Healthcare | WithinReach WA
Home  >  Category Archives: Healthcare

Healthcare

Health Insurance Open Enrollment Through January 15th 2018!

Post originally written by Cristina Cardenas, Outreach & Enrollment Specialist.

This year’s Open Enrollment period for health insurance in Washington state through the Washington Health Plan Finder continues through January 15, 2018. For health insurance plans that are active starting January 1st, a plan must be selected by Friday, December 15th, 2017.

With the deadline for coverage coming, here are some considerations to make while you are looking to purchase a Qualified Health Plan:

Your doctor
Do you have a specific doctor’s office or clinic in mind?
What plans are currently accepted by that doctor or clinic?

While picking an insurance plan, one of the most important factors is being able to use that insurance for services at a clinic or doctor’s office with which you would like to work. If you have a specific health clinic or provider in mind, you’ll want to make sure they accept the insurance you choose. While shopping on Washington Healthplanfinder, the health insurance marketplace for Washington state, you can check which insurance plans are accepted by clicking the “Who’s Shopping” box, located on the upper left-hand side of the QHP selection screen. You will be able to search by your provider’s name, hospital, or zip code. Be sure to call the office to confirm if the plan is accepted and get the most updated information!

Medical needs
Do you have any chronic health conditions or specialty care needs?
Are any of your typical medical needs listed under the excluded services?

Although all health insurance plans listed on the exchange are required to cover the Ten Essential Benefits, you’ll want to spend some time looking into the details of the plans you are considering to see what other services may or may not be covered. This is especially important if you have any specific medical needs or services you know you will be seeking. You’ll want to make sure the plan you pick is going to work the best for you and your health.
To see more details about the plan, click the link that says “More information on this plan,” located under the name of each plan option on the shopping page of Washington Healthplanfinder.

Cost considerations
What is your monthly budget for health insurance?
Are there any tax credits and/or cost-sharing available to you?

There are many factors to consider when deciding which health insurance plan might be most affordable for you or your family. Every plan has a different amount for what you must pay from your own pocket before the insurance company will help you pay for your healthcare. There are five insurance payment terms to keep in mind:

  • Premium—the monthly payment you make to ensure you have coverage.
  • Deductible—the amount you will need to pay yourself for healthcare services before the insurance company starts to pay for healthcare costs.
  • Copayment—An amount you pay for a covered healthcare service after the deductible has been met. This may vary depending on the service.
  • Co-Insurance—the percentage of the bill you are responsible for before the deductible is reached. For example, a 20% co-insurance means that you pay 20% of the bill and the insurance company pays 80%.
  • Out-of-Pocket Max—the maximum amount you can pay in a year. After this is reached, all covered services will be paid for by the insurance company

At first glance, a low monthly premium might seem like the most affordable option, but these plans tend to come with a higher deductible. That means that if you have an unplanned medical need or accident, you may end up paying more out of your own pocket since the deductible needs to be met before the insurance company will help you pay.
You might also qualify for help paying for your insurance through government subsidies. If your income is under 400% of the federal poverty level (or $8,200/month for a family of four), you may qualify for tax credits that help pay for the monthly premium, or cost-sharing reduction to help reduce your out of pocket expenses!
On Washington Healthplanfinder, you are able to customize your search using the categories on the left-hand side and narrow your selections to plans within the range of what you may be comfortable paying. You can also see more detailed information about the cost

Plan flexibility
What is the size of the network for this plan?
Do I have to stay “in-network?
Will I need a referral to see a specialist?

Another aspect to keep in mind while picking a health insurance plan is the type of network available to you. The plan network includes physicians, hospitals, and other healthcare providers that have agreed to provide medical services at pre-negotiated prices and rates. There are three different categories:

  • Health Maintenance Organization (HMO)—This type of plan limits coverage to care from doctors who work for the insurance organization. Services by providers outside of the network will most likely not be covered. Your doctor, or primary care physician as they are usually called, will help to coordinate your care and provide referrals to see specialists.
  • Preferred Provider Organization (PPO)—In this type of plan, you will save more money seeking services from providers who are part of the plan’s network. You can see doctors, hospitals, and/or specialist outside of the network without a referral, but they may end up costing you more.
  • Exclusive Provider Organization (EPO)—This plan will require you to see providers within the network to have your services covered. Any services by out-of-network providers will not be covered.

Each of these types of plans have their pros and cons, so to help you make a decision, you’ll want to ask yourself how flexible you would like your health insurance plan to be.

