Find out how Project Access® plans to help your uninsured patients obtain affordable insurance

January 27, 2014

Dear Project Access Physicians and Safety Net Providers,

On October 1st the Affordable Health Care Act increased access to healthcare for many Americans by enabling them to enroll in the Marketplace Insurance Exchange. The law requires that all people who can afford insurance take responsibility for their own health care by participating in the Insurance Exchange or pay a Personal Responsibility Fee. With these added options for the uninsured/underinsured residents of Buncombe County, Project Access® (PA) is adjusting the eligibility requirements for enrollment and re-enrollment in PA:

  1. Effective immediately Project Access®  will require that all patients who fall between 100% - 133% of Federal Poverty Level first apply for insurance in the Marketplace Insurance Exchange. Through the Insurance Exchange many patients between 100%-133% FPL may be eligible for premium tax credits and/or subsidies to help cover the cost of a health insurance policy. Once your patient is successfully enrolled in the Marketplace we will disenroll them from PA and notify your practice by fax.
  2. Current and future PA patients who apply for the Marketplace and meet the eligibility requirements for an exemption will be required to submit their letter of exemption from healthcare.gov to a PA Navigator in order to be eligible to enroll in Project Access®. If your patient applies for a hardship exemption and must wait for a decision, we will enroll him/her in PA for 90 days while they wait on the outcome so they will not be deprived of necessary care.
  3. PA patients whose enrollments expire between April 1, 2014 and Nov.14, 2014 will also be required to apply for coverage with the Marketplace Insurance Exchange. During this time while the enrollment window is closed, your patients will be allowed to remain in PA but they will be required to meet with one of our Certified Application Counselors (CACs) and submit their application in preparation for the November 15th reopening.
  4. People under 100% FPL do not qualify for subsidies in the Insurance Marketplace. Once the Supreme Court ruled that the federal government could not force Medicaid expansion onto States as part of the ACA, North Carolina opted not to expand Medicaid. Therefore, your patients under 100% FPL will continue to need Project Access®.

WCMS will soon have two Certified Application Counselors (CACs) on staff to assist Project Access® patients with their Marketplace enrollment. We are committed to helping your PA patients receive the assistance and support necessary to understand the Affordable Care Act and access the Insurance Exchange, or remain in PA if necessary.

After open enrollment closes on March 31, 2014 the only way an individual can purchase healthcare coverage up until the enrollment window re-opens on November 15th, 2014 is to have a life qualifying event. During that time:

  • Our CACs will assist eligible PA patients in preparing their applications in anticipation of the November 15th enrollment opening, and…
  • Our PA Navigators will continue to serve the needs of the low-income, uninsured residents of Buncombe County who fall under the 133% FPL.

Thank you for your dedication and commitment to Project Access® and the Marketplace Insurance Exchange as we enter into a new standard of healthcare delivery.

Sincerely,

Sharon Lewis
Chief Operating Officer

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