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Affordable Care Act

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   

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   

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   

Breastfeeding: Your rights in the workplace

http://www.etsu.edu/students/univcent/pictures/LactationSuite.jpg

A couple of months ago I got a call on our Family Health Hotline from a woman who was approaching the end of her maternity leave and was trying to better understand her rights in going back to work as a breastfeeding mother. She was returning to work at a large tech company and her expectations were low that her employer would be accommodating of a flexible schedule that would allow her to breast-pump.  As I scrambled to locate and articulate the legal jargon around this topic, I was glad to discover that the law does protect women in this situation, but I also craved more detail to better guide callers in the future and provide women with confidence to advocate for themselves in the workplace.

It’s recommended by the American Academy of Pediatrics that mothers give their babies nothing but breastmilk for the first six months of life, and continue giving breastmilk for at least one year or longer. The reasoning behind this is worth celebrating! Breastfeeding provides significant cost-savings and strengthens the trusting, loving bond between a mother and her baby by increasing levels of oxytocin, also known as the “love hormone.” The cells, hormones, and antibodies in breastmilk make it easier for babies to digest than formula and reduce their incidence of developing respiratory infections, asthma, diabetes, and obesity, among other health conditions. From a mother’s perspective, breastfeeding has also been shown to reduce the risk of breast and ovarian cancer as well as postpartum depression.  Employers also have reason to encourage breastfeeding as research supports it contributes to lower health care costs and absences from work due to caring for a sick child. For more information on the benefits of breastfeeding as well as tips for making the transition back to work while breastfeeding, please visit our “Work and Breastfeeding” resource.

The Affordable Care Act (ACA) advanced the rights of mothers in the workplace and the benefits that breastfeeding mothers are required to receive. New health insurance plans (since March 2010) are now mandated to offer women full coverage of a breast pump as well as a range of preventative services and lactation counseling. Breastfeeding is now more accessible to a majority of employed women as most employers are required to provide a space and “reasonable break time” for women to express breast milk or pump during the workday. The space provided must be “shielded from view and free from intrusion from coworkers and the public.” A bathroom, even if private, is not considered an acceptable location under the Act. Employers can find cost-effective tips on providing time and space to support nursing mothers in a variety of work settings on the Office of Women’s Health Website.

While the Affordable Care Act established a new and improved standard for the affordability and accessibility of breastfeeding, there are still barriers to breastfeeding supplies and support that need to be addressed. For example, while most women can now receive full coverage of a breast pump and lactation consulting through their insurance, this may not apply to Medicaid-recipients in certain states, mothers who are most in need of extra assistance. In this case, it’s likely that the Women, Infants, and Children (WIC) program can pick up where the law left off and provide women with these resources. Increasing awareness of how the law protects nursing women and how to navigate health and legal systems can help bring our workplaces and communities forward in recognizing the importance of breastfeeding in fostering healthy, happy mothers and babies.

Here are a few additional resources to learn more about breastfeeding and how to access WIC and other food and health programs:

Tags: ACA   Affordable Care Act   Breastfeeding   Breastfeeding support   ParentHelp123   

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   

Not Having Health Insurance Might Impact Your Family’s Finances!

Collaboratively written by: Francesca Murnan, Benjamin Johns, and Benito Sanchez (WithinReach Healthy Connections Team)
Since the passage of the Affordable Care Act, the majority of people in the United States are now required to have health insurance. As a key component of the law, individuals and families will be asked to maintain health insurance at least nine months out of the year. People that choose to go uninsured may face a fee associated with not enrolling in health insurance coverage. Not everyone will be impacted by these changes, nor will they be asked to pay a fee, but it is important to understand where you and your family fit into this complex puzzle. In this blog, we explain the basic structure for how to determine if you are “covered” and what your options may be if you find yourself without health insurance.
Am I covered?
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 [1], 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:

1Health_FeeChart

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.

Citation:
[1] 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   

2014 Legislative Session Week Two – Innovation in our Health Care System

The Affordable Care Act has brought about unprecedented change, especially in the area of access to health care. As of January 9th, over 270,000 Washingtonians have newly enrolled in either private health insurance or Apple Health (Medicaid) through the Washington Healthplanfinder.   These newly enrolled won’t just have an insurance card to throw in their wallet – they now have the peace of mind knowing that they are covered.

But as the saying goes, this is not the end.  This is not the beginning of the end.  This is the end of the beginning.

There is so much more that we can and must do to improve the health of our families.  One of the next major steps to create some wide level change in our health care systems.  The current system is segmented, doesn’t utilize effective payment and delivery models, and doesn’t focus on prevention first.

It is with this in mind that Washington State applied for, and was awarded, a State Innovation Model grant from the Center for Medicare and Medicaid Innovation (CMMI).  With this grant, health care leaders from across Washington state came together to create the State Health Care Innovation Plan. 

This plan has the three main goals of better health, better care, and lower costs for Washingtonians. To achieve this, our State will take on the different strategies of value-based purchasing, building healthy communities and people through prevention early mitigation, and better integration of health care and social supports, especially in the area of integrating physical and behavioral health needs.

These goals are shared by WithinReach and our staff has a lot of experience working with families who have seen the best and the worst of our current health care system.  By transforming the system to better meet health care needs in an effective and more affordable way, we can help Washington families have better health outcomes.

Last week, legislation was introduced into the State House of Representatives to develop and implement the five-year State Health Care Innovation Plan.  Getting this bill (House Bill 2572) passed is a necessary and important step toward getting this plan in motion.  You can follow the progress of this bill by checking in here.  It has already been scheduled for a hearing on January 27th in the House Committee on Health Care and Wellness, which you can watch on TVW.

It is an exciting time in the health care world!  Through the great ideas and strategies in the State Health Care Innovation Plan, our state can begin to transform the system and create better, healthier lives for our friends, families, and communities.

Tags: Affordable Care Act   Center for Medicare and Medicaid Innovation   State Health Care Innovation Plan   Washington Apple Health   

WithinReach Starting New Health Insurance Enrollment Sites in Snohomish County

Do you need health insurance for you or your family? Do you want to understand if you are eligible for free or low cost coverage? With the new changes under the Affordable Care Act starting this fall, most people will be required to have health insurance in 2014. If you are uninsured, you can enroll in health insurance between now and March 31st.  If you want insurance coverage to start January 1st you need to be enrolled by December 23rd. All this can be confusing, but WithinReach is here to help you apply. We are certified health insurance assisters and, just in case you were wondering, we live and work in Washington State too. We are here to help families and individuals connect to health and food resources. To make it even easier, we have set up two locations in your community. Come by and get enrolled!

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

Lynnwood YWCA 

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

Tags: Affordable Care Act   Health insurance enrollment   In-Person Assisters   Snohomish County   Washington state   

Health Reform Isn’t Just About Individuals; It’s About Communities

This article by WithinReach Executive Director, Alison Carl White was published today in the Puget Sound Business Journal

 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.

Tags: Affordable Care Act   Health Reform   Washington state   

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.

Tags: Affordable Care Act   Dental Insurance   Medicaid expansion   Washington 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.

 

Tags: Affordable Care Act   Affordable Health Care   health insurance   Medicaid   

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.

Tags: Affordable Care Act   HealthPlanFinder   In-Person Assisters   Navigators   Washington Health Benefit Exchange   

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