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/

 

 

 

It’s a guy thing: Staying Fit & Healthy with the ACA.

Men's Health photo basketball players
Catch health problems early with health screenings covered by the Affordable Care Act (ACA)

Guys, the Affordable Care Act (ACA) has you covered.

ACA healthcare policies aren’t designed just to treat you when you’re sick, but to catch problems early – when they can best be treated –  through regular health screenings. These can help you stay fit and healthy, and can even save your life.

While men are significantly more likely to put off doctor’s visits and get screened for illnesses than women, they are much more likely to be hospitalized for diabetes complications heart failure and pneumonia.

Screenings for diabetes (high blood sugar), for example, are particularly important to catch early, when treatment is most effective. Your doctor can also check for high cholesterol and high blood pressure. ACA health policies cover screenings for depression, HIV, Hepatitis C and can help you with weight loss, which can lead to many of the diseases already mentioned.

Some screenings are tied to age. For example, did you know if you’re 50 or older, you are covered for colon cancer screening (or earlier if you have a family history)? If you are between 65 and 75 (or have smoked more than 100 cigarettes in your lifetime), you can receive an Abdominal Aortic Aneurism ultrasound test. This can detect whether the largest artery in your body is bulging, which could prevent it bursting leading to internal bleeding or death. Those between the age of 55 and 80 (or those who have smoked extensively or quit in the past 15 years) can receive a lung cancer test.

 

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Quick guide to Men’s Health Screenings

 

For more information on men’s health, go to: healthfinder.gov – Men: Take Charge of Your Health:

Learn more about ACA essential health benefits: https://www.healthcare.gov/coverage/what-marketplace-plans-cover/

Do you  have more questions about what your healthcare policy covers? The Epilepsy Foundation of Florida’s federally licensed healthcare navigators are here to help! You can call our toll-free statewide number at 877-553-7453 to schedule an appointment with a navigator.  More information is also available at www.efof.org/acanavigation.

Women’s Well-Care Essential to ACA healthcare policies

 

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Well-women check-ups include preventive screenings for diabetes, cancer and depression

Improvements to health coverage have been one of the hallmarks of the Affordable Care Act (ACA), which mandates that all insurance plans cover certain health benefits.

 

This has been especially important for women. For example, contraception and maternity care are covered in ACA plans at no additional charge. Well-women annual exams are covered with no co-pays or co-insurance costs when provided by an in-network provider. And deductibles don’t apply for these services either.

Other required benefits include breastfeeding equipment, HPV testing and domestic violence screenings.

In addition, all ACA healthcare policies and Medicaid plans cover pregnancy and childbirth, which are considered “essential health benefits.”  In fact, all qualified health plans both inside and outside the health marketplace must cover them.

 

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Practicing good health is a life-long pursuit

 

What exactly is a well-woman yearly check-up? It’s where you can talk to your health provider about your health and get preventive screenings, including for:

  • Certain types of cancer
  • HPV (human papillomavirus), which can lead to cervical cancer`
  • HIV and other sexually transmitted diseases (STDS) DYK? Regular Pap tests lower the number of new cervical cancers and deaths by more than 80%.
  • High blood pressure and cholesterol. DYK? More than 75% of women 40-60 years of age have at least one risk factor for heart disease.
  • Diabetes Osteoporosis (weak bones)
  • Depression
  • Domestic violence

For a complete list of all #PreventiveCare offered women, go to: https://www.healthcare.gov/preventive-care-women/

In between visits, check out these “Healthtips” for a healthier you all year and all life long: http://go.usa.gov/x9JSz

Do you still have questions about what your healthcare policy covers? The Epilepsy Foundation of Florida’s federally licensed healthcare navigators are here to help! You can call our toll-free statewide number at 877-553-7453 to schedule an appointment with a navigator. More information is also available at www.efof.org/acanavigation.

 

SHOP is the small business source for health insurance under the ACA

 

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SHOP has succeeded with small urban firms and not-for-profits. Photo: Commonwealth Fund

 

The federal healthcare marketplace for businesses is always open for business.

Enrollment in healthcare plans is year-round under the Small Business Health Options Programs (SHOP), which was created under the Affordable Care Act (ACA) for employers with one-to-50 workers.

The ACA created the SHOP program to address the lack of health insurance availability to employees of small firms. Even when insurance was offered, it didn’t offer a choice of plans or the range of benefits larger employers offered. Only 57 percent of small businesses offer health insurance benefits.

SHOP makes it easier for employers to compare health plans and give employees (and their family members) coverage choices. The ACA also offers firms tax credits.

Though still relatively small, the program has succeeded with small urban start-ups and not-for-profit organizations. In spring 2017, the federal government reported that SHOP had enrolled 232,698 employees from 27,205 firms, most through state-run SHOP programs.

The Epilepsy Foundation of Florida has federally licensed navigators that specialize in SHOP policies and are ready to assist small businesses in enrolling employees.  An employer can call the EFOF navigation office at 1-877-553-7453 to make an appointment to find out more about the program.

Greg Jenkins
EFOF health care navigator Greg Jenkins is a SHOP specialist.

See if your firm qualifies for the SHOP program: https://www.healthcare.gov/small-businesses/

WATCH this informative video that provides an overview of the SHOP Marketplace: https://www.youtube.com/watch?v=UWPCSXmxX68

Learn more about the success and challenges of the SHOP program in the U.S. at http://www.commonwealthfund.org/publications/fund-reports/2017/jul/talking-shop-small-business-marketplaces-california-colorado

 

 

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

 

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