AmeriCorps Week: Language is a source of empowerment!
There was one particular client story I walked away with from this experience that enhanced my perspective of language barriers. This client helped me see the other side of this complex barrier by showing me how much language is a source of empowerment.
Mariana** is a middle-aged Latin American woman who approached me toward the end of the event accompanied by a volunteer interpreter. She sat down and prefaced the conversation by saying that she wanted to try to communicate with me independently, but she also wanted the interpreter present in case there was any confusion. Mariana told me that she had recently become self-employed and was having difficulty navigating the exchange to choose a health plan for herself. The interaction was more drawn out than my usual interactions to confirm understanding on both ends; there were occasional tangents in Spanish until Mariana remembered that I didn’t understand. Since it was the end of the day, we weren’t able to complete the interaction with the purchase of her health plan so we exchanged information in order to complete it over the phone at another time.
In the following weeks we exchanged multiple phone calls so I could complete her application, explain the terminology surrounding insurance, guide her through the process of going to Staples so she could fax me her income verification, and finally purchase a plan.
In the months of my service I’ve had a wide range of final remarks from clients after finishing an interaction with them: “Finally,” or “glad that’s over,” as if the service was something I had withheld from them that I had finally granted. However, most of the final remarks are those of gratitude: “Thank you for making this easy for me,” and “thank you for being so kind.”
On my last phone call with Mariana she said, “Noelle, before you go I want to tell you something…” She thanked me first for assisting her with her application, but then went on to thank me for taking the time to understand her. She said that she had always been nervous about speaking English in public for fear of not being understood or taken seriously. She said she truly felt that our interactions had occurred in such a way where she understood what I was telling her and that I understood what she was trying to say.
Before my work with Mariana, I had seen my AmeriCorps service as a way to tear down the general systemic barriers that prevent people from accessing the resources they need. Now, I view my interactions with clients as opportunities to build bridges to resources despite these barriers. The value in our work comes from providing assistance that is personal and empathetic to the difficulties of navigating complicated systems.
**Client name has been changed to protect privacy.
All It Takes Is One Accident!
Edited by: Kari Geiger, WithinReach AmeriCorps Program Lead
The current deadline for enrollment is February 15th 2015! Create an account or log in to your account on www.wahealthplanfinder.org today to update your application and explore your options. For tips and tricks, check out some articles we wrote over the past year:
- What to consider when buying a Qualified Health Plan
- How to Apply For Health Insurance If Your Income Is Unpredictable
- Self employed? We Have Answers to Your Health Insurance Questions
- I bought health insurance through the Washington Healthplanfinder. What’s next?
Remember: The deadline to enroll is FEBRUARY 15th, 2015, so log on today or call us for help through our Family Health Hotline for assistance at: 1-800-322-2588!
Tags: Accident Family Health Hotline finances health insurance Health Plan Healthcare insurance coverage Open Enrollment out of pocket WA HealthPlanFinder Washington Health Benefit Exchange Washington state
Being Prepared Over Feeling Invincible: Why Medical Insurance Is Important While You Are Young
Not Having Health Insurance Might Impact Your Family’s Finances!
Health insurance is a very broad term and could encompass a variety of health insurance plans. For the purposes of the Affordable Care Act health insurance coverage is determined by a standard called “minimum essential coverage”. If a health plan has this label, it means that it has met the federal standard of a quality health insurance plan. For many people the establishment of minimum essential coverage plans now provides a higher quality and broader scope of service from their health insurance providers than what was available prior to the Affordable Care Act. All minimum essential coverage plans must cover 10 essential health services that are outlined here. For a large number of people, the minimum essential coverage requirement has been met through their existing health plan. If not, the Affordable Care Act has created new health plan options.
Common types of minimum essential coverage:
- The vast majority ofemployer-sponsoredhealth plans
- All of theprivate health plans offered through the Washington HealthPlanFinder
- Apple Health plans offered through the Washington HealthPlanFinder
- TRICARE plans offered through the US Military
For some people, there will be no changes in their health plans or how they apply for health insurance. But for 41 million uninsured Americans , the enactment of the Affordable Care Act has opened new doors to affordable, accessible and quality health insurance coverage. In Washington State, new health insurance plans are now offered through the Washington HealthPlanFinder with government subsidies such as tax credits and cost sharing reductions to make the insurance more affordable for most individuals and families. Other programs, like Washington Apple Health, have expanded to allow more people to enroll in free and low-cost health insurance. These new options present viable opportunities for health insurance that have not existed in the past.
What happens if I did not get health insurance?
