Access Health 101: Get to Know AHCT
Moderator: Evelyn Mantilla Presenter: Gina Breton Agenda
A. Important information for consumers
B. Recent changes affecting consumers
C. How organizations can partner with AHCT
Important Information For Consumers
3 3 What is Access Health CT (AHCT)? • The Patient Protection and Affordable Care Act (ACA) • Quality, affordable health coverage to CT residents and employers • Only place in CT where individuals, families, and employers can shop, compare, and receive help paying for the cost of health care if they qualify
Mission • Increase number of insured residents • Retain current members and improve benefit utilization • Promote health • Lower costs • Eliminate health disparities
4 Talking points about healthcare coverage
• Health care coverage can play a big role in maintaining and improving your health and the health of others in your household.
• Health care coverage can provide your household with peace of mind in knowing you have access to quality health care without the worry of big medical bills.
5 Talking points about Access Health CT
• Open Enrollment for Qualified Health Plans is quickly approaching: November 1, 2016 (note that consumers can enroll in Medicaid year-round)
• Enrollment assistance is available and FREE. Consumers can enroll online, over the phone, or receive free in- person assistance.
• Financial help may be available – over 76% of consumers who purchase a Qualified Health Plan receive financial assistance!
• Get covered or you may have to pay a penalty of $695. 6
Key Affordable Care Act features
7 Essential health benefits included in all plans
1. Outpatient care 2. Trips to the emergency room 3. Treatment in the hospital for inpatient care 4. Care before and after your baby is born 5. Mental health and substance use disorder services 6. Your prescription drugs 7. Services and devices to help you recover if you are injured, have a disability or a chronic condition 8. Your lab tests 9. Preventive services 10. Pediatric services
8 Health coverage available through…
Connecticut’s Medicaid & Children’s Health Insurance Program
9 Financial help may be available
up to $97,000
up to $47,080 Eligible for Financial Help*
up to $48,743 up to $16,243 Eligible for Medicaid*
Single Family of 4
* Eligibility will depend on actual income level and household size.
10 Application process
Shop plans
Apply for financial assistance
Eligibility determination
Select plan
Verification
Application sent to insurer
11 What to expect after you complete enrollment
Confirma on Le er Access Health CT and your About 3 days a er enrolling insurance company will mail a le er.
First Bill from insurance company Your insurance company will send About 5-10 days a er enrolling the bill with direc ons for your first payment.
ID Card Your insurance company will send About 1-2 weeks a er enrolling your ID card. You can also print one from their site of you need it sooner.
Pharmacy & Doctor Directories Find in-network pharmacies, Available 24/7 online primary care doctors, specialists and hospitals to help reduce cost.
12 Dental coverage with AHCT
• The Affordable Care Act treats dental coverage differently for children versus adults. For children, dental coverage is an Essential Health Benefit, which means it must be made available either as part of a health plan or a stand-alone plan. However, insurers do not have to offer adult dental coverage as part of their health plans.
• All of the plans offered through Access Health CT provide free preventive pediatric dental coverage as a benefit. For anyone who does not have dental coverage or wants increased benefits, Access Health CT currently offers standalone dental coverage, which can be purchased in addition to your health insurance plan
13 What we’ve accomplished together
• Less than 4% of residents remain uninsured
• 116,019 total Qualified Health Plan (QHP) membership (As of Feb 2016)
• 61,747 new members in the last Open Enrollment period • 32% QHP • 68% Medicaid
• Nearly 600,000 total Medicaid membership
14 Important 2017 Open Enrollment Dates
Nov. 1, Dec. 15, Jan . 31, 2016 2016 2017
Open Deadline to Last day to enroll Enrollment enroll for 1/1/17 during Open begins effec ve date Enrollment
15 Enrollment channels
Online: Our website is available 24/7 to AccessHealthCT.com provide guidance and tools and services to help you enroll
Phone: AHCT has a full time call center to answer any questions consumers have 1-855-805-4325 and help them enroll over the phone
In-Person: Brokers and Certified Application Counselors are available year- AccessHealthCT.com round to provide enrollment assistance. Click on “Get Help” tab During Open Enrollment AHCT opens additional locations for in-person help
All assistance from AHCT and our partners is FREE!