Even with a list of questions to help you find the best plan, we here at WithinReach realize that it can still be overwhelming to sift through all the information. That is why we are here to help! By calling our Family Health Hotline at 1 (800) 322-2588, we can walk you through the whole application process and help you narrow down your plan options! 

Building Healthy Families in Washington

Have you ever tried to call your bank, but couldn’t get a real person on the phone to answer your question? Or gotten stuck filling out a form online and didn’t know who to call? Systems can be overwhelming even for the savviest of us. They can be even more overwhelming for families with limited resources. That’s where our Healthy Connections Team comes in – trusted experts in navigating systems and local resources. We work with families to connect them to resources they need to be healthy and safe, including health insurance.

This month, the Healthy Connections Team was given an award from Public Health – Seattle & King County for enrolling 3,657 King County residents into health insurance from November 1, 2016 – January 31, 2017. WithinReach has been assisting families in obtaining health insurance during Open Enrollment since the inception of the Affordable Care Act four years ago. This year, our team was the top community service organization for enrollment numbers in King County!

What makes the Healthy Connections Team unique is that our outreach specialists and coordinators meet people where they are at – whether it’s providing information online, enrolling people in benefits programs over the phone, or meeting them in-person where they are. We understand the best way to connect people to the services they need is to eliminate the barriers standing in their way.

Many people don’t realize that if someone is referred to a service, it doesn’t mean that they actually receive the service. Sometimes, the application process may not be in a language they understand. Or they may always reach a busy signal when trying to call. Oftentimes, people don’t understand the qualifications for benefits or exactly what the benefits are. These are all things the Healthy Connections Team can navigate to make sure Washington families receive the support they need.

The Team is located in Seattle but provides services to people across the state. All of our team members are certified King County Navigators, trained to know the various health coverage options in Washington and help with eligibility and enrollment forms. Through this work, Washington families get connected to everything they need to be healthy and safe. To learn more about what the Healthy Connection team does, check out our ParentHelp123.org website!

Tags: Affordable Care Act   families   health insurance   Navigators   Public Health – Seattle & King County   Washington   WithinReach   

Tax Season is Here!

Written by Becca Reardon, AmeriCorps Outreach & Enrollment Specialist

When you hear “tax season,” what do you think of? Probably not anything super-positive. But what if “tax season” meant that you would be assisted by a team whose goal was to get you the best refund possible AND to explore ways to improve your quality of life? Sounds pretty good! Luckily for individuals and families in King and Snohomish counties making less than $64,000 a year, that’s exactly what the United Way Free Tax Prep Campaign does.

UWKC has been offering free tax preparation to the community since 2003, and their ultimate goal is to help put some of our hard-earned money back into our savings accounts come springtime. One of the best tools they use–one that was designed specifically to help lift low- and moderate-income houses out of poverty–is the Earned Income Tax Credit (EITC). This credit primarily benefits individuals and couples within certain income brackets who have qualifying dependents, although others can access it as well. Last year in their 2016 campaign, UWKC filed 21,750 returns, earning their clients about $29.1 million in refunds. Of this, $9.4 million came from the EITC.

As if having someone else doing your taxes for free isn’t enough, UWKC goes a couple steps further. First of all, their service is accessible and low-barrier, which means that those in the most need can get help. UWKC has 27 sites in King County, from Shoreline to Federal Way, out to Bellevue and Renton. These sites have varying hours and days, from early morning to late evenings and even weekends. Many of their tax preparers are bilingual, so language isn’t a roadblock for those seeking help. And for those of us who are somewhat antisocial and were reared by technology (here’s looking at you, 20-somethings), UWKC also offers an online option that will allow you to e-file yourself for free.

So where does WithinReach fit into tax returns? A simple screening questionnaire at intake can quickly determine if families feel like they have enough to eat, if they can pay their utility bills, or if they have healthcare needs. These issues are much more up our alley, and that is where we can address creating healthy futures for our community.

From November through January, our in-person team helped train the tax campaign’s Volunteer Intake & Benefits Specialists, or VIBS. These volunteers greet clients, manage paperwork, make sure everyone has the appropriate materials, and screen clients for possible programs. They then make referrals to our Healthy Connections Online portal in order for our staff to reach out and assist. We trained the VIBS on identifying food, health, and transportation needs, and some of the local public benefits that can help. This way, they can effectively screen clients for eligibility (using a handy-dandy UWKC screening tool) and make referrals to us, coaching their clients through how they will be contacted and what WithinReach can do for them. VIBS can also give clients information on utility assistance, credit pulls, and financial counseling.

