helping consumers understand how to use their healthcare coverage
DESCRIPTION
Helping Consumers Understand How to Use Their Healthcare Coverage. Presented by: Leigh Grauman, LSW Portico Healthnet. Topics for Today. What we know about new enrollees What’s so important about accessing health care coverage? Confirming coverage - PowerPoint PPT PresentationTRANSCRIPT
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PRESENTED BY: LEIGH GRAUMAN, LSWPORTICO HEALTHNET
Helping Consumers Understand How to Use Their Healthcare
Coverage
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Topics for Today
What we know about new enrollees What’s so important about accessing health
care coverage?Confirming coverageEducating enrollees on how to use their
healthcare coverageResourcesQ&A
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MNsure Enrollment Numbers
Over 200,000 people enrolled in health insurance through MNsure during 2014 Open Enrollment!
Total 200,174
Medical Assistance 108,675
MinnesotaCare 41,403
Qualified Health Plan 50,096
Source: MNsure press release 4/23/14
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New Enrollees Want Access to Care
Source: Enroll America
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Source: Health Reform Monitoring Survey: Urban Institute Health Policy Center
Many New Enrollees Don’t Have Usual Source of Care
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Knowledge Gaps in Health Literacy
Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.Source: Enroll America
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What’s so Important? Primary Care
Ability to get care when you need it without having to worry about cost
Primary Doctor gets to know you and your family and your medical history
Referrals to Specialists“Everyday” care
Cold Flu Earache etc.
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What’s so Important? Preventative Care
Detect problems early Health care law
makes many preventative services free! Screening
mammograms Flu shots
Reduce number of work days missed due to illness
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What’s so Important? Cost Savings
Don’t have to worry about getting stuck with a large medical expense
Insurance companies negotiate rates with providers which lowers costs for enrollees (generally 40% savings)
If you go without Minimum Essential Coverage you may have to pay a penalty when you file your 2014 Federal tax return
Source: CMS National Training Program
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Confirming Coverage
MNsure online eligibility determination is preliminary- important to confirm coverage
How to confirm depends on program Assistor Resource Center (for certified Navigators) DHS Member Helpdesk MNsure Contact Center Health Plans for QHP Counties
Permission to Share InformationHelp client collect important information
PMI, Case Number, Effective Date
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Choosing a Health Plan: Public Programs
Completing Health Plan Enrollment Form Form must be returned within 30 days or client will be
enrolled in a default plan Amount of paperwork from health plans can be
overwhelming for clients Important to explain that MA and MNCare plans have
basic services that must be covered- coverage very similar from plan to plan.
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Choosing a Health Plan: Public Programs
Do you have a regular Doctor or clinic? Listing for each network’s
clinics on DHS edocs website
Can also call plan’s customer service numbers
Things to consider when choosing plan: Is my clinic in network? Is there a clinic close to
my home? Language and cultural
needs
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Scheduling Appointments
Offer to assist with scheduling appointment
Use of Interpreters
What to bring to first appointment
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Resources
CMS Presentation on Health Literacy: http://marketplace.cms.gov/training/get-training.html
HealthCare.Gov (Spanish and English) https://www.healthcare.gov/using-your-new-marketplace-coverage/
Other suggestions? Languages? Things you have created or use?
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Questions?
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Sources
Enroll America: The Affordable Care Act’s First Open Enrollment Period: Why Did Some People Enroll and Not Others? conducted by PerryUndem Research/Communication and funded by the Robert Wood Johnson Foundation and The California Endowment:http://www.enrollamerica.org/resources/public-education/why-did-some-people-enroll-and-not-others/
Health Reform Monitoring Survey, Urban Institute Health Policy Center: http://hrms.urban.org/briefs/Who-Are-the-Newly-Insured.html