enrollment

Preparing For Open Enrollment - Employer, Marketplace and Medicaid

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Don’t be frightened! Health care isn’t scary!

Medicaid Enrollment is Always Open.

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You can always apply for Medicaid. Anytime during the year you become eligible, you can apply for Medicaid. No qualifying events, no special documents. Check your income here and apply here. As always if you have questions, call us at 734-544-3030.

Employer Open Enrollment

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If you are offered health insurance through your job, chances are your open enrollment period is in the fall with a January 1, 2019 start date. Some employers (schools, universities, businesses with fiscal years based on other calendars) may have open enrollment during other times of the year.

Evaluate your options every year.

Each year your employer negotiates new benefit packages with health, dental and vision insurance companies. Your open enrollment may also include retirement options, disability and life insurance. When it comes time to evaluate your options make sure to look at each plan. If you don’t understand the details of a benefit, contact your HR department to explain it to you. Here are some tips for thinking about your particular family and your how you use your health insurance.

  1. How much health care do you expect to use?

  2. What is my deductible? What is my maximum out of pocket?

  3. Is my employer insurance affordable? Do I have another option?

You may be wondering if you can sign up on the Marketplace, read more about that option, Do I Have To Take My Employer Healthcare Coverage? (Usually, Yes).

Marketplace Open Enrollment Nov. 1 - Dec. 15

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The Open Enrollment Period for the Marketplace (aka Obamacare, healthcare.gov, ACA) is November 1 to December 15. During open enrollment anyone who is eligible can sign up for health care coverage that will start on January 1, 2019. In order to sign up on the Marketplace ask yourself these 3 questions:

  1. Am I eligible for Medicaid? If yes, you are not eligible to enroll with tax subsidies on the Marketplace. If you are a family, children may be eligible for Medicaid/MIChild and parents may be eligible for the Marketplace.

  2. Does my employer offer affordable insurance? If your employer insurance is less than 9.69% of your income for the lowest priced, ACA-compliant employee only plan, you are not eligible to enroll with tax credits on the Marketplace. Read more here Do I Have To Take My Employer Healthcare Coverage? (Usually, Yes).

  3. Do you have income and are you filing taxes? You must have income and file taxes to receive tax credits and enroll in health care on the Marketplace.

Information needed for a Marketplace application

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Did you answer yes to all 3 questions? The next step is to gather the documents and information you will need to complete a Marketplace application and select your health care plan. You will need the following:

  • Names and social security numbers for everyone in your tax household. Your tax household includes anyone you will claim on your tax return.

  • Earned income information -recent paystubs for everyone who is working or self-employment records (Schedule C from the previous year’s return).

  • Unearned income information - pension, retirement, real estate income, social security (RSDI or SSI) income or capital gains.

  • 2017 Tax return including Schedule C, if applicable.

  • List of doctors

  • List of prescriptions

  • Marketplace Account information - user id and password.

    • If you don’t have an account and need to create one you will need an active email account that you can access immediately. You must be able to access the email to access a verification email.

The next step is to estimate your income for 2019. For some people this is easy, but for anyone whose income varies during the year, it can be tricky. (We have written many posts about income, click here to browse all the income blogs.)

Now go to the Marketplace website, healthcare.gov, complete an application and select your 2019 health care coverage. You can preview 2019 plans here.

If you have questions, if you need assistance with the application or if you need help with the whole thing, please call the Washtenaw Health Plan and make an appointment. Michigan residents, we can also answer questions over the phone. Call us at 734-544-3030. The sooner you call the better! If you are not in southeast Michigan, use this resource to find local help for healthcare.

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Washtenaw Health Plan

734-544-3030

We Help People - Like You!




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Open Enrollment Tips, Part 3: Should I Choose A Dental Plan?

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After you choose a health insurance plan on the Marketplace (healthcare.gov), you generally will get a screen that says that dental insurance is not included. Would you like dental insurance?

If you answer yes, you will be directed to look at some of the dental insurance plans on the Marketplace.

How does individual dental insurance work?

