients are ready to enroll in health coverage in the months leading up to Open Enrollment. 

• Special Enrollment Periods Consumer Fact Sheet
  This fact sheet provides consumers with an overview of the life events and special circumstances that may qualify them for a Special Enrollment Period, as well as what to do if they think they are eligible. This resource is also available in Spanish and Haitian Creole. 

Using Coverage and Staying Covered

• Making the Most of Your Coverage - Consumer Resource
  This resource is intended to help newly enrolled clients get started with using their health insurance benefits. Topics include identifying important health insurance documents, defining key insurance terms, anticipating potential health care costs, knowing where to go for care, and making the most of each medical visit. This resource is also available in Spanish and Haitian Creole.

• "Covered" Video Series
  The “Covered” video series is a collection of short videos for consumers that provides tips for RWHAP clients on how to make the most of their health insurance. Topics include: key health insurance terms, what’s covered by insurance, where to go for care, and how RWHAP and ADAP can help. The “Covered” video series is also available in Spanish. 

• My Health Insurance Works for Me - Stay Covered Poster Series
  This poster series was designed to help consumers understand what they need to do in order to maintain their health insurance coverage throughout the year. The poster series is also available in Spanish and Haitian Creole.  

• Stay Covered All Year Long - Consumer Resource
  This consumer resource is designed to help consumers understand what they can do to maintain their health coverage, including paying premiums on time, reporting income and household changes, and what to do if they lose their coverage. This resource is also available in Spanish and Haitian Creole. 

Taxes and Financial Help

• Understanding Premium Tax Credits and Cost-Sharing Reductions eLearning Module
  This eLearning module is a self-paced, interactive tool designed to help RWHAP program staff understand the basics of premium tax credits (PTCs) and cost-sharing reductions (CSRs) as well as how they can help RWHAP clients pay for their Marketplace insurance and reduce out-of-pocket costs.

• FAQ: Premium Tax Credits (PTCs) and Cost-Sharing Reductions (CSRs)
  This Frequently Asked Questions (FAQ) guide provides information about the two main types of financial support available for many consumers who get health coverage through the Marketplace: premium tax credits (PTCs) and cost-sharing reductions (CSRs). 

• Taxes and Health Coverage - Consumer Resource
  This consumer tool is designed to help consumers understand the relationship between Marketplace health coverage and taxes and how to reconcile advance premium tax credits (APTCs) through tax filing. This resource is also available in Spanish and Haitian Creole.

• Financial Help and Taxes
  This resource provides an overview of the tax filing process for individuals with Marketplace coverage, including guidance for reconciling advance premium tax credits (APTCs) and information on state-specific individual mandates.