Once we receive the referral from the VIBS, it is the job of our Outreach & Enrollment Specialists to reach out to the client within two business days. Once we get in contact with the client, we talk with them to determine what they feel they need and screen them for eligibility for a host of programs. There are a huge number of community resources out there, such as play and learn groups, food banks, and prescription assistance, that people aren’t accessing simply because they don’t know they exist. Our ParentHelp123 website can also be used by clients if they want to explore resources on their own.

To bring assistance even closer to these clients, our team of AmeriCorps Outreach & Enrollment Specialists will be attending four of the busier tax sites once a week through tax season– Lake City Neighborhood Service Center, Rainier Community Center, Burien Goodwill, and the Central Library. Instead of sending in a referral, our team can actually help clients on the spot.

The Tax Campaign aims to put money back into the pockets of low-income households across King county. This money can pay medical bills, help with groceries, keep the lights turned on, or be tucked away for later. This partnership between WithinReach and the UWKC tax sites aids with our own personal mission of making healthy futures attainable for families across Washington, by connecting them to the resources they need to be healthy and safe.

Tags: Basic Food   health insurance   United Way of King County   

How to choose a health insurance plan

Health insurance Washington state
Written by Cristina Cardenas, AmeriCorps Outreach & Enrollment Specialist
Open Enrollment is well under way, which means that it’s time to sign up for health insurance! But with so many options out there, how can you possibly decide? Here are a few questions to think about to help you choose the best insurance plan for you and your family!

 

Your doctor
Do you have a specific doctor’s office or clinic in mind?
What plans are currently accepted by that doctor or clinic?

While picking an insurance plan, one of the most important factors is being able to use that insurance for services at a clinic or doctor’s office with which you would like to work. If you have a specific health clinic or provider in mind, you’ll want to make sure they accept the insurance you choose. While shopping on Washington Healthplanfinder, the health insurance marketplace for Washington state, you can check which insurance plans are accepted by clicking “Add”, listed under “Health Care Provider” in the “My Search” box, located on the upper left-hand side of the QHP selection screen. You will be able to search by your provider’s name, hospital, or zip code. Be sure to call the office to confirm if the plan is accepted and get the most updated information!

Medical needs
Do you have any chronic health conditions or specialty care needs?
Are any of your typical medical needs listed under the excluded services?

Although all health insurance plans listed on the exchange are required to cover the Ten Essential Benefits, you’ll want to spend some time looking into the details of the plans you are considering to see what other services may or may not be covered. This is especially important if you have any specific medical needs or services you know you will be seeking. You’ll want to make sure the plan you pick is going to work the best for you and your health.
To see more details about the plan, click the link that says “More information on this plan,” located under the name of each plan option on the shopping page of Washington Healthplanfinder.

Cost considerations
What is your monthly budget for health insurance?
Are there any tax credits and/or cost-sharing available to you?

There are many factors to consider when deciding which health insurance plan might be most affordable for you or your family. Every plan has a different amount for what you must pay from your own pocket before the insurance company will help you pay for your healthcare. There are five insurance payment terms to keep in mind:

  • Premium—the monthly payment you make to ensure you have coverage.
  • Deductible—the amount you will need to pay yourself for healthcare services before the insurance company starts to pay for healthcare costs.
  • Copayment—An amount you pay for a covered healthcare service after the deductible has been met. This may vary depending on the service.
  • Co-Insurance—the percentage of the bill you are responsible for before the deductible is reached. For example, a 20% co-insurance means that you pay 20% of the bill and the insurance company pays 80%.
  • Out-of-Pocket Max—the maximum amount you can pay in a year. After this is reached, all covered services will be paid for by the insurance company

At first glance, a low monthly premium might seem like the most affordable option, but these plans tend to come with a higher deductible. That means that if you have an unplanned medical need or accident, you may end up paying more out of your own pocket since the deductible needs to be met before the insurance company will help you pay.
You might also qualify for help paying for your insurance through government subsidies. If your income is under 400% of the federal poverty level (or $8,100/month for a family of four), you may qualify for tax credits that help pay for the monthly premium, or cost-sharing reduction to help reduce your out of pocket expenses!
On Washington Healthplanfinder, you are able to customize your search using the categories on the left-hand side and narrow your selections to plans within the range of what you may be comfortable paying. You can also see more detailed information about the cost

Plan flexibility
What is the size of the network for this plan?
Do I have to stay “in-network?
Will I need a referral to see a specialist?