If an individual or family was not able to enroll in a health insurance plan in 2014, they could face a fee when they file their 2014 taxes. This fee acts as the enforcement piece of the Affordable Act Care and it is commonly referred to as the individual responsibility requirement. In order to make health insurance affordable and accessible to everyone, the majority of people need to participate. Fees acts as a way to hold each other accountable and keep the overall cost of health insurance low. The amount of the fee will vary by household. The basic fee schedule for not having health insurance in 2014 and 2015 is:
Are there any other options?
The fee is not designed to punish people that cannot afford health insurance or have experienced hardship. There are a number of reasons why someone may not have been able to enroll in health coverage over the past year. In response to the unique needs of individuals and families, the federal Health Insurance Marketplace offers exemptions that allow people to go insured for short periods of time or to be completely exempt from the individual responsibility requirement and therefore exempt from paying any fees associated with not having health insurance.
To find out more about the exemptions offered through the Health Insurance Marketplace and how to apply for them, call the Family Health Hotline at 1-800-322-2588 or contact us through our website: ParentHelp123.org
2015 Open Enrollment for the Washington HealthPlanFinder is happening now to February 15th. Call the Family Health Hotline to speak to a Health Insurance Navigator about your options: 1-800-322-2588.
 Kaiser Family Foundation. Key facts about the uninsured population. http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/
Tags: ACA Affordable Care Act Family Health Hotline fee exemption options Health Coverage Health Fee health insurance Health insurance enrollment marketplace ParentHelp123 TRICARE uninsured Washington Apple Health Washington HealthPlanFinder Washington state
WA Healthplanfinder Gets a Makeover: 6 things you need to know!
WithinReach Bridge to Basics Outreach team, AmeriCorps
The sign in button is now located in the upper right corner. Additionally, there is now a designated section on the homepage to directly access Apple Health Renewals and Enrollment in the middle of the page.
“Is any member on this application a child 26 or older seeking adult disabled dependent coverage?”
Answer “yes” to this question if one of your dependents is an adult child with a disability; meaning, they cannot work due to their disability and are financially dependent on you. How this question is answered won’t affect your eligibility for Apple Health.
If someone is covered by Medicare, they are likely ineligible for Qualified Health Plans and Apple Health.
After submitting your application, you will be taken to the Eligibility Status screen. This page provides the following information for each member of your household:
- Eligibility status (Approved, Ineligible, Conditional, etc)
- The program name (for example, Washington Apple Health)
- Coverage dates
- Next steps
Change #4: Pending Coverage and Document Upload
If you, or someone on your application, has a “pending coverage” eligibility status, you may be required to submit documents for additional verification. You can click the “upload documents” button to upload files. If you are prompted to submit documents, do so as soon as possible to avoid losing coverage.
If you need to report a change on your application, you can now see how the change affects your eligibility. This is an improvement from how change reporting used to go, which required you to select and purchase a plan if you tried to make a change.
This year, there will be more Qualified Health Plans to choose from. Be sure to shop around, consider your needs, and explore your options to make sure you’re getting the best plan for your needs and budget.
March Is the Time to Enroll In Health Insurance
Written by Jefferson Rose, Bilingual Community Outreach Specialist
This weekend we hosted a health fair and health insurance enrollment event at the Lynnwood Senior Center with free blood pressure screenings, kids activities, chair massages and health plan information.
The event was part of a statewide push to enroll as many people as possible before the end of March, the deadline to sign up for coverage and not be subject to the tax penalty. There have been a lot of dates and times floating around, but the Washington Health Benefit Exchange recently announced the official guidelines. For coverage to begin April 1st for a Qualified Health Plan, payment must be received by 5 PM on March 23rd.
Open enrollment does continue through March 31st, and if you enroll between March 24th and the 31st, coverage will begin May 1st. If you do not enroll by the March 31st deadline, your next opportunity to apply for health coverage will be November 15th. If you are income eligible for free coverage (Washington Apple Health Medicaid), open enrollment is year-round.
There are many events across Washington where people can sign up or get more information. Visit the WithinReach event calendar to see where we will be enrolling individuals and families for coverage or visit the Washington Health Benefit Exchange event calendar for an additional list of events across the state.
Come see us and enroll before the deadline!
How to Apply For Health Insurance If Your Income Is Unpredictable
Written by AmeriCorps member, Natasha Pietila
Since October 1st, we have received many questions about how to report complicated income on the Washington Healthplanfinder applications. Below, we discuss two common income questions.
Question: My income fluctuates every month. How should I report this on my application?
Answer: The Health Care Authority instructs Washington residents to report estimated monthly income. You should report the most accurate, up-to-date income for 2014. Here are some scenarios and tips:
- If you predict that your 2014 income will fluctuate and mirror last year’s income, you might report a monthly average income, based on last year’s income.
- If your income was stable last year, but is fluctuating now, you might report an estimated monthly average, based off your income earned since January 1st, 2014.
