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.
‘Young Invincibles’ Helping ‘Young Invincibles’ Enroll in Health Insurance
Ring In the New Year With Health Insurance
Are you uninsured?
Enroll now for coverage starting January 1, 2014. Here is what you need to know:
- Don’t delay! Visit Washington Healthplanfinder to shop for health insurance plans and find out if you qualify for low-cost or free health coverage.
- For low cost coverage you must apply and make your first payment by December 23rd (to begin coverage on January 1, 2014).
- If you are found eligible for Washington Apple Health, also known as Medicaid, you do not need to do anything more.
Need help with your application?
We can help! We are certified health insurance assisters and, just in case you were wondering, we live and work in Washington too.
- If you live in King or Snohomish counties and need help applying for insurance, you can call the WithinReach Family Health Hotline at 1-800-322-2588.
- Visit our event calendar to find out where we are doing in person enrollment in King and Snohomish Counties. If you live outside of King and Snohomish counties find a navigator or broker near you.
Don’t have time to complete your application before December 23rd?
Don’t worry. December 23rd is the deadline if you want coverage to start January 1, 2014. Open enrollment goes through March 31st. Anyone who is enrolled before March 31st will not be penalized.
Turkey Talk: Your Guide to Surviving Health Reform Conversations This Thanksgiving
Original post created by Families USA
It’s easy to imagine. You’re enjoying a wonderful Thanksgiving meal with your family, savoring that last piece of pumpkin pie, when the conversation abruptly turns from the big game on television to the big changes from ‘Obamacare’. Suddenly you realize that your closest relatives have no idea what is in the new health reform law—or even worse— believe the malicious lies and rumors surrounding it. Your first instinct may be to run and get a DNA test. Luckily, you know exactly what to say to each of your relatives to debunk any false notions they have, and you can help them understand how their lives will improve under the Affordable Care Act.
Grandma, who’s on Medicare: “Reform’s going to destroy Medicare!”
Perhaps Grandma fell for some of the opposition scare tactics and now expects death panels
and the ruination of Medicare. Short of unplugging her cable television, you can gently
assure her that health reform actually strengthens Medicare and lowers some of her out-of-
What to tell grandma: Health reform gradually eliminates the Part D doughnut hole, meaning that if your grandma is one of the 3.4 million beneficiaries who fall into the doughnut hole each year, she will receive substantial and immediate savings. In addition, she will get free preventive care, so she can save those dollars she would have spent on check-ups for spoiling her grand-kids.
Uncle, 52 and laid off: “No job, no insurance—what am I going to do?”
Your uncle thought he could count on his health insurance, just like he can always count on watching football after the turkey dinner. Turns out, that’s not the way the insurance game works. Now, out of a job and not yet eligible for Medicare, your uncle may struggle to find affordable coverage in the individual private market.
What to tell your uncle: Health reform guarantees that older adults who are no longer covered by their employer will be able to get high-quality, affordable health care through a new marketplace called a health insurance “exchange.” The Washington Healthplanfinder allows your uncle to easily compare different plans and pick the one that best suits his needs.
Aunt, with a pre-existing condition: “I always worry that one day the insurance company will just cut me off.”
Like a vegan on Thanksgiving, she may feel like there just isn’t anything in it for her. But that simply isn’t true. Even though her breast cancer has been in remission for years, insurance companies had been allowed to deny her coverage based on this pre-existing condition.
What to tell your aunt: Health reform has brought long-overdue consumer protections to the private health insurance market so that she can no longer be denied coverage or charged exorbitant premiums because of her pre-existing condition, health status, or gender. Plus, the cost protections in the exchange will prevent her income from being “gobbled” up by insurance premiums.
Cousin, just out of college: “There are no jobs with insurance out there.”
In this economy, finding a job right out of college can be more difficult than figuring out what to do with all that leftover turkey, and finding one that also offers health insurance can be even more challenging.
What to tell your cousin: Health reform allows your cousin to stay on his parent’s health insurance plan until he turns 26. He may not yet have his dream job, but at least he can rest assured knowing that he will no longer have to go without needed care as he builds his new career.
Sister, small business owner: “It’s tough paying for employee health coverage.”
Your sister may be more interested in the day-after-Thanksgiving sales than what’s going on in Washington, but it’s important to remind her that she too will benefit from health reform. Like thousands of small business owners, your sister may want to offer her employees quality health coverage but fear she can’t afford to do so.
What to tell your sister: Health reform gives her the opportunity to provide affordable coverage to her employees at a fair price. She will be able to shop for coverage in the exchange, where she can easily compare prices, services, and the performance of various health plans. And a new tax credit will help pay a portion of her cost for employee coverage.