Another aspect to keep in mind while picking a health insurance plan is the type of network available to you. The plan network includes physicians, hospitals, and other healthcare providers that have agreed to provide medical services at pre-negotiated prices and rates. There are three different categories:

  • Health Maintenance Organization (HMO)—This type of plan limits coverage to care from doctors who work for the insurance organization. Services by providers outside of the network will most likely not be covered. Your doctor, or primary care physician as they are usually called, will help to coordinate your care and provide referrals to see specialists.
  • Preferred Provider Organization (PPO)—In this type of plan, you will save more money seeking services from providers who are part of the plan’s network. You can see doctors, hospitals, and/or specialist outside of the network without a referral, but they may end up costing you more.
  • Exclusive Provider Organization (EPO)—This plan will require you to see providers within the network to have your services covered. Any services by out-of-network providers will not be covered.

Each of these types of plans have their pros and cons, so to help you make a decision, you’ll want to ask yourself how flexible you would like your health insurance plan to be.

Even with a list of questions to help you find the best plan, we here at WithinReach realize that it can still be overwhelming to sift through all the information. That is why we are here to help! By calling our Family Health Hotline at (800) 322-2588, we can walk you through the whole application process and help you narrow down your plan options.

Tags: ACA   health insurance   Health insurance enrollment   Open Enrollment   Washington HealthPlanFinder   Washington state   

Podcast: Open Enrollment is here!

WithinReach podcast

We’re talking about Open Enrollment for health insurance on this episode of the WithinReach Podcast. There’s a lot of information packed into this episode; here are some of the sites we referenced so you can learn more:

Washington HealthPlanFinder
Blog post on Qualifying Life Events
ParentHelp123.org

And as always, you can call our Family Health Hotline at 1(800) 322-2588 for assistance.

Tags: Family Health Hotline   health insurance   Open Enrollment   Washington Health Benefit Exchange   Washington HealthPlanFinder   Washington state   

Beyond Open Enrollment: Qualifying Life Events

Updated & Written by Emma Lieuwen, AmeriCorps Program Lead 4/25/2017

You may have heard that the Open Enrollment Period for health insurance closed on January 31st. You might be wondering if you can still get health insurance. The answer is yes, but only if you have a Qualifying Life Event before the next Open Enrollment Period. We’re here to break it down for you and help you figure out your next steps.

What counts as a Qualifying Life Event?

Adding a Dependent

  • Marriage
  • Birth
  • Adoption
  • Foster Care
  • Receipt of a court order (including child support)

Loss of Other Health Coverage

  • Expiration of a non-calendar year health insurance policy (even if you have the option to renew)
  • Loss of pregnancy-related Medicaid coverage
  • Beginning or ending service in AmeriCorps, VISTA, or NCCC
  • Loss of Employer Sponsored Insurance (ESI)
  • Loss of Washington Apple Health (Medicaid)
  • Loss of a Qualified Health Plan due to permanent move

Did you know?

You can enroll in a plan up to 60 days before or after the loss of other coverage. But, be sure to wait until the month your other coverage will end so you don’t have a month of overlapping coverage.

Permanent Move

If you move and become a resident of Washington or move to a new county in Washington that results in new plan options.

Did you know?

A permanent move to Washington State is only a qualifying event if you had minimum essential coverage for at least one day within the 60 days before you moved?

Change in Citizenship or Lawful Presence Status

If you become a citizen, national, or lawfully present individual, you may qualify for a Special Enrollment Period.

Did you know?

Those with tribal membership (American Indian or Alaska Native), may enroll in a QHP or change from one QHP to another once a month (and access other benefits)!

Release from Jail/Prison

If you have at least one individual on an application that changes status from incarcerated to no longer incarcerated you may be able to open a Special Enrollment Period to sign up for coverage.

Special Enrollment Periods Only Available to Existing Customers

If you already have an account on WAHealthPlanFinder and are enrolled in a plan you can report the following events to open up a Special Enrollment Period to change your plan. You cannot get a Special Enrollment Period with the following events if you are a first time applicant.

Losing a Dependent or Dependent Status

Including:

  • Death
  • Divorce
  • Legal Separation

Filed or Reconciled Taxes

If you received tax credits in the previous year, you must have correctly filed a tax return even if you do not usually have to file taxes. If you do not file a tax return and reconcile the tax credit you received, you will lose the opportunity to receive a tax credit until the IRS has confirmed that you have filed your federal taxes.

Change in Income

If your income changes, you could lose or gain eligibility for (or change the amount of) health insurance premium tax credits (help paying your monthly premium).

