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How to choose a health insurance plan

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

 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Podcast: Open Enrollment is here!

WithinReach podcast

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

Washington HealthPlanFinder
Blog post on Qualifying Life Events
ParentHelp123.org

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

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

Beyond Open Enrollment: Qualifying Life Events

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

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

What counts as a Qualifying Life Event?

Adding a Dependent

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

Loss of Other Health Coverage

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

Did you know?

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

Permanent Move

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

Did you know?

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

Change in Citizenship or Lawful Presence Status

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

Did you know?

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

Release from Jail/Prison

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

Special Enrollment Periods Only Available to Existing Customers

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

Losing a Dependent or Dependent Status

Including:

  • Death
  • Divorce
  • Legal Separation

Filed or Reconciled Taxes

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

Change in Income

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

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

Did you know?

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

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

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

Estoy inscrito en Washington Apple Health ¿Qué sigue?

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

providerone

 

 

 

 

 

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

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

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

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

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

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

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

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

¿Qué plan de cuidado administrado debería elegir?

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

●    ¿Qué planes acepta su médico?

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

●    Beneficios Adicionales

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

¿Cómo puedo cambiar los planes?

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

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

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

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

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

AmeriCorps Week: Language is a source of empowerment!

By Noelle Horario, WithinReach AmeriCorps Bilingual Outreach & Enrollment Specialist
Public Health – Seattle King County organized an assistance event in partnership with the Mexican, Peruvian, and Salvadorian consulates at the end the of January to offer a variety of services to families in the South Park community of Seattle. The services provided at the event included everything from concerns about health insurance and health screenings to taxes and other assistance programs folks could be eligible for. This event was catered to account for the various barriers that underserved communities experience when seeking assistance with government and state programs; barriers such as time, site location, transportation and language need, to name a few.
Location-wise, the event was held at a neighborhood information and resource center, a site familiar to many members of the surrounding community as being a welcoming environment. And as far as transportation accessibility, I found the site location to be extremely straightforward and easily reached, having taken the bus myself. The day of the event was scheduled for a weekend, allowing working families and individuals to attend outside of business hours. And finally, service organizations took advantage of their partnerships in order to provide bilingual health insurance in-person assisters (IPAs) for many languages of need, which is how I found myself at the event. Though the need for bilingual IPAs who spoke Tagalog was minimal, I was still able to assist a few individuals and families with their health insurance questions either in English or with the help of some of the volunteer interpreters.

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.

 

Tags: AmeriCorps   AmeriCorps Week   Community Health   health insurance   Health insurance enrollment   In-Person Assisters   Language Barriers   Volunteer   Washington HealthPlanFinder   Washington state   

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   

WA Healthplanfinder Gets a Makeover: 6 things you need to know!

By Emma Lieuwen and Irina Verevkina
WithinReach Bridge to Basics Outreach team, AmeriCorps
Open enrollment began November 15, 2014 and will continue until February 15, 2015. If you have not yet enrolled for health coverage, now is the time! Even if you signed up last year, your options may have changed, so be sure to review your plan.
If you have any questions about your coverage, need help navigating Washington Healthplanfinder’s website, or would like help with your application, please call the Family Health Hotline at 1-800-322-2588.
If you would rather talk to someone in person, call the Family Health Hotline to find out where our team will be in the community.
…………………………………………………………………………………………………………………………………………………………………………………
Recently, Washington Healthplanfinder’s website got a new look! When you go to wahealthplanfinder.org the homepage looks a little different. The new look was designed to make finding information about enrolling in free or low-cost health coverage easier. Here are six changes that we think are important:
Change #1: New look for the Homepage
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.
Homepage
Forgot your username or password? Simply click the green “Sign in” button and you will be able to retrieve it, or call the Healthplanfinder Customer Support Center at 1-855-923-4633.
Sign_In_Button
Change #2: New Application Questions
“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.
“Is any household member on this application currently enrolled in Medicare?”
If someone is covered by Medicare, they are likely ineligible for Qualified Health Plans and Apple Health.
Change #3: Eligibility Status Screen
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

Eligibility_Status

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.

