HealthCare Access Maryland - bcpcouncil.org

HealthCare Access Maryland - bcpcouncil.org

HealthCare Access Maryland Central Region Connector Aileen Zimmerman Certified Navigator Baltimore County Facebook: /HealthCareAccessMaryland Twitter: @hcamaryland Website: www.hcamaryland.org About HCAM Non-profit agency created in 1997 Today: 19

programs/30 grants Formerly Baltimore HealthCare Access Areas of expertise: Eligibility & enrollment Navigation of health care system Care Coordination Education & Advocacy Renamed to reflect expanded reach & focus Originally two core

programs: Eligibility Care Coordination Diverse and culturally competent staff Baltimore County Affordable Care Act Patient Protection and Affordable Care Act Signed into law March 23, 2010 Health Care Reform ACA expands coverage to 800,000 uninsured in Maryland

Individuals, families, and small businesses are all eligible for coverage through ACA Baltimore County Key Features Coverage Cost Care 10 Essential Health Benefits Baltimore County How will ACA effect my coverage? Choice of doctor You can choose any doctor you prefer

If a woman wants her OB/GYN to be her primary care physician, that is allowed Children up to age 26 stay on their parents insurance 52,000 in Maryland Children with preexisting conditions are no longer denied coverage Insurers can no longer deny or limit coverage to children under age 19 Baltimore County What about the cost of insurance? No more life-time dollar limits on care More dollars are now spent on your care

not on administrative costs Baltimore County What about the care being offered? You can see the doctor of your choice Preventive care No pre-authorization required to go to the emergency room Baltimore County 10 Essential Health Benefits Qualified Health Plans

Ambulatory Services Emergency Services Preventive Care Maternal and Newborn Care Hospitalization Pediatric Services including dental and vision Habilitative and Rehabilitative Services Laboratory Services Mental Health and Substance Use Benefits

Prescription Drugs Baltimore County Expand Coverage Medicaid expansion up to 138% FPL Advanced Premium Tax Credits Reduces monthly premium 138-400% FPL Cost Sharing Reductions Reduces out-of-pocket costs 100-250% FPL Baltimore County Individual Mandate Individuals must obtain health coverage or pay a penalty

2014: $95 or 1% of income 2015: $325 or 2% of income 2016: $695 or 2.5% of income Exceptions: Financial hardship, religious objections, incarcerated individuals, undocumented immigrants, those for whom the lowest cost plan is 8 percent of annual income, and those whose income is below the tax filing threshold Baltimore County Maryland Health Connection The Health Exchange for the state of Maryland authorized in supplying individuals with health insurance approved by the Affordable Care Act

States had a choice to establish a state-based exchange, or join the federally-facilitated exchange; Maryland opted to establish a state-based health insurance exchange Maryland Heath Connection Baltimore County Maryland Health Connection Individuals and small businesses can explore, compare, and enroll in private health plans or public assistance plans Obtain access to tax credits and cost sharing reductions The state-based health insurance exchange is NOT an insurer or issuer of health insurance plans

Baltimore County Maryland Health Connection Maryland Health Connection offers tax subsidies and cost sharing reductions to individuals and families who do not have access to affordable health care insurance Federal government will pay a portion of costs for health insurance for people who earn up to 400% of FPL Cost sharing reductions are available to individuals under 250% of FPL Open Enrollment Period: Oct. 1, 2013 March 31, 2014 Coverage Effective: Jan. 2014 Baltimore County

Maryland Health Connection Eligibility determination Plan Selection using standardized format to compare: Compare Apples to Apples Need more assistance? Get help! Premium and co-pays Website

Plan performance on quality measures Telephone Plan ratings by quality and price Baltimore County Navigators What Insurance is offered through the Maryland Health Connection? Medicaid Expansion

7 Managed Care Organizations Private Insurance 4 metal levels bronze, silver, gold, and platinum 10 Essential Health Benefits Baltimore County Medicaid Expansion: up to 138% FPL Approximately 100,000 new enrollees in 2014 Benefit package is the same Simplified enrollment process No Wrong Door policy

