As we begin 2014, most of the major components of the Affordable Care Act (ACA) are now in effect, though the federal government has issued multiple delays and waivers of parts of the law. Indiana Medicaid is now using new applications, implemented changes to aid categories, and adheres to realigned income eligibility methodologies. The Health Insurance Marketplace open enrollment period is at the midway point and scheduled to end on March 31st of 2014. As part of our ongoing commitment to our clients, we continue to announce several enhanced services that will ensure you have the information and resources needed throughout this transition. Our goal remains to provide you and your patients / clients / consumers with the ClaimAid Advantage. Marketplace Enrollment

  • December enrollment was 7 times the totals from October and November.
  • What you need to know: Nationally, 975,000 “enrolled” from December 1st through December 23rd (compared to 137,000 for October and November.) The website is now working for many applicants and continues to improve in both speed and accuracy. To verify enrollment of a patient in a Marketplace QHP, you may access the Database of QHP Customer Service Phone Numbers by clicking HERE.

More Individual Mandate Exemptions

  • On December 20th, U.S. Health and Human Services Secretary Kathleen Sebelius announced that some individuals who had their health plans cancelled may be eligible for a hardship exemption.
  • What you need to know:  Secretary Sebelius’ letter states that “Individuals who qualify for this ‘hardship exemption’ are also able to purchase a catastrophic plan on the Marketplace. The premiums for these plans, which are otherwise only available to individuals under 30 years of age, are on average about 20 percent lower than premiums for other plans available in the Marketplace.” For more information on Marketplace catastrophic plans please click HERE.

Hospital Presumptive Eligibility

  • Effective January 1, 2014, qualified acute care hospitals have the ability to enroll qualifying individuals in certain aid categories using the new “Hospital Presumptive Eligibility” process.
  • What you need to know: The table below details the aid categories and income limits for the new program. If your organization would like more information on this program, please CONTACT US.  You may access the Hospital Presumptive Eligibility Qualified Provider Manual in its entirety by clicking HERE.

Indiana Health Coverage Program Changes

  • As required by the Patient Protection and Affordable Care Act (ACA), the Indiana Family and Social Services Administration (FSSA) has implemented many eligibility changes within the Indiana Health Coverage Programs (IHCP).
  • What you need to know: New applications, changes to aid categories, and new income eligibility methodologies for Indiana Health Coverage Programs are now in effect. ClaimAid advocates are trained and available to assist patients with questions and concerns about the new programs. All ClaimAid Patient Advocates are certified as both Indiana Navigators and Federal Certified Application Counselors. For additional information on these changes, click HERE.

For more details and up-to-date information, please contact J Hopkins, Vice President at 800.842.4052 x126 or by email at