16 Get covered or you may be required to pay a penalty
If you do not enroll in qualified coverage, you could owe a tax penalty of $695 or more depending on your income.
17 Special Enrollment & Qualifying Life Events
Just Having, married Divorced adopting, or to an or Legal fostering a AHCT Separation child customer
Loss of Just coverage 26 Aging off moved to due to job parents’ Connecticut change plan
18
Recent Changes Affecting Consumers
19 HUSKY Transitional Medical Assistance transition
• A Connecticut State law was passed on June 29, 2015. It lowered the income eligibility limit for parents and caretakers of HUSKY A eligible children from 201% of the Federal Poverty Level (FPL) to 155% of the FPL. Due to this change some parents and caretakers will now have monthly incomes higher than the HUSKY A eligibility.
• The change is considered a Qualifying Life Event (loss of minimum essential coverage) and triggered a Special Enrollment period. Parents or caregivers will lose coverage as of July 31, 2016. These individuals have 60 days to enroll in other health care coverage offered through Access Health CT. TMA: Options
• May still qualify for Husky A or another HUSKY program • Qualified Health Plan (QHP) from a private insurance carrier
– Advanced Premium Tax Credits (APTC) to help lower monthly premiums
– Cost Sharing Reductions (CSR) to help lower the cost of coverage, such as lower deductibles, co-pays, etc. Communication Strategy to alert affected individuals
• Notices – 60-Day (sent 6/4/16) 30-Day (sent 7/1/16) – Reviewed by Focus Groups (5/24/16 & 6/21/16) • Facilitated by Office of the Healthcare Advocate – English and Spanish • Poster – Regional Department of Social Services Offices – All Community Health Center Association of CT Facilities – All Planned Parenthood Centers
• Postcard – Directly mailed to all 13,811 (6/20/16)
• Live Outbound Call Campaign – 1st Pass – July 9th – 2nd Pass – July 25th
22
For updates visit our Husky Move webpage http://learn.AccessHealthCT.com/husky-move/ http://learn.AccessHealthCT.com/es/cambio- husky/
23 Carrier update: HealthyCT
• HealthyCT is leaving the Connecticut Insurance marketplace
• The CT Insurance Department placed the company under an order of supervision – Decision prevented the company from writing any new policies and also renewing any policy that expire after July 1, 2016
• Individual Marketplace Impact – No immediate impact • Members should continue to pay premiums – and on time – to keep coverage in place through 12/31/16. These customers will need to enroll in a new plan during 2017 Open Enrollment to avoid a gap in coverage. Current enrollment by carrier
Connec Care 55,578 Anthem BCBS 34,403 HealthyCT 11,592 UnitedHealthcare 1,835 Grand Total 103,408 How organizations can partner with AHCT What is a community partner?
• Partners share information about access to health coverage with communities all over Connecticut • AHCT provides resources and invites dialogue with our partners • Our community partners include:
Community Health Centers Health Departments Community Organizations Hospitals Department of Labor Libraries Educational institutions Faith organizations Elected Officials and many others! Healthcare providers
27 Learn More
• Par cipate in our Webinar series- including upcoming webinar in Spanish • Check out Community Partner Website: h p://learn.accesshealthct.com/community/ • Sign up for our email list
28 Distribute materials to consumers
• Currently we have following materials on website for download: When Can I Enroll?, Immigra on Status and Ge ng Health Care Coverage, Ge ng Help Paying for Health Care Coverage, A er You Enroll, Tax Penalty (Fine) Exemp on Form
• Soon we will share more informa on about materials that we will make available for partners
29 Invite AHCT to join your events
• Presenta ons for your community members or staff • Tabling at community events • Email [email protected] or fill out the form on our Community Partner website to invite AHCT
30 Become a Community Partner! To reach the AHCT Outreach Team: Call: 860-327-5517 Email: [email protected] Online: http://Learn.AccessHealthCT.com/community
Follow us @AccessHealthCT
#AHCT #GetCoveredCT
31 QUESTIONS ? Thank you!