Epilepsy Florida.

WHO WE ARE AND WHAT WE ARE DOING REGARDING THE AFFORDABLE CARE ACT

Epilepsy Florida (EFL), which is headquartered in Miami, is the principal agency for epilepsy programs and services sponsored by the state of Florida. EFL services an estimated 400,000 Floridians in 36 counties who suffer from the condition. The core missions of EFL is leading the fight to stop seizures, finding a cure, and overcoming challenges created by epilepsy and other seizure disorders.

Presently, EFL is one of 10 organizations in Florida that make up the Covering Florida consortium under the University of South Florida (USF). USF was chosen by the U.S. Department of Health and Human Services (HHS) to provide in-person resources for Floridians, self-employed businesspersons, and Small Business Owners who require assistance in shopping for and enrolling in plans in the Health Insurance Marketplace (HIM) during open enrollment periods.

EFL is a non-profit organization which specifically uses navigators to conduct its outreach, educational, and enrollment services in south florida and the treasure coast. Each component involves:

Outreach and Education: Providing consumers with educational information about the Affordable Care Act (ACA) and health insurance.

Enrollment Assistance: Assisting eligible consumers to enroll in coverage.

Navigators are trained to provide unbiased information in a culturally competent manner to consumers about health insurance, the Health Insurance Marketplace (HIM), qualified health plans, public programs including Medicaid and the CHIP, and other health insurance options. We are available to help consumers understand their healthcare insurance coverage options and to assist uninsured Floridians in enrolling in coverage under the ACA.

EFL’s funding is year-long.  The target population of its HHS grant is as follows:

  • Uninsured communities, targeting consumers of Hispanic, African-American and Haitian origin; and
  • Increased focus on immigrants, persons with disabilities, the LGBT community, and all other consumers without access to or knowledge of their health insurance options.

Outside of each open enrollment period, EFL assists individuals in several key-groups, during the “Post-enrollment Period,” who are still able to enroll in coverage:

–Consumers with questions related to utilizing their coverage,

–Consumers eligible for a Special Enrollment Period (SEP);

–Consumers eligible for Medicaid/CHIP; and all other consumers previously without access to or knowledge of their health insurance options.

EFL continues to educate consumers about the benefits of the ACA in preparation for the 2022 enrollment period which begins on November 15, 2021, and ends on January 15, 2022.

Each and every year since 2013, EFL has rolled out new initiatives to assist its consumers or clientele population. During the first post-enrollment period in 2014, EFL rolled out the Coverage-to-Care initiative whose purpose is to provide newly insured consumers a step-by-step introduction to their newly purchased health insurance. This initiative remains a part of EFL’s yearly post-enrollment curriculum and has won national recognition from CMS as well as the Sapphire Award from the Florida Blue Foundation.

In 2015, and 2016, as part of its post-enrollment services, EFL partnered with local VITA tax sites to provide services to consumers who encountered tax issues relative to their participation in the ACA.

Since 2015, EFL has been involved in an initiative involving recently arrived (less than five years in the country) legal immigrants who have no access to health insurance. The purpose of this initiative is to determine whether certain immigrant applicants are eligible for Marketplace qualified health plans (QHPs) with advance payments of the premium tax credit and cost-sharing reductions.  In addition, EFL has worked with federally recognized Indian Tribes in Florida providing outreach education, and enrollment services.

EFL also provides services to consumers who are victims of human trafficking and domestic violence, who are immediately eligible for enrollment in Medicaid, CHIP and/or QHPs through the Marketplace (ward from Healthcare.gov) based on their qualifications.