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Healthcare Reform

The Top 7 ACA Call Center Questions, Answered

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With online options often on the fritz, more and more potential consumers on the insurance exchange are calling hotlines for help. In Kentucky, for example, agents had answered more than 100,000 calls from consumers as of early November.Kentucky also happens to be among the more than half dozen state exchanges that Xerox helps to coordinate. From those sources, we’ve collected a list of the most common questions people are asking when they call in. Oh, and we answered them, too.

 What is the status of my application? Callers are checking in on their applications for Medicaid and other benefits, and also health insurance offered through private companies. Applicant information needs to be confirmed through the Federal data base and can affect what credits can be applied to health insurance.

 Can you assist me with my application? Professional customer service representatives at Xerox-operated contact centers work with callers to complete and submit eligibility and health insurance applications – via the Internet or in hard copy.

 Am I eligible for Medicaid? Many callers need to be evaluated for Medicaid eligibility, based on Federal guidelines. Professional customer service representatives at Xerox-operated contact centers can help callers file an application to determine eligibility for benefits.

 How can I use Medicaid? Medicaid is a Federal program that provides health care for Americans who meet specific requirements. Depending on what a person is eligible for, Medicaid can cover adults and children for medical and dental health care.

Do I need to apply for insurance through the exchange? If you already have health insurance, you are not required to shop for insurance on the exchange. Some existing plans may be cancelled by insurance companies because they don’t meet the ACA’s essential health benefits. President Obama announced, though, that insurance companies – subject to state approval – can renew individual and small group coverage that would not otherwise be legally compliant under the ACA for 2014. If you don’t currently have insurance, you aren’t required to purchase it through an exchange, but there will be a financial penalty for Americans who do not have health insurance by 31 March 2013. A health insurance exchange is one way to ensure coverage is in place in time.

Can you help me understand what is covered under the different plans? Insurance plans in the exchanges are offered by private companies. They are all required to cover the same core set of benefits called essential health benefits. No plan can turn someone away or charge more because of an illness or medical condition, and all plans must cover treatments for these conditions. Plans can’t charge women more than men for the same plan. Many preventative services are covered at no cost to the individual. Each exchange is offering Bronze-, Silver- and Gold-level plans. Providers and specifics of the plans vary by state.

Can you share basic information about the exchange and/or the ACA? Customer service representatives at contact centers can provide current and thorough information about that state’s health insurance exchange and about the ACA. Another good resource is: http://www.hhs.gov/healthcare/rights/.