The Service Tree lists all services in "branched" groups, starting with the very general and moving to the very specific. Click on the name of any group name to see the sub-groups available within it. Click on a service code to see its details and the providers who offer that service.
Affordable Care Act Insurance Information/Counseling
Programs mandated by the Affordable Care Act (ACA) that help individuals who want to purchase insurance, and small businesses that need to provide health insurance for their employees, understand the qualified private health plans that are available within the marketplace and guide them through the enrollment process. The navigator conducts public education activities to raise awareness about the marketplace; distributes fair, accurate and impartial information concerning enrollment including information that acknowledges other health programs such as Medicaid and the Children’s Health Insurance Program (CHIP), and the availability of premium tax credits and cost-sharing reductions; provides referrals for consumers with a grievance, question or complaint; and offers information that is culturally and linguistically appropriate to meet the needs of the population served by the marketplace. Navigators are trained to offer expertise on each health insurance plan with the objective of empowering individuals to make informed choices and to facilitate selection of a qualified health plan; and either have or can easily establish relationships with the target population.
State Health Insurance Marketplace Call Centers/Websites
Call centers operated by state-based health insurance marketplaces under the Affordable Care Act (ACA) that provide assistance for individuals and/or small businesses wanting to purchase private insurance through the marketplaces for themselves or, in the case of employers, for their employees. The call centers are staffed by individuals who have been trained to help callers with application navigation (both online and paper); comparison shopping and health plan enrollment (and re-enrollment), e.g., calls to confirm enrollment start date or reinstatement of coverage for late payment; health plan issuer questions (status of enrollment or identification cards, general health plan inquiries, provider network inquiries); billing questions; case updates (income changes, insurance status changes, address changes); assistance with the self-service Web portal; SHOP support; assister support (questions from navigators, in-person assisters, agents and brokers); assistance with appeals, grievances and referrals, e.g., to navigators, in-person assisters, agents and brokers, health plan issuers, state agencies including Medicaid; and general inquiries, e.g., general education, health reform questions and inquiries from providers, state legislatures and the media.