Plan Ahead for 2018 Health Plans

 

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EFOF offers in-person assistance with healthcare enrollment year-round.

 

Get ready for 2018 Open Enrollment.

The federal marketplace open enrollment period is much shorter this year – November 1 through December 15, 2017 – for coverage that begins January 1, 2018.

Though it’s still months away, you can get ready now to decide what kind of coverage you’ll need.  Education and prep time beforehand is critical.

Make sure you pick the right insurance company and the right policy. You will not be able to make a change throughout the year unless you qualify for a Special Enrollment Period due to change of circumstances, like a move, job loss or other life changes.

Although the costs of 2018 policies aren’t available yet, there are still some issues to consider as you start planning for open enrollment. Start by asking yourself these questions:

  1. Do I like my current plan? Consider not just the monthly premiums, deductible and co-insurance – but also the hospitals and health providers in the network.

  2. Do I like my current health providers? The most affordable plans have a set network of doctors, specialists and facilities. Make a list of your providers. When deciding whether to stick with your current plan or get a new one, you will be ready to see if your providers are on the plans you are considering for 2018.

  3. What prescriptions or services do I currently use? Know what your out-of-pocket costs were in the past year. This way you will be ready to compare the costs in 2018.

There are many more considerations you should take into account in deciding whether to renew your current policy or seek a new insurance plan in 2018.

Find out more about preparing here: https://www.govloop.com/community/blog/early-preparation-open-enrollment/

The Epilepsy Foundation of Florida’s federally licensed healthcare navigators  have the knowledge and experience to help you enroll. We are a statewide organization with offices in the Pensacola, Jacksonville, Gainesville-Ocala, Collier, Palm Beach, Broward and Miami-Dade County regions. We offer these services year-round for consumers who may qualify for a Special Enrollment Period as well as for year-round enrollment programs, including Kidcare, Medicaid and the SHOP program for small businesses.

EFOF is now scheduling appointments for the 2018 Open Enrollment period which begins Nov. 1, 2017. Please call 1-877-553-7453 for assistance and appointments. You can also make an appointment at a location most convenient to you through our online appointment service: https://nes.efof.org/CalendarEvent

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Surprise! Life Changes and the ACA

Life is always full of surprises and changes. Job loss, marriage, child birth, moving. Any of these things could trigger the kind of life change that makes you eligible for a Special Enrollment Period (SEP).

 

 

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Marriage – or divorce- could trigger eligibility for a “Special Enrollment Period.”

 

 

If you qualify for a SEP, you may still be able to get health insurance in 2017, outside the open enrollment period that ended earlier in the year.

But you have to hurry. The marketplace usually gives you just 60 days after the life-changing event to enroll in a plan. Miss the deadline and you have to wait for the next Open Enrollment Period, which begins Nov 1, 2017 for 2018 healthcare coverage.

Not sure you qualify? The health marketplace makes it easy to find out by answering a few questions. You can go here to find out if you qualify: https://www.healthcare.gov/screener/

Some healthcare programs have year-round enrollment, including Medicaid and CHIP, also known in Florida as Kidcare, the children’s insurance program. These are not tied to SEPs.

 

George Valdes & Consumer at Homestead event use this
EFOF healthcare navigators work year-round to enroll consumers in federal marketplace plans.

 

The federally licensed healthcare navigators with the Epilepsy Foundation of Florida enroll consumers through healthcare.gov all year long and can help answer your SEP questions. Call 877-553-7453 to speak to a navigator or make an appointment for in-person assistance. More information is also available at http://www.efof.org/acanavigation

To find out more about Special Enrollment Periods, go to https://www.healthcare.gov/blog/special-enrollment-period-facts/

 

 

 

The Affordable Care Act (ACA) gets the job done

 

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As Congress begins its debate on changing the Affordable Care Act (ACA), it’s good to review the success the federal health care law has had in reducing the uninsured rate in the U.S.

Today, more than 30 million people are currently insured as a result of the ACA’s insurance subsidies, expanded Medicaid eligibility, state and federal outreach efforts, and market regulations.

Before the ACA, more than one-third of people who tried to buy health insurance in the individual market were either turned down, charged more or were told a condition excluded them from their health plan.

