Marketplace Coverage

The following tools and resources are intended to guide RWHAP managers, staff, and enrollment assisters as they engage, support, and enroll RWHAP clients in Marketplace health 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.

  • Eligibility Decision Tree
    This one-page tool is designed to help RWHAP program staff assess a client’s eligibility for Marketplace or Medicaid health coverage. Staff may use this tool to prepare for a client visit or during an enrollment appointment to determine the client’s health coverage options. 

  • 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

Enrolling Clients in Marketplace Coverage

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

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.