HOPE Family Health’s Outreach & Enrollment Program

Do you or your children need help with health insurance?

HOPE Family Health can help you understand your options and apply for coverage! We specialize in assisting individuals and families to apply for TennCare Medicaid, CoverKids, and private plans and subsidies offered through the Health Insurance Marketplace. These Marketplace plans can not turn you down OR charge you more based on your medical history. All offer free preventive services and include coverage for doctor visits, hospital and emergency care, mental health care, maternity care, and prescriptions. Many people qualify for help paying monthly premiums, and some people also get reduced deductibles, co-pays, and co-insurance.

For help understanding YOUR options, call our front desk at 615-644-2000 and ask for an appointment with Michelle McRae, our Certified Application Counselor. If Michelle has no open appointments and you would like in-person assistance, please call Family and Children’s Services at 615-724-1339. If you are applying independently or will be applying by phone with the Marketplace, please prepare first by referring to our Step by Step Application Guide below.

2017 Step-by-Step Marketplace Application Guide

Don’t miss Open Enrollment for 2018! November 1 – December 15, 2017
This year we have a shorter-than-ever enrollment period for Marketplace plans. Don’t miss your chance to enroll in a plan for 2018! After December 15th, only people in limited special situations will be able to enroll for 2018.

Scroll down to see more information on the following topics:
• What to bring to your appointment
• Does your child need health insurance?
• Do you need coverage for prenatal care and childbirth?
• Are you an adult seeking coverage?
• Already have TennCare, CoverKids, or a Marketplace plan?
• Need help understanding your Medicare benefits and options?


BULLETIN: In spite of many attempts to repeal and replace Obamacare, as of 8.28.2017, the Affordable Care Act is still the law of the land. That means many Americans will still qualify for private Marketplace plans for 2018 with full coverage REGARDLESS of their health history. Many also still qualify for generous help paying monthly premiums and for reduced deductibles, co-insurance, and co-pays. It also means that tax filers without insurance or an exemption may still be subject to tax penalties. To learn more about the penalty, automatic exemptions, and hardship exemptions, please
Click Here
What to bring to your appointment:

• Full name, date of birth, and social security number for each person who appears on your tax return even if they don’t need coverage. (Not a tax filer? That’s okay – bring the facts for yourself, your children, and your spouse.)
• Information about current and expected income for 2017 and 2018 for each person listed above. (Recent check stubs, social security letters, and most recent tax return)
• If you own your own business, are a farmer, or are otherwise self employed, be prepared to report “profit” after “expenses”
• ONLY if your employer or your spouse’s employer offers health insurance to you or your family (even if you are not enrolled in it) have the following form completed by your employer. Please click on this link to download the Employer Coverage Tool
• A list of your medical providers and all the medications you need, so that we can see if they are in-network/covered by each plan. (Optional but helpful!)

Do you qualify for a Special Enrollment Period due to a recent marriage, birth, adoption; loss of job-based or TennCare benefits; release from incarceration or other qualifying event? Bring proof, so we can send it on in. Thanks!

Does your child need health insurance?

TennCare Medicaid and CoverKids are open to new applications year round. Most Tennessee children are eligible for free health insurance through one of these two programs, and HOPE’s Certified Application Counselor, Michelle McRae, would be happy to help you apply. Please call our front desk to schedule an appointment: 615-644-2000.

Are you pregnant? / Do you need coverage for prenatal care and childbirth?

You may be eligible for full benefits under TennCare OR the CoverKids HealthyTNBabies program! First, go to your County Health Department to apply for immediate temporary coverage, called Presumptive Eligibility. Then, within 30 days, come in or apply independently for continuing coverage at www.healthcare.gov For help from Michelle, call our front desk to schedule an appointment: 615-644-2000. Blessings to you and your baby!

Are you an adult seeking coverage?

We can help you apply for Medicaid OR for a private plan through the Marketplace.

More about Medicaid:

Tennessee has not accepted the Medicaid Expansion funds under the Affordable Care Act, but some adults may still be eligible for TennCare Medicaid depending on their income and situation. If you have or are raising children under 19, you may be eligible as a relative caregiver. If you need treatment for breast or cervical cancer, and you don’t have other insurance to cover your care, you may also be eligible for Medicaid. Adults who receive Supplemental Security Income (SSI) from Social Security get Medicaid, and many individuals who need nursing home level care are also eligible. To find out more about Tennessee’s TennCare categories and benefits, or for help with your application, call Michelle at 615-644-2000.

More about Marketplace Plans:

Every year, U.S. citizens and other individuals with legal status in the United States have a certain window of time to learn about and apply for private health insurance through the Health Insurance Marketplace. This is called Open Enrollment.
Open Enrollment for 2018 Marketplace Plans is very short!!! It starts November 1, 2017 and will end six weeks later on December 15th. Almost anyone can apply for a 2018 plan during this period.