How has the ACA succeeded in increasing the insured rate? The ACA has made purchasing easier and more affordable. Consumer protections that ban discrimination for pre-existing conditions have also allowed more people to get covered.

The ACA’s primary goal is to allow anyone without employer coverage to have affordable health coverage – no matter what their current health status is.  Under the ACA, insurers must:

  • Offer a plan to everyone who applies
  • Can’t charge more based on gender or health
  • Are limited in how much more to charge older vs. younger persons
  • Can’t impose lifetime or annual benefit limits or cancel coverage.
  • Include Essential Health Benefits
  • Provide premium tax credits that reduce share of costs for incomes between $24,000 and $97,000 for a family of four.

Why is having health insurance important? Having health insurance coverage allows people to have  regular doctor visits and get timely medical care.  Americans without health insurance are less likely to go to the doctor when they need to or get preventive care and cancer screenings. Even a gap in coverage increases the likelihood someone will not get timely health care.

The Commonwealth Fund report breaks down the success of the ACA by the numbers:

Near the end of the ACA’s fourth open-enrollment period, nearly 9 million people had signed up for a plan through HealthCare.gov.  Millions of other consumers in 11 states and the District of Columbia have enrolled through states’ marketplaces. In addition, 7 million have purchased health insurance in the individual market. Expansions to Medicaid and the Children’s Health Insurance Program have allowed an additional 16 million people.

If you need assistance enrolling in health insurance, including Medicaid and Florida Kidcare,  licensed navigators from the Epilepsy Foundation of Florida can help. Call 877-553-7453 to make an appointment. Or go to efof.org/acanavigation for information on navigation sites and upcoming events.

 

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EFOF’s federally licensed healthcare navigators provide in-person assistance throughout Florida.

 

Read more: http://www.commonwealthfund.org/publications/issue-briefs/2017/feb/how-the-aca-has-improved-ability-to-buy-insurance

 

Make the Most of Summer Fun with Preventive Care

 

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Whether you’re on a healing hike or hitting the beach, make the most out of your summer by staying healthy with preventive care.

Get the most out of your health coverage this summer by getting the preventive care you need.

Did you know? Most health plans cover shots and screening tests — at no cost to you. This means your plan can’t charge you a co-pay or coinsurance – a share of costs – for preventive services. This is true even if you haven’t met your deductible.

What is preventive care?

Screenings, check-ups, and counseling that prevent illnesses, disease, and other health problems, or other healthcare services designed to detect illness at an early stage – it’s all considered  preventive care.

Why is preventive care important?

It helps you stay healthy and happy throughout your life and can detect illness at earlier stages, when treatment is most likely to work best.  Preventive care counseling can help you make healthier lifestyle choices – better diet, no smoking, curbing excessive drinking – that lead to good health and well-being.

Preventive services for all adults include: blood pressure, cholesterol and diabetes (Type 2) screenings. For adults over age 50, preventive care includes colorectal cancer screenings. Lung cancer screenings for adults at higher risk because they are heavy smokers or have quite within the last 15 years are also covered for ages 55-80. Immunizations and flu shots are always  included.

Women have their own set of covered preventive care services, including annual “well-women” visits and mammograms every 1-2 years for women over 40. Beginning at age 60, osteoporosis screening for good bone health is included. Contraception and STD screenings are both considered preventive care for women.

There are extensive preventive care services for children, each suited to the appropriate life stage, from autism and developmental screenings beginning in infancy to lead and vision screenings and even obesity and diet counseling as they get older. Immunizations are always covered as preventive services for children.

No matter where your summer takes you – to the beach or to the woods for healing hikes – stay healthy with preventive care.

Learn more about preventive care and all the services included: https://www.healthcare.gov/preventive-care-adults/

#Coverage2Care #PreventiveServices #Immunizations

Have questions about how to best use your #HealthCare coverage? EFOF’s licensed & certified navigators are here to help. Call 877-553-7453 for answers.

When going without health insurance is not an option

Family Health
Hector Salgado and his wife, Liliana Pinzon depend on an affordable ACA policy to stay healthy and happy.