What to tell everyone: Perhaps your family is lucky in that everyone is in good health and securely employed. But before they write off health reform, have them consider how it is helping families who are less fortunate. Health reform will provide secure and stable health insurance for millions of American families. In addition, it will help protect the health of the lowest-income individuals by expanding the Medicaid program and providing subsidies in the exchange.
If none of what you say works, and members of your family continue to argue over the merits of reform, politely remind them that all this screaming could cause high blood pressure— which is, after all, a pre-existing condition! If any of your family or friends have questions about enrolling in health insurance they can call the WithinReach Family Health Hotline at 1-800-322-2588 or visit ParentHelp123.
WithinReach Starting New Health Insurance Enrollment Sites in Snohomish County
Health Insurance Enrollment Locations:
Mountlake Terrace Library
23300 58th Ave W
Mountlake Terrace, WA 98043
Thursdays, December 5th, 12th and 26th from 2:30 PM – 6:00 PM
Saturday, December 21st from 11:00 AM- 3:00 PM
6027 208th St. SW
Lynnwood, WA 98036
Fridays, December 6th, 13th, 20th and 27th
9:30 AM-1:30 PM
Bring the following items with you:
- Social security number (for all applicants)
- For household members that are not US citizens: Legal Permanent Resident Card or other immigration documentation (for LPRs we will need this AND the SSN)
- Date of birth (for all applicants)
- Tax filing status for the past year, current year and anticipated status for next year
- Information on your current health plan
- May need to bring an electronic form of payment (i.e. credit or debit card, pre-paid Visa, e-check)
Can’t make it to either location? Call 1-800-322-2588 or visit www.ParentHelp123.org
Health Reform Isn’t Just About Individuals; It’s About Communities
There has been a lot of water cooler chatter on health-care reform. Comments cover the technology issues, the creative ads to engage young people and media splashes by groups trying to overturn the Affordable Care Act. Absent from these conversations is the real goal of health reform — to transform our nation’s health. This is not just a feel-good effort, but a real chance to strengthen the fabric of our country and make our nation more globally competitive. Good health is at the core of a healthy economy.
Key indicators from institutions such as the World Health Organization show that health and the health-care system in the United States are substantially worse than those of other developed countries. The U.S. has some of the best health-care facilities, yet behavioral factors such as physical inactivity, smoking and diet — combined with socio-economic disparities — result in poor health outcomes. Innovative solutions from the individual to the national levels are needed to address our future health-care challenges.
The Affordable Care Act is one step toward improving individual and community health. The real potential of the Affordable Care Act is as a catalyst for change. Since 80 percent of health is determined by one’s environment, behaviors and socio-economic circumstances, we all need to change how we live. Our focus must be on the holistic wellness of the individual that includes food, shelter, education and jobs.
Our current system is broken if a family faces financial crisis or foreclosure in order to pay for cancer treatment. Or if a construction worker cannot afford an emergency room visit and opts to stitch up his own injury. Or if a mom struggles to put food on the table or make the right preventative health-care decisions for her child.
Government’s role has shifted from safety net to change agent. The Affordable Care Act has the potential to be a trigger for social change that will give that family, that construction worker and that mother the options and opportunities to think differently about their health. This is going to require the state Legislature, corporations, nonprofit organizations and government agencies to work together differently. We can no longer view affordable housing, health care, food security or transportation as unrelated issues.
In our community, taking care of vulnerable populations means targeting the disparities that prevent them from accessing services. That is a good investment. Social change is hard. It is much easier for us to talk about change and focus on our small piece of the system. What we need now is great community leadership and dogged persistence. We need a Legislature that will put the needs of families ahead of politics. We need nonprofits to stop competing with each other for grants and instead find ways to collaborate. We need government agencies to stop clinging to the way it was and embrace new technology, new media and new practices. But most of all, each one of us needs to commit to behaving differently.
The complexities of health reform dwarf even the most well-resourced and well-managed organizations. We have an opportunity before us to use health-care reform as an even larger chance at social change. But true social change requires all stakeholders involved in the issue to understand the problem and their role in being part of the solution. We must change our own behaviors by breaking down silos, forging long-term partnerships and connecting with others who are experts in particular areas of work. This way, we can leverage the investments being made in this state as part of health-care reform to create a better Washington state for each and every member of the community.