Pending_Coverage

Change #5: Reporting Changes
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.
Reporting_Change
Change #6: Plan-palooza
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.
More questions? Call the Family Health Hotline at 1-800-322-2588 today!

 

Tags: Apple Health Renewals   Family Health Hotline   Free-Low Cost Health Coverage   health insurance   Open Enrollment   Washington HealthPlanFinder   Washington state   

Self employed? We Have Answers to Your Health Insurance Questions

Written by AmeriCorps Member, Natasha Pietila
In the past few weeks we have received many questions about how to report self-employment income on Washington Healthplanfinder applications. Below we discuss one question in particular which impacts thousands of people in Washington.
Question: I’m self-employed; When I report income my health insurance application, do I report my gross or net income?
Answer: Net. Net self-employment income is determined by subtracting allowable business costs from the gross income.
According to the Health Care Authority, self-employed persons may report their net income as opposed to their gross income. These allowable business costs are outlined by the IRS, on Schedule C and the net income is reported on Line 12 of Income Tax Return, Form 1040. If your self-employment income has not changed since last year, you may use the net income reported on last year’s 1040, on your health insurance application.

Tags: health insurance   self employment   Washington HealthPlanFinder   

What To Consider When Buying a Qualified Health Plan

Written by AmeriCorps Members Kari Geiger and Lisa Andersen
There are two categories of health insurance available through the Washington Healthplanfinder: Washington Apple Health, also known as Medicaid, and QHPs (Qualified Health Plans), which are paid plans for those who have higher income but still qualify for government assistance.

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.

Tags: Medicaid   Qualified Health Plan   Washington HealthPlanFinder   

‘Young Invincibles’ Helping ‘Young Invincibles’ Enroll in Health Insurance

Written by AmeriCorps members Kari Geiger and Natasha Pietila
On Friday, December 13th, a few of my colleagues and I left the city and headed off to Stevens Pass Ski Resort for a special health insurance enrollment event. Although Friday the 13th is often considered unlucky, we experienced no ill luck. It was a beautiful, snowy day – particularly exciting for me, a California-girl, who had never played in the snow. As certified In-Person Assisters, we had the opportunity to join the event with the Washington Health Benefit Exchange at Stevens Pass Ski resort to help enroll some of their 600 seasonal and part time employees in health insurance.
After crossing the resort’s quad, a slippery journey for my first time in snow (and lack of snow boots), we joined a large group of In-Person Assisters and Insurance representatives in the cafeteria and started talking to and helping enroll the ski instructors, emergency rescuers, and ski enthusiasts. Stevens Pass was generous enough to set up a hot drink and snack station, as well as providing a hot lunch of chili and grilled cheese. Whenever we were available, a new client would swish up in their snow gear and sit down with us to navigate through the Washington Healthplanfinder. While I got to teach about the healthplanfinder and how to use it, my clients taught me the difference in snow sport climates and conditions. One ski instructor, Clayton, pointed out the differences between the rain and snow falling on the mountain, and how it affects the mountain and skiing conditions.  Another one of the clients I talked to that day was a ‘young invincible,’ who at 27 was no longer covered by her parent’s health insurance, and was nervous about using the free ski pass (a perk of being employed at Stevens Pass) without health coverage.
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At the end of the day we enrolled several people in Washington Apple Health, others selected a Qualified Heath Plan, and others went home to discuss the intricacies of their cases with their families and finish their application on their own. It was a great asset to have access to the knowledge of other the In person assisters from King County Public Health and other organizations. Overall, it was a lovely day of watching skiers and snowboarders race down (and sometimes fall down) the mountains, hot chocolate, and connecting people to healthcare.

Tags: Health insurance enrollment   Stevens Pass   Washington Health Benefit Exchange   Washington HealthPlanFinder   Young Invincibles   

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.

Tags: ACA   Affordable Care Act   Apple Health   Apple health for Kids   health insurance   In-Person Assisters   Obamacare   Open Enrollment   ParentHelp123   Washington HealthPlanFinder   

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