If any of these happen, be sure to report the changes on Washington Healthplanfinder. You can find more information about Qualifying Life Events here.

Did you know?

If your income is below a certain amount, you may qualify for Washington Apple Health. If this is the case, you don’t have to wait for an Open Enrollment Period– you can sign up any time!

Don’t know where to start or what you qualify for? Give the Family Health Hotline a call at (800) 322-2588!

Tags: Family Health Hotline   health insurance   Health insurance enrollment   qualifying life event   Special Enrollment Period   Washington Apple Health   Washington HealthPlanFinder   Washington state   

Estoy inscrito en Washington Apple Health ¿Qué sigue?

Traducido del blog original escrito por Maritza Cazares, Especialista Bilingüe en Inscripciones & Asistencia Social.
Si usted ha solicitado un seguro de salud y está recibiendo cobertura médica por medio de Washington Apple Health (también conocido como Medicaid)  se ha de estar preguntando ¿qué sucede después? Nosotros tenemos las respuestas a algunas de las preguntas más comunes que hemos estado oyendo de personas llamando a nuestra Línea de Salud Familiar.
Tengo seguro por medio de Washington Apple Health. ¿Qué pasa ahora?
¡Felicidades! Casi dos semanas después de inscribirse usted recibirá una tarjeta de servicios azul (también conocida como la tarjeta ProviderOne) en el correo. Conserve bien a esta tarjeta, ya que comprueba que usted está inscrito en Washington Apple Health y querrá mostrarla para sus citas al doctor y para recoger recetas.No es necesario activar su tarjeta, ya que su cobertura y la tarjeta estarán activas el día después de su inscripción. La tarjeta se ve así:

providerone

 

 

 

 

 

Dentro de un mes de inscribirse en Washington Apple Health, también recibirá una tarjeta blanca con el nombre de su plan de salud, que es la compañía de seguros por la cual recibirá su cuidado médico.

He oído a gente hablar de ProviderOne. ¿Qué es ProviderOne?

ProviderOne es el sistema computarizado que coordina sus planes de salud también conocido como “Managed Care”, que están disponibles bajo Washington Apple Health (Medicaid) . Si usted está inscrito en Apple Health, usted puede manejar su cobertura a través del Portal del Cliente ProviderOne . Los proveedores de salud también pueden utilizar el Portal del Cliente ProviderOne para comprobar y ver si está inscrito en Washington Apple Health.

Han pasado dos semanas y no he recibido mi tarjeta ProviderOne. ¿Qué debería hacer?

Si usted no ha recibido su tarjeta dos semanas después de que se haya inscrito, puede llamar a servicio al cliente por medio de línea de la Autoridad de Salud al 1-800-562-3022. La buena noticia es que todavía puede ir al médico y recoger las recetas antes de tener sus tarjetas. Usted sólo tendrá que ir a una clínica o farmacia que acepte Washington Apple Health (Medicaid) y su plan de salud. La clínica o farmacia puede buscar su Identificación de cliente ProviderOne sin la tarjeta y le preguntaran por su nombre, fecha de nacimiento y número de seguro social.

¿Cómo puedo saber a qué plan de salud me he inscrito?

Después de entregar su solicitud de Washington Apple Health usted tiene la oportunidad de elegir en cuál de los seis planes de atención administrada desea inscribirse.  Si usted no sabe en qué plan desea inscribirse, no se preocupe; se le asignará un plan automáticamente durante la noche del día en que su solicitud es recibida, sin embargo,  usted puede cambiar su plan si resulta que no es el que desea.

También recibirá un libro Medico de Beneficios llamado Healthy Options, con información sobre sus beneficios y planes disponibles en su área. También puede ver esta publicación como un archivo PDF.

¿Qué plan de cuidado administrado debería elegir?

Se requiere que todos los planes de cuidado administrado proporcionen un conjunto de servicios básicos, por lo que a la hora de elegir un plan de atención administrada puede ser útil tener dos cosas en cuenta:

●    ¿Qué planes acepta su médico?

  • Algunos médicos aceptan algunas coberturas de Washington Apple Health de cuidado administrado y otros no. Por lo tanto, es importante que llame a su médico o clínica para ver primero si aceptan Washington Apple Health, y si es así, qué planes de cuidado administrado toman.

●    Beneficios Adicionales

  • Además de los servicios básicos ofrecidos por todos los planes de atención médica administrada, los planes también proporcionan beneficios únicos adicionales que pueden ayudarle a tomar su decisión.

¿Cómo puedo cambiar los planes?