The Affordable Care Act: Improving the Health Assets of Individuals in Washington
Last week we hosted our first webinar about the Affordable Care Act and the changes in how people access health insurance in Washington. Around 100 Community organizations and professionals joined us for information on Medicaid Expansion and the new options for health care coverage on Washington Healthplanfinder, our state-run Exchange. If you missed the webinar you can download the presentation slides or watch the webinar recording to learn more about who is covered under the Medicaid expansion, immigrant eligibility, where to find help applying and more.
Here are answers to a few of the questions asked during the webinar. (Look here for more answers to Affordable Care Act questions in the upcoming weeks.)
What dental services will be covered for adults on Medicaid in 2014?
Starting January 1, 2014, Washington Apple Health will resume covering dental services for all adults with Medicaid. This Includes clients who already have Medicaid AND clients who are eligible for “Expanded Medicaid” as part of health care reform. The following services will be included in adult dental coverage:
- Routine Check-ups – exams and x-rays
- Preventive services – cleanings and Fluoride applications
- Dentures and Partial Dentures (prior authorization required)
- Restorative Fillings (crowns are not covered)
- Limited root canals (front teeth only)
- Extractions and limited oral surgery
- Additional services will be available for adults served through the Division of Developmental Disabilities.
For more details about dental coverage, see the following resources:
Who should I send to WithinReach for help?
At WithinReach we offer Basic Food application assistance and an extensive database of health and nutrition resources to clients across Washington State. Resources include community medical and dental clinics, WIC clinics, food banks, child development, parent support and more. Use our online Resource Finder to connect your clients to the resources they need.
For clients specifically looking for health coverage, our Family Health Hotline (1-800-322-2588) can assist with enrollment for King and Snohomish County residents and will direct clients to their local in-person assister for other regions of the state.
Finding Help in Washington State
Through Medicaid expansion, a large group of adults who would not have qualified for Medicaid in the past are now eligible for free health coverage. In our work on the Family Health Hotline phone lines, and outreach at community food banks, libraries and job training centers we meet people like Pamela each day.
Pamela recently relocated from Arizona to Belfair, WA in hopes of finding a job. After being laid off a year ago and losing her health insurance, Pamela struggled to find a job in Arizona. Living without health insurance for the last year has put mental strain on Pamela. She says, “I’ve worked my whole life and have never asked for help from anyone. I lost my job due to a merger and I can’t find a new one. I’m in my 60’s and I was taking medication for arthritis and hormone replacement when I lost my health insurance.”
Unable to see a doctor to get her prescriptions, Pamela could not take her medications, which caused her to often worry, ‘What if I get sick?, What if I get in an accident?’ The constant worry kept Pamela anxious and stressed most of the time. The move to Washington was a new start and she was excited for the natural beauty of Washington, and the potential of finding work.
Being new to Washington, and confused about the Affordable Care Act, Pamela did not know where to turn for help. She said, “I was so confused by ObamaCare. I was scared that I would not be able to afford health insurance and would be penalized. I tried to watch TV and stay informed but everything I heard was different. I could not get a hold of what was going on.”
A friend referred Pamela to WithinReach and within five days, we had helped her enroll in both Food Stamps and Washington Apple Health Insurance. For anyone who is unsure about signing up for health insurance, Pamela would tell them, “I had my doubts but the state of Washington has been more than gracious and helpful to me. I’m so impressed with how nice everyone is and how empathetic everyone is. It seems like people with children get most of the help but us older folks need help too. I am so grateful I found it.”
If you or someone you know is looking for help applying for health insurance or just wants more information about their options, they can call our Family Health Hotline at 1-800-322-2388 or visit ParentHelp123.
Mohamed Ali: A True Champion of Change
I am a refugee from Somalia, who swore to devote his personal and professional life to bettering the health and lives of Americans in 2004. I am someone who invested his entire education in health sciences and public health on two continents. I studied tropical medicine and researched solutions for curative tools for devastating pathogens in prestigious research laboratories. I never stopped following my dreams, and I changed my career path to population health, recognizing the unmet needs faced by many of my fellow Somalis in America and elsewhere.
Somalis in the United States confront many challenges accessing healthcare as well as in understanding and receiving health services and information. Health issues can be daunting, and few organizations are well equipped to handle the customs and language of my community. As a result, my people sometimes suffer. I decided to advocate and fill the gap in refugee health services, and I wanted to do something to ensure my community had access to information that would protect them. When a major storm headed for King County in 2012, I knew from experience that many immigrant communities may not be prepared. People had died from carbon monoxide poisoning in past storms when they tried to heat their homes with grills and other unsafe sources. This time, I worked with partners at King County and a local mosque to send a phone message to Somalis with information about storm preparedness and hotline number. We also set up a warming shelter and rented vehicles to bring meals to families. This time, nobody died.