- If you know that your income will be changing, report a change of income on your application after it has stabilized. This may be particularly relevant to seasonal workers. If your income changes by $150 or more per month, report the new income within 30 days – you may make this change on your application, even after open enrollment has ended. Note that this may change your eligibility for the type of insurance which you are receiving and/or the government subsidies for which you are eligible.
Essentially, you want your income on the Healthplanfinder to match up with the income which you report to the IRS.
Question: I receive rental income. Do I report my gross or net rental income?
*Please note that there are exceptions. You should report the income which you report on your taxes and refer to an accountant for specific questions.
Self employed? We Have Answers to Your Health Insurance Questions
What To Consider When Buying a Qualified Health Plan
What is a QHP?
Qualified Health Plans are similar to the traditional health insurance plans that existed prior to the Healthplanfinder, with a few essential differences:
1) QHPs must cover the Ten Essential Benefits, as mandated by the Federal Government.
2) QHPs cannot deny coverage because of preexisting conditions.
3) QHP costs may be subsidized by the Federal Government, through tax credits (Health Insurance Premium Tax Credits) and cost-sharing reductions.
4) QHPs can be compared, side-to-side, on the Washington Healthplanfinder.
Please note: Dental coverage is not included in QHPs for adults but can be purchased, separately. Many plans do not offer adult vision coverage, but do offer adult hearing coverage.*
How can I narrow my search?
By medical provider:
- Click “Add”, listed under “Health Care Provider” in the “My Search” box, located on the upper left-hand side of the QHP selection screen.
- In the pop-up window, search by: your provider’s name, hospital, or zip code.
By price range:
- Cost parameters for premium, deductible, and out-of-pocket maximum, can be controlled by clicking on the price-range options in the “Customize My Search” box on the left-hand side of the QHP selection screen. For definitions of these, and other health-insurance related terms, refer to this glossary from the Federal Government.
- Another method for cost-based comparison is to search for plans based on metal level. There are three metal levels: bronze, silver and gold. These search options are located in the “customize my search” box on the left-hand side of the QHP selection screen. The Federal Government recommends considering medical needs when selecting a plan because “the lower the premium, the higher the out-of-pocket costs when you need care; the higher the premium, the lower the out-of-pocket costs when you need care”.
By comparison with other plans:
- To select a plan for comparison, click the “Add to Comparison” option, located in each plan’s box. You can compare three plans, side-to-side, at a time.
- Once you have selected plans for comparison, click the “View Comparison” tab, located at the top of the page.
Do I have to buy through the Washington Health Plan Finder?
No. However, you must purchase a plan through the Washington Healthplanfinder if you want to receive tax credits.
How do I enroll in a QHP?
1. Once you have, selected a plan, click “Buy”.
2. If you are ineligible for tax credits, please skip to step 3. If you are eligible for tax credits, you will be allowed to select how the tax credits will be applied. For more information about applying the tax credit, please refer to this blog entry.
3. Next, you will be required to pay for your first month of coverage. When purchasing a QHP, have an electronic form of payment ready to make the initial payment – either an eCheck , a debit card, or a credit card. For questions about subsequent payments, contact your QHP provider or the Washington Healthplanfinder customer support at: 1-855-923-4633.
What is the last day for buying a QHP?
The end of Open Enrollment and the deadline to get coverage, is March 31st, 2014 in order to avoid a penalty on your 2014 taxes. You should purchase a plan by March 23rd in order to ensure that your enrollment is processed and that your coverage is active by March 31st, 2014.
What happens after I buy a QHP?
Please to refer to this blog entry for information on what happens after purchasing a QHP.
I’m still confused. Where do I get help?
There are two types of help: Navigators and Brokers. Both services are free for you to use through the Washington Healthplanfinder. When selecting a QHP, keep in mind that Navigators are legally unable to recommend specific plans. For advice about which plan will be best for you and your family’s needs, contact a Broker – they are legally allowed to recommend plans. Brokers can be found through the Washington Healthplanfinder:
1. Click on the “Customer Service” tab in the upper right hand corner.
2. To search for a Broker in your area, enter your zip code.
Please note: Before clicking “Request Help” we recommend that you call and/or email the Broker you are interested in partnering with, to insure their availability.
*Finding Dental, Hearing, and Vision Coverage for each plan: To see whether or not a plan covers adult dental, vision, or hearing:
1. Click on the blue, “More Information on this plan” link located under the name of each plan.
2. Scroll down to the bottom of the page and click “See More Details”.
3. Scroll down to the bottom of the page, again, and click the blue, “Open Summary of Benefits and Coverage” link.
4. This will open a document that summarizes the entirety of the health plan. Search for the section titled “Excluded Services & Other Covered Services.” This will detail coverage for dental, eye, and hearing care.
I bought health insurance through the Washington Healthplanfinder. What’s next?