Hay maneras diferentes en las que usted puede cambiar los planes de cuidado administrado. Usted puede acceder a su ProviderOne Portal del Cliente, por correo o fax (1-866-668-1214) el formulario de registro incluido en el folleto de beneficios médicos Healthy Options, o llame a línea de Apple Health de Servicio al Cliente (1-800-562-3022).

¿Puedo seguir viendo a los mismos proveedores de atención médica con mi nuevo plan?

Su proveedor de atención médica sólo podrá aceptar ciertos planes de cuidado administrado, aunque generalmente aceptan Washington Apple Health (Medicaid). Llame a su médico para ayudar a determinar cuál es el plan que elegirá.

También puede llamar a su plan de atención administrada o visite su sitio web para obtener una lista de proveedores de cuidado de la salud en su área.

Tags: ACA   Affordable Care Act   health insurance   Washington Apple Health   Washington Health Benefit Exchange   Washington HealthPlanFinder   Washington state   

Adulting: Health Insurance Style

Written by Outreach & Enrollment Specialist/AmeriCorps Member Anne Mulligan

Taking responsibility for your own health insurance when you turn 26 can be quite the daunting task. Luckily, lots of us at WithinReach feel your pain, and we’re here to help! AmeriCorps member Anne breaks it down in the universal language: a list of GIFs.

 

 

 

 

When the Affordable Care Act (ACA) passed in 2010, I breathed a huge sigh of relief. Not only did it provide access to health care for millions of Americans, but it allowed me to stay under my parents insurance until I turn 26. This meant I had a few more blissful years of having coverage and not needing to understand insurance jargon and the confusing system!


via GIPHY

When I had my 25th birthday (and quarter life crisis) I realized that I had a fleeting year of insurance ignorance left, but was fortunate to start working at WithinReach, which provided me with a crash course in health insurance! Even with the best experts training me, I still get confused with all the terms thrown around and can imagine it is even more confusing for my peers who are not discussing health insurance like it’s their J-O-B.


via GIPHY

While some may be lucky enough to have a grown up job and get insurance through their employer, there are many of us who are not offered benefits and must enter the world of grown up decisions regarding our health.  But where does someone even start?!?!?


via GIPHY

If you’re like me, sitting and reading  dry materials gives you flashbacks to college days of sleep deprivation, so this helpful video and its fun graphics make things a little more manageable. Deductibles, co-insurance, and co-payment, oh my!

Also, did you know that another thing the ACA enacted was penalties for those who are uninsured?


via GIPHY

So make sure you take care of your insurance needs or else pay a penalty at tax time.

So now you generally know what’s what in the insurance world… but what is the next step?


via GIPHY

If you’re in Washington State, you can call our SUPER friendly Family Health Hotline at (800) 322-2588 and get immediate help over the phone signing up for insurance, or you can visit the Washington Health Plan Finder. But it’s way more fun to call us and picture this in your head as we help you:


via GIPHY

And don’t forget that open enrollment for 2016 is over on January 31st–you don’t want to miss this deadline!

Tags: get enrolled   health insurance   Open Enrollment   

Open enrollment is here!

November 1st marks the start of open enrollment for health insurance! This is great news for many Washington families who have been waiting for the opportunity to enroll into affordable, comprehensive health insurance. Open enrollment means that you can shop for and enroll in the right health insurance plan for you and your family. If you want coverage that begins on January 1st, you must enroll by December 23rd. So don’t wait! Open enrollment closes on January 31st.The WithinReach Family Health Hotline is here to help you navigate the process of applying for and helping you enroll into the plan that will meet your needs. Here are some things to consider before selecting and purchasing a plan:
 

What do you need out of a Health Plan?

Health Plans are not one size fits all. If you plan on using your coverage only for preventive care, you may think that the cheapest plan is the best fit. But accidents happen—and they can lead to hefty out-of-pocket costs depending on the type of plan that you purchased. If you have existing health conditions or take prescription drugs, there are certain plans that can help keep your money right where it belongs: in your pocket. It can be helpful to think through all that you need from your health insurance before beginning the enrollment process so you end up with the best plan for you.

You may be eligible for subsidies to help you pay your premiums.

Worried about how having health insurance would impact your budget? You may be eligible for tax subsidies (also known as tax credits). Tax subsidies can help lower the cost of your monthly premium. You can apply these credits to your premium amount right away so that your monthly health insurance payment is affordable.

More plans means more competition–and that is a WIN for you and your budget!