Fortunately, good work sometimes gets rewarded, and mine was noticed by the White House! In September, I was was recognized as a Champion of Change at the White House. On September 24th, the same day I was honored as a Champion of Change, there was something else taking place in the capitol: Ted Cruz made his historic stand on the chamber floor, speaking for 21 hours about the need to defund the Affordable Care Act (ACA) in exchange for avoiding a government shutdown. He made his point, but as an immigrant who advocates for healthy equity and social justice for all Americans, I could not sit and let it go unaddressed. I got a pen and paper and expressed my opinion on the new law. It read “ YES ACA.”
It might not seem like much, but it was a monumental statement for me, the 2013 Champion of Change who was recognized for protecting his community from a potentially deadly winter storm.
I stood up with my sign in front of the Capitol Hill where Senator Ted Cruz made his speech. I choose to say ‘YES!’ to the Affordable Care Act, I choose to represent Americans who could not be there, and I spoke for millions of Americans who are voiceless and uninsured. I did it because health insurance companies should not be allowed to take advantage of us anymore and turn away million Americans with pre-existing conditions. I support the marketplace for all insurance providers to compete on behalf of consumers, hopefully leveling out uncontrollable premiums. I spoke for those tens of millions who are underinsured, the many who had coverage but were afraid of losing it, and the 50 million Americans who had no insurance at all. We are not asking government handouts here, but a fair system.
I believe all American families deserve to be healthy. That’s a big statement, I know. Let me explain how we think about it at WithinReach. To us, a healthy family knows they can see a doctor before there’s a crisis, not only when they are in crisis. They don’t have to decide between paying for groceries or paying the bills. They have a community that can support them and as a result they, in turn, can support others. Being healthy in these ways positions families for success in all ways. Unfortunately, there are thousands of families across Washington state who want to be healthy and could be healthy, but currently are not. Health must be seen as a central element of a thriving society and not something that causes constant anxiety and fear for our families. Let’s work together to make health a reality for all families.
Five FAQ’s About Health Care Coverage in Washington
Written by WithinReach AmeriCorps member, Lisa Andersen
There’s been no shortage of questions during Washington’s first month of health insurance open enrollment. Here are some questions we’ve heard from lots of people who want to sign up for health insurance coverage:
1. This is confusing – where can I get help with my application?
There are lots of ways to get help! The Washington HealthPlanFinder has a list of assisters who can help you: click the “customer support” tab in the top right corner of the page, and then click “find a navigator” on the drop-down menu. You can search by zip code for a navigator in your area. I suggest calling or emailing the navigator before partnering with them, just to explain the basics of your application and ensure that the navigator will be able to help you in a timely manner. If you live in King County, you can also search for enrollment events near you where navigators will be present to help you with your application in person. A list of enrollment events in King County is available here: http://www.kingcounty.gov/healthservices/health/personal/coverage/calendar.aspx.
At WithinReach we are also certified as “in-person assisters” by the Washington State Health Benefit Exchange, and regardless of your financial situation, we are here to guide you through this new system and help you understand and apply for health insurance. Visit our ParentHelp123 Benefit Finder or call the WithinReach Family Health Hotline at 1-800-322-2588 today to get started.
2. When do I need to sign up by, so I don’t have to pay a penalty fee?
There are several dates floating around that can be confusing for people who want to sign up for health care. We are often asked if people will be penalized for not signing up for health coverage by January 1st. Everyone should know that you have a lot more time than that to sign up for coverage before you have to pay a penalty fee. Coverage starts on January 1st, 2014, but you don’t have to send in your application before March 31st, 2014, if you don’t want to. You won’t get coverage until you sign up, but you can sign up at any point between now and 31 March without having to pay a fee.
3. What if I submit my application for health care, and then my financial situation changes drastically? What if I get a raise, or lose my job? Will I have to pay the same premium for the rest of the year?
Not to worry: if something in your life changes drastically after you submit your application, you are allowed to change your application without a penalty. Simply log in to your HealthPlanFinder account and click on the “Report a Change in Income or Household” link. The HealthPlanFinder will be able to calculate your premiums based on your new situation, and will prompt you to scan documents to verify your new situation if needed.
4. Will Medicaid pay for visits to the dentist?
Dental coverage is undoubtedly a huge concern for many Washingtonians who haven’t seen the dentist in months or even years. If you are eligible for Medicaid, you WILL HAVE dental insurance starting 1 January 2014. Dental coverage is being re-instated for Medicaid patients, so Medicaid patients who have not previously been able to see the dentist will be able to this January.
