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The marketplace was offered to individuals and families who are not covered by their employer, allowing enrollees to compare health insurance plans and provides those who qualify with access to tax credits. Enrollment started on October 1, 2013, and the first enrollment period ended March 31, 2014.
In addition, dual-eligibles may choose a type of MA plan called a dual-eligible special needs plan (D-SNP), which is designed to target the needs of this population. For Medicaid benefits, beneficiaries generally enroll in their state's Medicaid FFS program or a Medicaid managed care plan administered by an MCO under contract with the state.
The Centers for Medicare & Medicaid Services (CMS) is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
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The subsidies for insurance premiums are given to individuals who buy a plan from an exchange and have a household income between 133% and 400% of the poverty line. [50] [56] [57] [58] Section 1401(36B) of PPACA explains that each subsidy will be provided as an advanceable, refundable tax credit [59] and gives a formula for its calculation: [60]
As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities. [2] There are two main forms of Medicaid managed care, "risk-based MCOs" and "primary care case management (PCCM)." [3] Managed care delivery systems grew rapidly in the Medicaid program during the 1990s.
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