NHC members are eligible for basic individual health insurance coverage through the NHC. NHC member health insurance does not cover family members and dependents. If a NHC member has health insurance at the time they enroll in the program, they may waive the NHC coverage and keep their own insurance. Members who choose to waive the NHC insurance must provide proof of coverage from their other insurance plan. If, during the term of service, the member is no longer covered by another plan, the member can apply for coverage through their NHC operating site.
The health insurance provided by the NHC is not an employer sponsored plan, however, it does meet the Minimum Essential Coverage (MEC) requirements set forth by the Affordable Care Act. The plan is called The Corps Network Plan and is underwritten by Cigna, a national known medical carrier. Members are strongly encouraged to read about and understand their coverage prior to seeing medical care. A summary of the Corps Network Plan can be found here. Members should note that the plan provides differing levels of coverage depending on if the member seeks care from an “in-network” or “out-of-network” provider. In addition, Cigna requires prior authorization for all inpatient hospital admissions, some outpatient procedures and certain prescription drugs.
In addition to the health insurance plan offered by the NHC, members have the following options for obtaining health insurance:
Family health care coverage: Under the Affordable Care Act, a member can stay on their parent’s health insurance policy until their 26th birthday. A member can remain on their parent’s plan even if they are married, are not living with their parent(s), are attending school, or are not financially dependent on their parent(s). Members can obtain more information about this option here. In addition, if a member is married, they may be able to get coverage on their spouse’s plan.
Health care coverage purchased through the Health Insurance Marketplace: Members may be eligible to obtain health care coverage through the Health Insurance Marketplaces in the state where they are serving, and they may qualify for financial assistance to lower the costs of insurance. In some cases, insurance may be available with no monthly premium.
Members can find out more information about obtaining insurance through the Health Insurance Marketplace at HealthCare.gov or, they can speak to their Program Director about accessing help via a Patient Navigator. The NHC does not cover the cost of a member’s premium if they choose to get coverage via the Health Insurance Marketplace. If a member chooses to seek coverage on the Health Insurance Marketplace, they should note that when asked during the application process if “their employer offers health insurance,” they should select “I’m not eligible for insurance through my employer.” AmeriCorps members are not employees of the program and the insurance provided by the NHC is NOT an employer sponsored insurance plan.
Medicaid coverage: Under the Affordable Care Act, many states are expanding their Medicaid program (as of the writing of this handbook, Illinois has expanded Medicaid; Pennsylvania and Florida have not). Eligibility for Medicaid is dependent on individual state laws and on a member’s individual financial circumstances. Members who apply for and receive Medicaid coverage may be required by state Medicaid policy to maintain their enrollment in the NHC health insurance plan, whereby, Medicaid becomes “secondary” insurance (i.e. Medicaid will cover medical costs not covered by the NHC health insurance policy). Members who are interested in finding out more about Medicaid should go see HealthCare.gov or contact their state Medicaid office or ask their Program Director about accessing help through a Patient Navigator.
Special Enrollment Period
Per a May 14, 2014 notice, the Department of Health and Human Services (HHS) issued guidance that created a special healthcare enrollment period (through December 31, 2014) for all AmeriCorps State and National members who wish to purchase insurance on the Health Insurance Marketplace at the beginning or conclusion of their term of service. This special enrollment period was created because the open enrollment period for the Health Insurance Marketplace does not coincide with most AmeriCorps members’ terms of service.
Start of Service: If a member starts their NHC service after the open enrollment period has ended on March 30, 2014, they have 60 days from their service start date to sign-up for healthcare coverage through the federal healthcare marketplace.
Ending Service: HHS also created a special enrollment period at the conclusion a member’s term of service. Members will be able to purchase a qualified health plan from the federal healthcare marketplace outside of the annual open enrollment period. Members have 60 days from the service end date to sign-up for healthcare coverage.
As of the writing of this handbook, HHS has NOT extended the special enrollment period for AmeriCorps members beyond December, 31, 2014. The NHC will provide members with an update as to whether the special enrollment period will be extended into 2015 if that occurs.