Presentation on theme: "“The mission of ASPIN is to provide innovative educational programs, resource management, program development, and network management in collaboration."— Presentation transcript:
“The mission of ASPIN is to provide innovative educational programs, resource management, program development, and network management in collaboration with all healthcare entities to address health disparities.” Affiliated Service Providers of Indiana: ASPIN Health Navigator Program IRHA’s Fall Forum: Harvesting Rural Solutions November 14, 2013
Today’s Presentation Goals 1.To introduce the Health Insurance Marketplace 2.To describe ASPIN’s role in the Marketplace 3.To discuss the Marketplace in Rural Areas 4.To provide information on resources available
Who is ASPIN? ASPIN, an Indiana based 501(C) 3 not for profit behavioral health network that operates five major service lines: – Third Party Contract Administration, – Professional Training, – Grants Management, – Consumer Education & Workforce Development, (CRS Program) – Technical Assistance
Grant Note: The ASPIN Health Navigator Project was supported by Funding Opportunity Number CA-NAV-13-001 from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents of oral, written, and electronic communications are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies unless cited otherwise.
Indiana’s Four Federal Navigator Grant Recipients 1.Affiliated Service Providers of Indiana 2.Plus One Enterprises, LTD, LLC. 3.Health and Hospital Corporation of Marion County 4.United Way Worldwide (211)
Goals of ASPIN’s Project To outreach and educate individuals, families and small businesses on Health Exchanges and to facilitate selection and enrollment in qualified health plans. To develop a navigator workforce consisting of Veterans, Certified Recovery Specialists, and Ivy Tech Community College students.
Keys Facts Regarding Rural Coverage Nearly one in five uninsured American lives in a rural area A greater number of rural residents lack health insurance compared to urban residents Due to income levels, a large segment of the rural population will be eligible for subsidized insurance coverage through the marketplaces
Health Insurance Market Place A primary goal of the Affordable Care Act is to help the 16 % uninsured and eligible Americans gain access to quality, affordable health care. Central to this goal is the Health Insurance Marketplace. Indiana has a Federally-facilitated Marketplace.
Key Dates DATEACTIVITY October 1, 2013Start of Open Enrollment. Plans and prices will be available January 1, 2014Coverage starts for enrolled individuals March 31, 2014Open Enrollment ends
Essential Health Benefits Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services – Including behavioral health treatment (which includes counseling and psychotherapy)
Essential Health Benefits Prescription drugs Rehabilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care
Who is Eligible? Individuals can buy insurance though the Marketplace if they live in the United States, are U.S. citizens or U. S. nationals (or are lawfully present) and aren’t currently incarcerated. Nobody can be turned away or charged more because of gender or a pre-existing condition. Depending on household income and family size, many individuals may qualify for tax credits to help lower their share of monthly premiums, or help that reduces deductible, copayment or other cost-sharing amounts.
Health Plan Categories Individuals will be able tochoose a Marketplace plan by health plan category – Bronze – Silver – Gold – Platinum, or – Catastrophic
Indiana Market Place Health Plans Physicians Health Plan (PHP) Managed Health Services (MHS) MDwise Anthem Blue Cross 17 Regions
What if a person chooses not to enroll in a plan? Health care law requires all people who can afford it to take responsibility for their own health insurance by getting coverage or paying a penalty. If someone who can afford health insurance doesn’t have coverage in 2014, they may have to pay a fee. They also have to pay for all of their health care. The fee in 2014 is 1% of your yearly income or $95 per person for the year, whichever is higher. The fee increases every year. In 2016 it is 2.5% of income or $695 per person, whichever is higher. In 2014 the fee for uninsured children is $47.50 per child. The most a family would have to pay in 2014 is $285.
Health Plan Information www.healthcare.gov/health-plan-information/ *12345 County - Johnson Metal Level - Bronze Insurance Issuer Name - Plan Marketing Name – Bronze Direct Access Plan Type – HMO
Health Plan Information cont. Rating Area – Rating Area 13 Premium Amounts – Adult age 27 $ 220.44 – Adult age 50 $375.67 – Family $744.62 – Single parent family $505.88 – Couple $537.62 – Child $133.57
You are cover if you have: Any Marketplace plan, or any individual insurance plan you already have Any employer plan including COBRA (including retiree plans) Medicare Medicaid The Children’s Health Insurance Plan (CHIP) TRICARE (for current service members and military retirees, their families, and survivors) Veterans health care programs (including the Veterans Health Care Program, VA Civilian Health and Medical Program (CHAMPVA), and Spina Bifida Health Care Benefits Program) Peace Corps Volunteer plans
Gaps in Coverage in States that Do Not Expand Medicaid
Who Can Provide Help in Rural Areas? Certified Application Counselors Agents and Brokers Navigators – Trained to provide unbiased information in culturally competent manner – Required to adhere to strict security and privacy standards – Certified annually through a training and testing process
How can ASPIN Assist ? Take phone referrals and schedule enrollment appointments at the ASPIN Health Navigator 800 number call center Schedule a navigator to provide enrollment assistance Conduct outreach and education meetings in your community
ASPIN’s Outreach Activites Consumers of behavioral health served by the Community Mental Health Centers Students in Ivy Tech campuses, staff, friends, and families Small businesses with less than 50 employees not required to provide insurance for employees
Outreach Workforce Targets Create a workforce of 3 FTEs and 30 part-time navigators that consist of: – Ivy Tech Community College Students – Unemployed Veterans and Service Members – Certified Recovery Specialists- Peer/Consumers
Outreach Contact Targets Population Outreach Consumers of mental health services Navigators at CMHCs 8,000 Community College students Navigators at Ivy Tech campuses 80,000 Small Business/Groups All navigators 23,200 Total 111,200
Outreach Strategies Onsite representation at college campuses and community mental health centers Mobile office 20 hours per week Local events Outreach materials Opportunities to contribute to announcements/ communications
Call Center and Social Media Toll Free Number: 877- 313-7215 Email: email@example.com@aspinhealthnavigator.org Website: www.aspinhealthnavigator.orgwww.aspinhealthnavigator.org Social Media Campaign – Facebook page – Twitter
Outreach to Small Businesses Identify businesses in local communities that navigators will reach out to Appointments with small business owners who call in for assistance SHOP information posted on the website
Additional Resources The Kaiser Family Foundation: Kaiser Family Foundation - Health Policy Research, Analysis, Polling, Facts, Data and JournalismKaiser Family Foundation - Health Policy Research, Analysis, Polling, Facts, Data and Journalism KFF.org – This website contains a wealth of information for individuals and helps them understand how the market place works, and allows them to estimate their cost
Where can you find more information about the Affordable Care Act State-by-state analysis http://www.hhs.gov/healthcare/facts/bystate/sta tebystate.html http://www.hhs.gov/healthcare/facts/bystate/sta tebystate.html Marketplace.cms.gov HealthCare.gov Health Insurance Marketplace Call Center: If you have questions, call1-800-318-2596. – TTY users should call1-855-889-4325.
Contact Information Kathy Cook, CEO firstname.lastname@example.org Julia Holloway, Project Director email@example.com 877- 313-7215 www.aspinhealthnavigator.org