Beginning November 15, 2014, uninsured Virginians can enroll for health care coverage through Virginia’s Health Insurance Marketplace established as part of the Affordable Care Act. Hospitals and health systems can play a vital role in educating uninsured patients about their coverage options and helping them navigate the Marketplace. This web page provides a number of helpful resources.
Getting Started: Virginia-Specific Resources Regarding ACA and the Marketplace
VHHA has prepared the following materials geared towards helping Virginia providers get started with enrollment activities:
- 10 Things Hospitals and Health Systems Can Do
- 10 Things Providers Should Know
- 10 Things to Tell Your Patients
The Department of Medical Assistance Services (DMAS), in partnership with the Department of Social Services (DSS), has prepared a number of helpful materials regarding the Affordable Care Act and Virginia’s Health Insurance Marketplace:
Virginia Health Insurance Marketplace
This is the site where online enrollment through the Marketplace is completed. The site provides information about health coverage options; side-by-side comparisons of private insurance plans’ benefits, quality and price; eligibility for assistance with the costs of health coverage; and more. Be sure to select “Virginia” before getting started.
Virginia-Specific Enrollment Websites
This website provides a number of helpful resources to assist patients and providers in their efforts to enroll the uninsured through the Marketplace. It includes an interactive map that allows users to get a list of organizations in their area that provide in-person assistance with enrollment through the health insurance marketplace and a list of health plans that offer coverage in their area. The site also provides a schedule of upcoming enrollment events and links to the health insurance marketplace and basic resources regarding coverage and enrollment.
This is the site where online enrollment in Virginia Medicaid or FAMIS is completed. It is geared towards the Medicaid-eligible population and includes Virginia-specific resources to help patients better understand their options for coverage through Medicaid and the Marketplace, and the steps involved in enrollment.
Helping Patients with Enrollment: In-Person Assistance
Go to Enroll Virginia to view an interactive map of in-person assistance available in your area.
There are several places that patients can get assistance with enrollment. These include:
- Navigators: Navigators are trained individuals that provide fair, impartial and accurate information that assists consumers in enrolling in a Qualified Health Plan (QHP). Navigators work with consumers to submit the eligibility application and help qualified individuals in making informed decisions during the health plan selection.
- Certified Application Counselors (CAC): These individuals will perform many of the same functions as Navigators including educating consumers and aiding them in completing an application for coverage. CACs may include community health centers or other health care providers, hospitals or social service agencies.
- Agents and Brokers: These are individuals licensed in Virginia to sell health insurance and appointed by the health plans participating in the Marketplace. They also must undergo training and be certified by the federal government.
- Federally Qualified Health Centers (FQHCs): FQHCs will have CACs in their facilities willing to help consumers enroll in a plan.
Becoming a Certified Application Counselor Organization
Your organization can become designated to certify your staff or volunteers to be certified application counselors. As a CAC Organization, your staff and volunteers will be eligible to complete the five hours of training necessary to become a Certified Application Counselor. CACs help people understand, apply, and enroll for health coverage through the Marketplace.
To be a CAC Organization, you must complete an application and agree to make sure that designated individuals complete required training and comply with privacy and security laws, and other program standards.
CMS has provided guidance on CAC Organizations, which is helpful in understanding this option.
Becoming a Champion for Coverage identifies your organization as willing to share publicly available information to inform and educate about coverage options and enrollment activities.