There are a lot more plans to choose from this open enrollment period. Competition between these plans means that many plan premiums are lower that they were at last open enrollment. You should shop around even if you are already enrolled in a Health Plan. Even if you think your health plan is great, check out the other plans that are out there. Chances are, you will find a plan that is better and at a lower cost than the amount that you are already paying.

Avoid getting fined for not having health insurance.

Don’t pay a penalty for not having insurance coverage for you and your family. The fine for not having insurance in 2016 can cost you as much as $695 per uninsured person in your household or 2.5% of your yearly household income. That means that when you file your income taxes, the amount that you pay the IRS could increase fast! And if you anticipate a refund at tax time, the penalty can lower the amount that would otherwise go back into your pocket.

You may be eligible for free coverage today!

Depending on your income and other factors, you could qualify for immediate coverage. Washington Apple Health coverage is comprehensive and free, and will cover you today!

How can the WithinReach Family Health Hotline help?

Enrolling in a health plan can be confusing. Our friendly and knowledgeable staff can help you make sense of your options and apply for coverage for you and your family. Not only can we get you enrolled into affordable medical coverage over the phone, but we can also help you access other programs that can help you and your family stay healthy. Don’t hesitate to call the Family Health Hotline at 1-800-322-2588.

 

 

Tags: ACA   Affordable Care Act   Family Health Hotline   health insurance   Health insurance enrollment   Open Enrollment   Washington Apple Health   WithinReach   

Calling on Mom: How do I find a doctor who takes Washington Apple Health?

Congratulations, you have successfully been approved for and enrolled in Apple Health! You may be wondering what happens now—how to take the next step and actually use your new health insurance plan to see a doctor (or other health care provider). Accessing your new benefits can be a confusing process to navigate at first, but with a little information and some planning, you will be able to begin using your coverage.There are a few things to take into consideration with Apple Health when preparing to visit a doctor.

If you have a doctor that you would like to continue seeing…

You will want to contact your physician’s office to see if they accept Apple Health and–if they do–if they have a preferred network. Asking these questions will guide your next steps and put you on the right track so you can continue to see your preferred physician.

If your preferred doctor DOES accept Apple Health…

That’s great!  Now that you know your physician’s preferred Apple Health network, you will want to request enrollment into that network. For assistance and guidance regarding this process, you can call our Family Health Hotline at 1-800-322-2588.

When you’re ready to enroll in a specific network, you can call the Medical Assistance Customer Service Center at 1-800-562-3022 to enroll into a specific network or log into ProviderOne (make sure you use Windows Explorer as your browser) to switch your enrollment online.

If your preferred doctor DOES NOT accept Apple Health

That’s too bad, but don’t panic! You have a few options to choose from. If you have yet to be assigned a specific network or Managed Care Health Plan, you can call our Family Health Hotline and we can find you a clinic in your area that accepts Apple Health.  If you have already received your Managed Care Plan, you will have an assigned primary care provider (PCP) or clinic printed on the front of the card along with a contact number.

If you DO NOT have a preferred doctor…

You should be able to follow the same steps as if your provider does not accept Apple Health. You can contact our Family Health Hotline to find a clinic in your area who accepts the coverage or you can refer to your Managed Care Plan card to see the PCP you have been assigned to.

Keep in mind that you can always switch your Managed Care Plan if you do not like the plan that you are currently enrolled in or if you have already been in enrolled into a plan that your preferred physician does not accept. If you have any questions about your coverage and need help navigating your health insurance benefits, please call our Family Health Hotline at (800) 322-2588. We are here to help you!

For general information about your Apple Health coverage, read our other blog post, I Have Insurance Through Washington Apple Health. What Is Next?

 

Chris_MomBlog

 

Our resident Mom (also known as Chris Gray) is a fulltime mother to a rambunctious and curious 2 year old, and is expecting her second child in early March. During the day, she is also an Outreach and Enrollment specialist at WithinReach and a Certified Navigator. Chris has first-hand experience being enrolled in programs such as Apple Health and WIC. She also supports the Breastfeeding Coalition of Washington and is a Certified Lactation Educator.

 

 

Tags: Apple Health   Family Health Hotline   health insurance   Washington Apple Health   

Do You Believe in Magic?

Dr. Paul A. Offit’s book Do you Believe in Magic? The Sense and Nonsense of Alternative Medicine examines the $34-billion-a-year business known as alternative medicine. Dr. Offit is chief of the Division of Infectious Diseases and director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, and a vocal advocate for immunizations.

