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Instructions and Help about Health Insurance Marketplace Appeal Request Form 0

Welcome to the sample application for the health insurance marketplace on here individuals and families can explore health coverage options and opportunities to get lower costs on monthly premiums individuals can submit applications starting October 1st when open enrollment begins the application features dynamic messaging to answer consumer questions to guide them through the process and to encourage them to apply this online dynamic tool will enable applicants to complete one application for enrollment in a qualified private health plan the children's health insurance program and Medicaid and determine if you're eligible for lower costs on your monthly premiums with integrated electronic verification applicants can get health coverage and be matched with programs to help make that coverage more affordable to demonstrate let's look at the application process for a fictional single man from Arizona William doe who is looking for health coverage just for himself William will fill out the application online to apply for coverage before beginning the online application William will create a user account then from his account he will access the application the privacy and use of your information page let's William know how the information he enters will be used and that data from other sources will be accessed to verify his information integrated systems will check his eligibility by retrieving information from other federal agencies to verify responses and provide real-time answers personal health data is not stored on this contact information page William answers a few questions about his home and mailing address his contact phone numbers the language he prefers to speak and read and how he wants to be contacted by the marketplace this information is not shared with any external party William has the option of naming someone as his trusted representative this person would have permission to talk to the marketplace about Williams application and sign Williams application on his behalf William declines this option William is only interested in getting health coverage through the marketplace for himself so on the who are you applying for health coverage for question he selects William dou William checks yes to see if he is eligible for help paying for health coverage William isn't adding any family members to his application if he changes his mind he can add additional family or household by clicking add another person in the next section family in household applicants can apply to get help with health insurance costs in the William Dell personal information screen William enters his personal information then he completes a series of questions about his household and how he files taxes here William has the option of providing his race and ethnicity William needs to answer a few additional questions that could determine whether or not he qualifies for additional assistance or certain protections here on the family and household summary screen William has a chance to review his answers and make any changes eligibility for financial assistance or for Medicaid or chip is based on income ...