Frequently Asked Questions for Consumers Whom the Federally-facilitated Marketplace or State-based Marketplaces on the Federal Platform Refers to a State Medicaid/Children’s Health Insurance Program (CHIP) Agency (SMA) and Who are Awaiting a Final Medicaid or CHIP Eligibility Determination from their SMA

The FAQ applies to consumers who were referred by the Marketplace as potentially eligible for Modified Adjusted Gross Income (MAGI)-based Medicaid/CHIP and were referred to their SMA, and who are waiting for their SMA to conduct a final MAGI-based Medicaid/CHIP eligibility determination. This can occur in households where all applicants are found by the Marketplace as potentially eligible for Medicaid/CHIP or in households where some applicants are found eligible for Marketplace coverage and others are potentially Medicaid/CHIP-eligible. Households in the latter scenario will have qualified health plan (QHP)-eligible applicants routed to enroll in coverage with the Marketplace, and applicants assessed as Medicaid/CHIP-eligible will have their application information securely electronically transferred to their SMA for final eligibility determinations and/or enrollment, if eligible. The FAQ can be used to assist consumers navigating these various scenarios.

See FAQs Consumers the FFM Refers to Medicaid and CHIP Agencies.pdf for frequently asked questions.

The post Frequently Asked Questions for Consumers Whom the Federally-facilitated Marketplace or State-based Marketplaces on the Federal Platform Refers to a State Medicaid/Children’s Health Insurance Program (CHIP) Agency (SMA) and Who are Awaiting a Final Medicaid or CHIP Eligibility Determination from their SMA appeared first on Pennsylvania Office of Rural Health.