After December 15th, you will have to prove that you are eligible for a Special Enrollment Period because of a qualifying event.

Please note: an injury, accident, or new diagnosis is NOT considered a qualifying event, no matter how serious! If you want coverage in 2018, please apply during Open Enrollment!

Here are some examples of Qualifying Events:

Have you recently:
• Gotten married?
• Had a baby or adopted a child?
• Lost group health insurance? (Perhaps because you have retired, lost a job, left an employer, gotten divorced, or lost your TennCare?)
• Moved to Tennessee from another state, or moved from one county/insurance market to another?
• Been released from incarceration?
• Gained citizenship or other legal status in the U.S.?
If you answered yes to any of these questions, you may qualify for a Special Enrollment Period. In most cases, you have just 30-60 days to enroll in a Marketplace plan after your special event. Don’t delay! Call HOPE today to set up an application appointment: 615-644-2000.
If, for any reason, we won’t be able to help you apply before YOUR deadline, refer to our Step by Step Application guide here: 2017 Step-by-Step Marketplace Application Guide to prepare for the call, then contact the Marketplace at 1-800-318-2596 to apply by phone. They are open 24/7.

Already have TennCare or CoverKids?

We can help you use your insurance, keep your eligibility and manage your costs by helping you understand your plan benefits, complete renewal packets and report changes in income, address, or family size to the Tennessee Health Connection.

Already have a Marketplace plan?

Need to report a change in your income, family size, address, or other contact information? The amount of help you get paying for your premiums is directly related to your expected income and the number of people that are supported with that income. If you have a new family member, lose a job, lose hours, or otherwise experience an increase in family size OR a loss of income, report the change to the Marketplace right away! In most cases, your tax credit will be adjusted within one month so that YOUR portion of the premium goes down. If, on the other hand, you actually get a raise, promotion, start getting disability, or otherwise experience an increase in income, be sure to report that change within 30 days as well. This helps reduce the likelihood that you’ll have to pay the IRS back for excess tax credits. To get help reporting changes, call HOPE at 615-644-2000 and ask for an appointment with Michelle.

Need help understanding your Medicare benefits and options?

Call the Tennessee State Health Insurance Assistance Program (TN-SHIP) at 1-877-801-0044! TNSHIP is a nonprofit education and support program of the Commission on Aging and Disability with the State of Tennessee. They can help you understand your Medicare benefits, help you select a Supplement/Medigap plan, Part D Prescription plan, or Advantage plan, and can help you apply for free programs to reduce your Medicare costs.
Please note: All calls to this central number go to voicemail. Leave a message, and your call will be returned by a trained staff member or volunteer within several days. If you need help selecting a Part D prescription OR all-inclusive Advantage plan, please have a list of your medications handy for the call. Thank you!

Are you wondering if you’ll face a tax penalty?

Certain tax filers are automatically exempt from paying a penalty (called the individual mandate), even if they don’t have insurance. For more information concerning exemptions, click on this link. More information about exemptions

• If your income is low enough that you are not required to file a federal tax return, you are automatically exempt, even if you choose to file for other reasons, like getting a refund or credit. Click here for more information.
These income guidelines are called the income filing threshold. You can find more complete information online at www.irs.gov

       > Individuals who file singly and have a modified adjusted gross income less than $10,350* are AUTOMATICALLY EXEMPT, even if they choose to file.

       > Couples who file jointly and have a modified adjusted gross income less than $20,700.00* are AUTOMATICALLY EXEMPT, even if they choose to file.

• If your income is low enough that you qualify for Medicaid under the law, but your state (i.e. Tennessee, Georgia, Alabama, etc.) has refused to accept the funds for Medicaid expansion, you are AUTOMATICALLY EXEMPT, even if you file taxes. {Note: If you live in Kentucky, and your income is below the following levels, please apply for Medicaid! KY has accepted the Medicaid Expansion funds, so this exemption does not apply to Kentucky tax filers.}

• Many other Americans qualify for exemptions that the IRS won’t automatically know about. You have to ask for these through either a special hardship exemption application or, in some cases, on your tax return. Here are just a few examples:
• If you are a member of a healthcare sharing ministry
• If you are a member of a group with religious objections to health insurance, including Social Security and Medicare
• You were without insurance for less than 3 consecutive months.
• If you are homeless
• If you are facing eviction or foreclosure
• If you have received a shut-off notice from a utility company
• If you have experienced domestic violence
• If you have experienced the death of a family member
• If you have experienced a fire, flood, or other natural or human disaster causing substantial damage to your home
• If you are filing for bankruptcy
• If you have medical expenses you can’t pay that have caused substantial debt
• If you have faced unexpected increases in medical expenses to care for an ill or disabled, or aging family member.

To learn more about exemptions and how to apply for an exemption, please visit the Marketplace at www.healthcare.gov/health-coverage-exemptions.