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Life Health > Health Insurance > Health Insurance

CMS: For PPACA eligibility changes, mail is too hard

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The Centers for Medicare & Medicaid Services (CMS) will let state-based public exchanges give consumers the option of telling them about possible health benefits eligibility changes during the plan year through traditional mail.

The Patient Protection and Affordable Care Act (PPACA) exchanges run by the parent of CMS, the U.S. Department of Health and Human Services (HHS). will require exchange users to tell the HHS exchanges about possible mid-year eligibility changes through the HealthCare.gov website, by using an in-person assister, or by calling a call center. The HHS-run exchanges will not let HHS exchange users report eligibility changes by mail.

“Experience has shown that eligibility changes reported by mail are often difficult to process because they frequently trigger  telephone contact to gather additional information needed to process the change,” officials say in a preamble to the final version of the PPACA annual eligibility redetermination rules.

In the final rule, CMS has kept a streamlined exchange qualified health plan (QHP) renewal process described in draft regulations released in June. 

See also: HHS exchanges may trim use of snail mail

Many QHP holders will be able to use that process to keep their coverage without interacting with an exchange website or exchange helper.

CMS also kept the plan notice requirements included in the draft rule.


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