[Md-sligo] FW: Affordable Care Act

[Reyazuddin, Yasmin]

Dear Federation members, 

Here is some general info about the health insurance program. two of my co-workers went to the public forum and provided the following information. There are still more forums happening so you are welcome to go and learn. 

Yasmin 

 

AFFORDABLE CARE ACT (ACA) - PATIENT PROTECTION 

 

MARYLAND HEALTH CONNECTION (MHC)

 

1-800-855-MHC (642)-8572

 

18 - 64 YEAR OLDS ARE REQUIRED TO ENROLL

 

 

 

---THERE ARE 730,000 UNINSURED MARYLANDRES (56% OF MEN & 44% OF WOMEN)

 

---MONTGOMERY AND PRINCE GEORGES COUNTIES - MARYLAND CONNECTOR ENTITY REGION

 

---LANGUAGES - CALL CENTER ADMINISTERED THROUGH THE STATE OF MARYLAND

 

--- ATHENA CONSULTANT'S IS HIRING 80 MORE NAVIGATORS (ASSIST PEOPLE IN ENROLLING IN INSURANCE) 

 

---ENROLLMENT BEGINS OCTOBER 1ST AND COVERAGE BEGINS JANUARY 1, 2014

 

---MD HEALTH CONNECTION (MHC) - PEOPLE ARE TO SHOP, COMPARE AND ENROLL - PEOPLE CAN   CREATE AN ACCOUNT (SAVE THEIR INFO.) AND INFO. WILL STAY FOR 6 MONTHS 

 

---CURRENT INSURANCES ARE:  CAREFIRST, COVENTRY, EVERGREEN (CO-OP), KAISER PERMANENTE, 

    UNITED HEALTHCARE

 

---LEVEL OF PLANS TO CHOOSE FROM ARE GOLD, PLATINUM, SILVER & BRONZE (COST LEVELS)

 

---NO VISION IN ANY PLAN, BUT THERE IS MEDICAL AND DENTAL IN THE PLANS

 

---DENTAL PLANS ARE STAND ALONE

 

---IF EMPLOYER OFFERS YOU INSURANCE 7 IT MEETS MINIMUM VALUE HEALTH COVERAGE, AS WELL AS REQUIREMENT FOR AFFORDABILITY THAT THE EMPLOYER MUST MEET NO MORE THAN 9.5% OF YOUR INCOME.  YOU WILL BE ELIGIBLE FOR FINANCIAL ASSISTANCE THROUGH MHC. 

 

---UNDOCUMENTED - GO TO CLINICS

 

---ACA/MHC IS ONLY FOR LEGAL RESIDENTS

 

---IF PERSON IS LAID OFF & INSURANCE STOPS, THEY CAN CHOOSE MHC OR COBRA.  TIMEFRAME TO APPLY IS DATE OF LOSS OF COVERAGE.  IF ENROLL BEFORE THE 15TH OF THE MONTH, COVERAGE STARTS  THE BEGINNING OF THE NEXT MONTH.  IF PERSON APPLIES ON THE 16TH OR LATTER PART OF THE MONTH, COVERAGE DOESN'T BEGIN FOR ABOUT 1 ½ MONTHS LATER (EX. IF YOU ENROLL ON THE 20TH OF JULY, SERVICE DOESN'T BEGIN UNTIL SEPTEMBER 1ST).  

 

---IF CHOOSE NOT TO ENROLL IN MHC, THERE IS A RISK TOLERANCE AND PERSON WILL BE RESPOSIBLE FOR ALL BILLS & PAY A FINE.

 

--- MHC ACCEPTS THE 1ST MONTHS PAYMENT & FROM THEN ON PEOPLE ARE TO PAY THEIR INSURANCE CO. DIRECTLY.

 

---IF SPOUSE IS EMPLOYED, THEY DON'T HAVE TO TAKE THE COMPANY INSURANCE.  QHCP (QUALIFIED HEALTH PLAN)

 

---STUDENTS CAN CHOOSE THE COLLEGE PLAN OR HEALTH INS. EXCHANGE PLAN (HIX) 

 

---NO QUESTIONS ASKED ABOUT DISABILITY (PRE-EXISTING).  HIX WILL IDENTIFY WHICH PLAN LEVEL IS BEST  FOR THE PERSON.  THE CARRIER CAN ASK ABOUT PRE-EXISTING CONDITION, BUT IT DOESN'T AFFECT THEIR ENROLLMENT.

 

---SOME SERVICS ARE FREE:  PAP SMEAR, MAMMO., ETC.

 

---IF HAVE MEDICAID/MEDICARE PERSON IS OKAY

 

---IRS & MHC ARE LINKED

 

---THERE ARE OUT-OF-POCKET EXPENSES WHEN VISITING OTHER STATES, IF NEED MEDICAL ATTENTION

 

---STATES ATTORNEY'S OFFICE HAVE A SPECIAL UNIT SET ASIDE TO HANDLE FRAUD, APPEALS, ETC.

 

---MHC COVERS;  HEALTH, RX'S, PEDIATRICIAN, ER, MAMMO, COLONOSCOPY, DOCTOR VISITS, MATERNITY, MENTAL HEALTH, SUBSTANCE ABUSE, HOSPITALIZATION

 

---IF HAVE MEDICAID, SELECT MCO (MANAGED CARE ORGANIZATION)

 

---ENROLLMENT BEGINS SEPT. 1, 2013 - INSURANCE BEGINS JANUARY 1, 2014

 

---SPECIALTY CARE - INFO. TO FOLLOW

 

---MHC WILL BE AT GROCERY STORE, METRO, CVS' AND MANY OTHER PLACES

 

--- CAN'T SWITCH INSURANCE UNTIL OPEN ENROLLMENT

 

----IF ENROLLED IN PRIMARY ADULT CARE (PAC), PERSON WILL HAVE AUTOMATIC ENROLLMENT IN MHC ON JAN. 1, 2014

 

--MHIP (MARYLAND HEALTH INSURANCE PLAN) - NEED TO ENROLL IN MHC

 

 

 

 

 

 

PRESENTER  THRU DHHS EMPLOYEE IS DOURAKINE ROSARION (MONT. COUNTY LIAISON WITH THE STATE OF MARYLAND)

AT 240-777-4397

 

 

 

 

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