5. What about dental care for people who don’t qualify for Medicaid? Do the health plans on the Health Benefit Exchange cover dentist visits for adults or kids?
Health insurance plans purchased through the exchange are NOT required to include dental coverage, so be sure to read the details of the plan you want to sign up for to find out if dental coverage is offered or not. If you have kids under the age of 19, you will be required to have pediatric dental coverage for them, even if the health insurance plan you bought through the exchange does not offer it. That means you will have to purchase a pediatric dental plan in addition to your health plan.
Big Changes Lead to Big Rewards
At WithinReach, we are on the forefront of health care reform and are excited about the future of health insurance enrollment in Washington State. We believe that with investments in people and technology and respectful engagement with folks, health insurance for all can be a reality.
The launch of the Washington HealthPlanFinder website represents big changes for our state, and for how all of us access coverage. It has also meant changes here at WithinReach. We have grown our team and increased our capacity to reach the thousands of Washingtonians who are newly eligible for health insurance. We welcomed 14 new people to WithinReach in the last two months and our total staff team count is over 50. This is more than double the size of our team from two years ago. Our office is literally busting at the seams as we shift space to accommodate new staff and move teams together. We have broadened our work into additional communities and expanded our skills—all while maintaining the personal and friendly culture that make this a great place to work!
Of course with all this change and growth, come some growing pains. We experienced some of those growing pains first hand, with the technical glitches of the HealthPlanFinder website earlier this week. Health exchange websites around the country experienced many of the same glitches and delays due to the large numbers of people trying to apply online at the same time. Despite the technical issues, our team of In-Person Assisters was out in the community talking to Washingtonians at 14 sites in King and Snohomish counties. Our team talked to over 1,000 people about health insurance at these sites, and have also received close to 100 inquires for health and food assistance through ParentHelp123 this week alone.
Because of the challenges with the Washington HealthPlanFinder tool, we focused our outreach on education about what to expect next and creating appointments with individuals to sign them up for health insurance within the next few weeks. Despite some of the technology glitches, we have already seen the positive impact of the Affordable Care Act on our families. Last evening one of our outreach and enrollment specialists, Benito, enrolled a single mother and her daughter in health insurance plans through HealthPlanFinder. The mother called in with the intent of getting her daughter covered. She was skeptical about finding affordable health insurance for herself, and anxious about what ‘Obamacare’ meant for her family. Benito explained that there were likely affordable options for her as well as her daughter, and encouraged her to explore those options. After entering her application in HealthPlanFinder Benito learned that her daughter was eligible for Free Apple Health for Kids effective October 1, 2013 and that she was eligible for a tax subsidy for herself for coverage effective January 1, 2014. She was excited that her daughter was covered, but was still apprehensive about what kind of coverage she might be “forced to purchase”. Benito found a SILVER level plan that was free after a $559 tax credit.
Stories like this one make our day, and fuel our desire to do more. This mother came to us looking for health insurance for her daughter and she finished the call with free health insurance for both herself and her daughter. We are ready for action and encouraged by the numbers of people we have already been able to help in the first week of open enrollment. We will continue to provide in-person outreach, schedule appointments, take calls and provide the education and outreach that is so crucial to getting families successfully enrolled in affordable health care.
I Love September
This powerhouse crew is changing the way people connect to benefits. As I’ve talked with our partners, elected officials, Exchange staff and board, I’m so proud to say that we have a model that builds on 25 years of connecting families with resources. We know the importance of meeting people where they are at‐‐whether that’s the food bank line, over the phone or online. We know our greatest impact will be in developing a trusting relationship with families so that we can connect them with the right resource and suggest other resources they might need. We know that when parents have access to quality health care, it improves the health of their kids. As we get close to launch, it’s also important for us to keep our eyes on the prize‐‐ Health Insurance for All! This isn’t going to be an easy process. It’s going to be frustrating and tiring. We will now be able to respond to clients who “sheepishly”ask after we’ve signed their kids up for Apple Health for Kids if there is anything for them, with a resounding YES! This is the pay off.
Over the last few weeks I’ve started to think about what is next. What happens after we’ve signed up folks? Having insurance doesn’t mean you’ll be healthier. Having healthy behaviors makes you healthier. This is where I see our work with breastfeeding, immunization and developmental screening massively growing our impact on family health. This is going to be fun, challenging and rewarding work. But first things first‐‐let’s go get those million Washingtonians that aren’t insured, insured.