For Liliana Pinzon and her husband Hector Salgado, the Affordable Care Act (ACA) has been a blessing. Her husband has diabetes and depends on health care coverage to get the regular check-ups and prescription medications he needs.

For this family, going without healthcare is just not an option.

“When my husband changed jobs and lost his health insurance, we were able to get a new healthcare policy through the ACA at a reasonable cost,” Pinzon said. “This has allowed us to have access to good doctors and hospitals when we need them.”

Pinzon and her husband pay $500 a month in premiums. Her five-year-old daughter Maya is on Kidcare.  Before the ACA, the family paid $2,000 a month in premiums, an unsustainable amount that became impossible after Hector switched to part-time work because of his health.

Pinzon is very grateful to have an affordable policy, too. A few years ago she had a complicated pregnancy that resulted in termination due to a fetal abnormality and knows how it important it is to have health care coverage, especially women’s well-care.  

Her Florida Blue HMO healthcare policy allows her to receive care at a Community Health Center where doctor visits cost $3 and labs are free or very low-cost. She has thyroid disease and requires annual blood exams and monthly medications.

 “The ACA offers families like mine the opportunity to choose among many different healthcare policies with different prices,” Pinzon said. “This allows you to pick a healthcare plan that meets your needs – financially and health-wise, depending on your personal circumstances and health concerns.”

According to the Commonwealth Fund, among adults ages 19 to 64 who purchased or looked for a health plan through the ACA marketplace, 70 percent had two or more plans available, an even higher percentage than options available through employer plans. In addition, thirty percent of consumers buying marketplace plans said they had five or more plans to choose from. The number of options increases in more urban areas like South Florida.

 

For her husband, Hector, age 63, the various options available in Broward County, Florida meant finding a healthcare policy that included his doctors and had a good diabetes treatment program. Salgado works part-time as a college instructor where he has no health insurance.

“Thank goodness the Affordable Care Act has been available to me,” Salgado said. “Without it I wouldn’t have been able to stay healthy and helping to support my family.”

 

Choosing a Health Care Plan can be complicated.  You can learn more about how to pick a plan here: https://www.healthcare.gov/choose-a-plan/

The Epilepsy Foundation of Florida has licensed healthcare navigators who can help you make a decision about what policy is best for you and your family. Call our statewide toll-free number to speak to a navigator and set up an appointment for a personal assistance: 1-877-553-7453. For more information on the EFOF navigation program: http://www.efof.org/acanavigation/

Read the Commonwealth Report: http://www.commonwealthfund.org/publications/blog/2017/jun/health-plan-choice-in-aca-marketplace

“Kids Oughta Be Covered”

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Children #Enroll365 kidcare

If your children need health coverage, they may be eligible for the Children’s Health Insurance Program (CHIP) – known in Florida as Kidcare –  which provides low-cost health insurance in families who earn too much to qualify for Medicaid.

Enrollment in Kidcare is year-round. Enroll this summer and your children can get the physicals and immunizations they need before school starts in August.

Most families pay $15 – $20 in monthly premiums for health coverage, which includes doctor visits, immunizations, prescriptions, emergencies, hospitalizations, as well as dental and vision care.

There are more than 2.4 million children covered by Florida Kidcare. But there are still more than 172,000 children estimated to be eligible for free or low-cost health coverage in Florida who are still not enrolled.

The Florida Kidcare tagline is “Kids Oughta Be Covered.” So what are you waiting for?  Enrolling is easy: You can apply by visiting floridakidcare.org or call 1-888-540-5437.

EFOF’s licensed healthcare navigators can also help you enroll through the healthcare insurance marketplace. Our free assistance is statewide with offices in South Florida – Palm Beach, Broward and Miami-Dade County – as well as Pensacola, Jacksonville, and the Gainesville-Ocala area.  Call 1-877-553-7453 for an appointment.

Passage of the Affordable Care Act helped reduce the number of uninsured children in Florida. From 2013 to 2015, the number of children with health insurance coverage increased by more than 234,000. During that same period, Florida experienced the nation’s second largest reduction in the uninsured rate, dropping from  11.1% to 6.9%.

Learn more about the Children’s Health Insurance Program (CHIP) under the Affordable Care Act: https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program

Learn more about Florida Kidcare at: www.kidcare.org