on target medicare presentation 2012
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ON TARGETHealthcare Insurance101
“Everything You Should Know About Medicare”
By CIOS2011.org
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Community Insurance Outreach Services
C.I.O.S. is an non-for profit organization providing insurance related services and support to the metro Youngstown area. Our mission is to bridge the gap between insurance companies, consumers, and localgovernment by providing education and resources.
C.I.O.S. address the need for educating consumers andemployers to better understand their insurance needs, assist the insurance industry with risk management, and provide employment opportunities within the insurance markets.
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C.I.O.S.
Community Insurance Outreach Services Non-profit organization Services
Education
Employment
Support
Community based programs designed & operated by the community it servesInsurance industry sponsored initiative Outreach partnerships with other non-profits Services based on community needs which provide superior satisfaction
Ohio...Let’s Start Here
!!!
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Parent Plan Dependent 26 Year Old
Healthcare
Access to Preventative Services and NO Lifetime Limits
Pre-existing Condition Insurance Plans
Coordination of Care
Secure Medicare Trust Fund
Partnership for Patients
The Affordable Care Act ACA (Healthcare Reform)
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Medicare
Everything You Need to Know…….
Getting Ready for Open Enrollment
October 15th 2012-December 7th 2012
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QUICK FACTS
AEP- Annual Enrollment Periods
October 15th 2011- December 7th 2011
• You can change your Medicare health or prescription drug coverage for 2012.
Disenrollment Period
January 1st 2012- February 14th 2012
• January 1st 2012 new coverage begins if you switched or joined a plan. New costs and coverage changes also begin if you kept your existing coverage.
QUICK FACTS
• NEW—Making changes to your coverage after December 31 Between January 1–February 14, 2011, if you’re in a Medicare Advantage Plan, you can leave your plan and switch to Original Medicare.
• If your Medicare Advantage Plan includes prescription drug coverage and you join a Medicare Prescription Drug Plan, you will be disenrolled from your Medicare Advantage Plan and returned to Original Medicare.
Enrollment Periods Medicare 2012 Saturday October 15th 2011
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1-800-686-1578 MEDICARE EXPERTS
OSHIIPOhio Senior Health Insurance Information Program
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MedicaidMedicaid pays for covered medical bills, dental bills, eyeglasses, and homemakers services. Certain people covered by Medicare may qualify for full Medicaid benefits. Other will qualify for partial Medicaid, also known as “spend down”.
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Medicare-Medicaid Coordination
Medicare Premium Assistance Program (MPAPThis program helps people eligible for Medicare who have limited income and assets get help in paying the cost of one or more of the following:Medicare premium(s) Medicare deductibles Medicare coinsurance
Eligibility Criteria: To qualify for MPAP, applicants must be eligible for Medicare and meet basic requirements.
When applying for MPAP, proof of income, resources, age or disability, citizenship (if not a U.S. citizen) and other health insurance is required.
No face-to-face interview with the local
county department of job and family services is necessary.
Medicaid for Older Adults and People with Disabilities
Medicaid for the Aged, Blind & People with Disabilities (ABD) Ohio Medicaid offers a span of programs for older adults and people with disabilities to assist with medical expenses. These programs provide health care coverage consisting of primary and acute-care benefit packages along with long-term care.
To qualify for ABD Medicaid, applicants must be:age 65 or older, or considered legally blind, or an individual with a disability (as classified by the Social Security Administration), and must meet basic requirements.
When applying for this type of Medicaid, proof of income, resources, age or disability, citizenship (if not a U.S. citizen) and other health insurance is required.
A face-to-face interview with the local county department of job and family services is also necessary.
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Medicaid Income Eligibility 2012
2011 HHS Poverty Guidelines
Personsin Family
48 ContiguousStates and
D.C. Alaska Hawaii
1 $10,890 $13,600 $12,540
2 14,710 18,380 16,930
3 18,530 23,160 21,320
4 22,350 27,940 25,710
5 26,170 32,720 30,100
6 29,990 37,500 34,490
7 33,810 42,280 38,880
8 37,630 47,060 43,270
For each additional
person, add3,820 4,780 4,390
Who Qualify in Ohio?
FPL Single
Married
ResourcesSingle/Married
Older Adults (age 65 or older) & Disabled People (of any age)
64% $589 $1,011
$1,500/$2,250
Qualified Medicare Beneficiary (QMB)
100% $867 $1,176
$4,000/$6,000
Specified Low-IncomeMedicare Beneficiary (SLMB)
120% $1,040
$1,400
$4,000/$6,000
Qualified Individual (QI-1)
135% $1,170
$1,575
$4,000/$6,000
Qualified Working Disabled Individual (QWDI)
200% $1,734
$2,334
$4,000/$6,000
SOURCE: Federal Register, Vol. 76, No. 13, January 20, 2011, pp. 3637-3638
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“Insurance Literacy”
“Claims Assistance” “Career Pathway”
Insurance Literacy Program provides free educational seminars on :• Basic Insurance• Health Insurance• Property & Auto Insurance• Life & Accident Insurance
• We also provide free insurance seminars for business
Our “Restoring the Community” program offers catastrophic claims assistance and support to local residents and business.
We provide advice and guidance during insurance claim process.
We act as an authorized agent and advocate, respond to denial letters, assist with documentation, and refer to local state insurance agencies for complaints.
The “Career Pathway” program offers career placement and credentials in the insurance industry. We provide recession –proof employment opportunities by securing our clients with an state insurance license with in 90 days. Our clients are vested after 5 years of commitment and provide training, credentialing, support, and marketing.
Our Common Pledge… “Providing progress, stability, & dedication to disadvantage communities across America.”
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WWW.CIOS2011.ORGFor more information and event dates visit
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