Baltimore County Medicaid Coverage Coverage begins January 1, 2014 Retroactive Coverage For the month enrolled Income level: Individual: $15,856 Household of 2: $21,404 Baltimore County Life Changing Events Life changing events include: Gain/loss of job, marriage, divorce, birth, death,

increase/decrease in salary, relocate If one of these occurs during the year, you must call the Maryland Health Connection and update your status. They will automatically re-determine your eligibility for affordable insurance Baltimore County Connector Entity Maryland is organized into 6 regions One connector entity serves each region Connector entities partner with local organizations to meet the needs of the entire region

Baltimore County 6 Regional Connector Entities Baltimore County HCAM -- Central Region Connector Central Region Baltimore City Baltimore County Anne Arundel County 17 Partners/ Subcontractors Local Health Departments

Department of Social Services Baltimore County Central Region Partners/SubContractors Anne Arundel Medical Center Baltimore City Health Department Baltimore Healthy Start, Inc. Baltimore Medical Systems Maryland Medical Society (MedChi) Mental Health Association of Maryland (MHAMD) Charm City Clinic

Mercy Hospital Chase Brexton Health Services Mosaic Community Services Chatman, LLC Park Heights Community Health Alliance Coordinating Center Healthcare for the Homeless Independent Marylanders Achieving Growth Through

Empowerment Inc. (IMAGE) Planned Parenthood of Maryland St. Stephens African Methodist Church/ Office Management &Technology (OMT/SSAME) Baltimore County Uninsured in Baltimore County 80,000 Baltimore County Residents are Uninsured Baltimore County

Central Region Connector HCAM and our 17 partners will employ 107 certified Navigators & trained Assisters to: provide outreach and education eligibility determinations facilitate enrollment of the 217,000 uninsured central region residents into Medicaid, MCHP & subsidized/ unsubsidized qualified health plans 80,000 in Baltimore County Baltimore County Central Region Connector Outreach/Education/Enrollment Health Departments/Social Services Faith-based organizations Community based organizations: clinics,

food banks, libraries, supermarkets Civic Associations, clubs Health fairs, festivals Baltimore County Responsibilities Assisters will: Navigators will: Conduct public education and outreach as required by the Affordable Care Act Distribute fair and impartial information Conduct public education and outreach

Facilitate enrollment in health plans Provide referrals for grievances, complaints and questions Provide information in a culturally and linguistically appropriate manner Maintain expertise in eligibility, enrollment and program specifications Refer insured small groups and individuals back to producers Provide information in a culturally and linguistically appropriate manner Facilitate enrollment in Medicaid Maintain expertise in eligibility,

enrollment and program specifications Refer insured small groups and individuals back to producers Both navigators and assisters will receive training through MHBE Baltimore County Navigators in Baltimore County Towson Department of Social Services Lauren Lucas (443) 925-9964 Dundalk Department of Social

Services Roshon Goode (443) 934-9454 Reisterstown Department of Social Services Kirsten Bickford (443) 925-9137 Liberty Workforce Development Center Tanys Lee (443) 934-9459 Essex Department of Social Services Roger Fenner (443) 934-9452

19 Baltimore County Public Libraries Catonsville Department of Social Services Tawanda Epps (443) 934-9466 Baltimore County Detention Center Baltimore County Consumer Assistance

Online at www.MarylandHealthConnection.gov Shop Compare Enroll Consolidated Services Call Center 855-642-8572 855-642-8573 TTY Customer Service Application and enrollment assistance Language line/ translation services

TTY for the hearing impaired In-person Assistance Navigators (Certified) Assisters (Non-Certified) Insurance Producers (Authorized) Captive Producers Application Counselors HCAM Call Center 877-223-5201 Baltimore County Aileen Zimmerman Certified Navigator Baltimore County

443-858-4767 [email protected] www.healthcareaccessmaryland.org Baltimore County

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