Dr. Offit understands the allure of alternative medicine and begins with the story of his own disappointing experiences utilizing the modern healthcare system. He gets multiple incorrect diagnoses, including one which led him to believe he was dying from a fatal illness for two years. In another incident, he awoke from what he had been assured would be minor knee surgery to learn that it had been a major surgery which would take a year to recover from. Offit says, “the miscalculation didn’t seem to surprise or upset the orthopedist. But it upset me.” Through misadventures and mixed advice, Offit looks into the chasm between modern and alternative medicine.

Offit argues that the popularity of media celebrities who promote alternative therapies, such as Dr. Mehmet Oz, comes from their offer of “an instruction book for something that doesn’t come with instructions: life.” These superstars, as he calls them, claim that following their advice will enable you to live longer, love better, and raise happier children. Who doesn’t want the playbook for how to live life? Unfortunately, this playbook is often full of medicine that doesn’t work.

One chapter is dedicated to the myth that vaccines cause autism, a belief propagated by celebrities like Jenny McCarthy. Offit doesn’t fault parents for searching for a cause for their child’s autism. He understands how easy it is for parents to believe in untested theories and describes how the unfounded fear of vaccines has allowed a resurgence of vaccine-preventable diseases in the United States and incited parents to fear vaccines more than the diseases they prevent.

Part of the appeal of alternative medicine is that it is personalized. Offit acknowledges that modern medicine often leaves a patient feeling more like a number than an individual. He recognizes how the fluidity of modern medicine can be unsettling, highlighting that many alternative medicines have remained unchanged for hundreds even thousands of years, which begs the question: Haven’t we increased our knowledge of human anatomy and disease over these years?

The continual evolution of modern medicine should be comforting. We are constantly learning and applying that knowledge to medicine, which in turn adapts – resulting in new and changing treatments and recommendations.

Paul Offit is a supporter of medicine that works – he does not discriminate against type of medicine, whether alternative or conventional, he only distinguishes between medicine that can be proven to work and medicine that only pretends. Offit argues that proper evaluation of all medicine is paramount. With over 40 pages of notes and selected bibliography, Offit uses the platinum standard in scientific reasoning—a case-control study—to make his point. If the treatment proves to make a difference in comparison to its control than he simply calls it medicine that works. Summing up the timely takeaway message of the book, he writes:

 “Although conventional therapies can be disappointing, alternative therapies shouldn’t be given a free pass. I learned that all therapies should be held to the same high standard of proof; otherwise we’ll continue to be hoodwinked by healers who ask us to believe in them rather than in the science that fails to support their claims. And it’ll happen when we’re most vulnerable, most willing to spend whatever it takes for the promise of a cure.”

Tags: alternative medicine   Autism   Dr. Paul Offit   immunizations   preventable diseases   Public Health   vaccines   WithinReach   

Coloring Isn’t Just for Kids

I have never worked with a more productive group of people.
WithinReach staff get SO much done!

The last few weeks have been insanely busy for us. Responding to a wave of media requests in reaction to the recent measles, coordinating stakeholders across the state to help pass Breakfast After the Bell legislation, helping thousands of families apply for or renew their Apple Health coverage, bringing our experience and expertise with the Affordable Care Act to a Health Benefit Exchange Board meeting, attending listening sessions with the US Surgeon General, Vivek Murthy, MD, during his visit to Washington…..The list goes on and on – and our staff are always ready to step up, to say ‘yes’, to dig in and do more to make the connections WA families need to be healthy. Though this may be a recipe for success, it most certainly creates some stress.

That’s why I decided to share a recent Huffpost article at our staff meeting this week. The article, Coloring Isn’t Just For Kids. It Can Actually Help Adults Combat Stress., says that it has been found that coloring – that’s right, crayons and coloring books – has the power to reduce stress. In fact, the article says coloring “generates wellness, quietness and also stimulates brain areas related to motor skills, the senses and creativity”.

Many of us are ‘yellow pad doodlers’, so this makes sense. Not only did I share the article, but I offered staff the opportunity to color during staff meeting and beyond. Staff jumped in, and the accompanying picture highlights the result of our staff meeting coloring.

I realize coloring will not reduce the demands placed on our staff, or the crazy fast pace with which they work, but perhaps it brought a small moment of quietness to the day – and hopefully, the message that we care about the health and well-being of all WA families – including our own.

 

Tags: Affordable Care Act   Breakfast After the Bell   coloring   creativity   Health Benefit Exchange   Huffpost   Measles   stress-relief   vaccines   Washington Apple Health   Washington families   Washington state   WithinReach   

Search Blog