Written by Erin Milliren and Natasha Pietila
Question: I’ve enrolled in health insurance through the Washington Healthplanfinder. What happens next?
Answer: You can expect to receive your health insurance cards in the mail, along with information from your health insurance company and an eligibility letter from the Washington Healthplanfinder. Depending on the type of health insurance you are enrolled in, you will receive different information and items in the mail.
If you are enrolled in a Qualified Health Plan (i.e. a paid plan) you will receive the following information:
1) A card from the plan you selected and bought
2) You can also expect to receive information from that insurance company about your coverage
3) You will either receive an email or letter from the Washington Healthplanfinder stating which insurance plan you purchased and listing your coverage start and end dates
Question: When I submitted my application I was told that I’m eligible for tax credits. What does this mean?
Answer: It sounds like you are eligible for the Health Insurance Premium Tax Credit (HIPTC) which is designed to make your insurance options more affordable.* The amount of the credit is estimated instantaneously by the Healthplanfinder, based on the information you reported on your application. It is important that you update your income, if it changes, because the IRS will verify the tax credit amount when you file your taxes. The IRS Facts About The Premium Tax Credit sheet explains how you can use this tax credit:
– Get It Now: have some or all of the estimated credit paid in advance directly to your insurance company to lower what you pay out-of-pocket for your monthly premiums during 2014; or
– Get It Later: wait to get the credit when you file your 2014 tax return in 2015
All of these methods can be managed on your Washington Healthplanfinder account.
*For a brief explanation about the purpose of the HIPTC, you can refer to this information from the Federal Government.
Here’s a review of what to expect when you become enrolled in Washington Apple Health:
If you are enrolled in Washington Apple Health (i.e. Medicaid) you will receive the following information:
1) A blue ProviderOne card, which is imprinted with information about your Medicaid coverage
2) A card from the Managed Care Provider (i.e. insurance company) to whom you will be assigned. There are five Managed Care Providers: Amerigroup, Community Health Plan, Coordinated Care, Molina, and United Healthcare
3) You can also expect to receive a Healthy Options booklet which contains information about your coverage
4) You will either receive an email or letter from the Washington Healthplanfinder stating that you are enrolled in Washington Apple Health and listing your coverage start and end dates
For more information, please see our blog post specifically dedicated to Apple Health.
Question: How long does it take to receive my health insurance cards?
Answer: According to Washington’s Healthcare Authority it will take about a month after your completed Apple Health enrollment to get you all set up with your health plan. If you need to go to a doctor or fill a prescription before your cards arrive, you can go to any doctor, health clinic, or pharmacy that accepts Apple Health. If you tell a provider or pharmacist your name, date of birth, and Social Security number, they can look you up online and find your ProviderOne client number.
You can find healthcare providers in your area at ParentHelp123.org.
Pregnant Teens and Washington Apple Health for Pregnancy: How to Apply!
Written by WithinReach Bilingual Outreach and Enrollment Specialist José Villalobos
• Prenatal care
• Post pregnancy follow-up
• Dental care
• One year of family planning services
• Newborns receive one year of full medical
This program also provides enhanced services such as Maternity Support Services, Infant Case Management and Childbirth Education. Teens looking to apply for coverage worry about having to report their parent’s income but for this program, no income or resource limits are taken into consideration. Any Washington State resident under 19 and pregnant is eligible! To apply, click on the following link, fill-out the form and send it to the Health Care Authority. Pregnant Teen Health Care Coverage. If you have any questions feel free to contact the WithinReach Family Health Hotline at 1-800-322-2588 to speak with our friendly and knowledgeable staff.
Health Insurance Enrollment: Which Dates Matter?
Yes. You may qualify for coverage that is of no cost to you, or coverage that will require you to pay a premium. The Affordable Care Act requires most U.S. citizens and legal permanent residents* to have health insurance coverage for at least 9 months of the year. Therefore, it would be best to enroll by the March 23 deadline so as to get coverage by April 1st and avoid paying a penalty on your 2014 taxes.
I have insurance through my employer at this time, but there is a chance that I will be laid off in the next few months. Will I be able to enroll in insurance after March 23rd without receiving a penalty?
Yes. Certain qualifying events like the loss of a job enable you to enroll without a penalty. For a list of other qualifying events, please refer to this list from the Federal government. Also, if you qualify for free coverage through Washington Apple Health (aka Expanded Medicaid), you need not worry since Washington Apple Health enrollment remains open, year-round.
*The Affordable Care Act mandates that Americans have health insurance, beginning in 2014. Those without insurance may be required to pay a penalty on their 2014 taxes. Some may be exempt from this mandate and will not have to pay a penalty if they do not have health insurance. For more information on these exemption eligibility requirements, please refer to this infographic from The Kaiser Family Foundation.