In general, individual dental insurance is similar to individual health insurance in two ways:

  1. You pay a monthly premium.
  2. Preventive care (cleanings and x-rays) are covered 100% and are encouraged. Other procedures will be covered at different percentages (50%, 80%, 100%) depending on the procedure, the dental network, and the company. Just like with most health insurance, dental insurance works with a "network" of providers, and out of network providers may be covered at a much lower cost, or not at all.

Individual dental insurance is different from individual health insurance in two ways.

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  1. More significant procedures (fillings, crowns, extractions, root canals, bridges, dentures) often have a waiting period of 6 or 12 months before you can use the benefit. 
  2. Most individual dental insurance has a maximum dollar amount that can be spent on you in any year. This is the opposite of medical insurance, where once you hit a maximum out of pocket costs, everything is covered.  With dental insurance, if you need a couple of expensive procedures, you will likely hit the point where the dental insurance has maxed out.

 

Can you use tax credits for dental insurance on the Marketplace?

In general, no. Dental coverage is an essential benefit for children under the age of 18. If it is not included in their health plan then you can use tax credits (if you have any left over) toward their dental plan.  Adults cannot use tax credits to buy dental insurance.  Marketplace dental information.

Are there other options?

Yes, there are (at least) three other options.

1. Take employer-offered dental insurance. If you are buying health insurance on the Marketplace because your employer health insurance is unaffordable, their dental insurance may still be affordable--and may not have the waiting periods that individual dental insurance has. You can only choose this during employer open enrollment or a special enrollment period.

2. Buy off the Marketplace. Since you are not using tax credits, you should look around. You can work through an insurance broker or directly with companies that offer dental plans like Blue Cross, Delta, Golden, etcetera. You can only do this during Marketplace open enrollment or when you qualify for a special enrollment period.

3. Set money aside each month for dental expenses as if you were paying a dental premium. Call around to find a dentist you like and who is affordable. Dentists' rates vary. Pay out of pocket for cleanings, fillings, etcetera. [You can also use money from a health savings account or flexible spending account to cover dental expenses.] You can choose this any time of year.

Read more about dental care, insurance and coverage here.

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Last Chance Events! Open Enrollment 2017 ends January 31, 2017

There is still time to enroll in the Marketplace (healthcare.gov)!  Enroll before January 31, 2017! 

Need health insurance?  Don't qualify for Medicaid?  No employer health insurance?

Certified Application Counselors are available to help you complete a Marketplace application and choose a health plan.  Call the Washtenaw Health Plan 734-544-3030, walk-in Monday through Friday from 9am to 4pm at 555 Towner, Ypsilanti, or attend one of the events below.  

 

Were you enrolled in 2016?  Need to update your information?  You still can!  Maybe you just received your first bill for 2017 and realize that your premium is higher than last year.

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There is still time for you to update your information on the Marketplace and choose a new plan.  Your new plan will start March 1, 2017.  You will have to pay your current plan premiums for January and February, but your new (potentially) cheaper plan will start March 1, 2017.  Get help at one of the events listed below, walk-in to the WHP office or call. 

 

If you qualify for Medicaid - Enrollment is always open!

Get help determining if you or your children are eligible for Medicaid or the Marketplace.  It is not unusual for a parent or parents to have employer or Marketplace (healthcare.gov) health insurance and children to have Medicaid or MiChild healthcare. Go to an enrollment event, call the Washtenaw Health Plan 734-544-3030 or walk-in Monday through Friday from 9am to 4pm at 555 Towner, Ypsilanti.

 

Open Enrollment Events

What to bring:  

  • login information for your healthcare.gov account
  • recent paystubs/income info
  • names, birth date and Social Security #s (if you have them) for all members of your household
  • 2015 taxes

 

Ypsilanti Middle School 

Friday, January 27 from 5:00 to 7:00pm

233 Spencer Ln, Ypsilanti, MI 48198  

Show Me the Money Day Along with financial workshops, tax assistance, fun and food, get your questions about health care answered.

 

United Way of Washtenaw County Enrollment Events

Saturday, January 28 from 10:00am to 4:00pm

Tuesday, January 31 from 1:00 to 7:00pm

2305 Platt Rd, Ann Arbor, MI 48104

 

Washtenaw Community College Enrollment Event

Thursday, February 2 from 9:00am to 4:00pm

4800 E Huron River Dr, Ann Arbor, MI 48105

 

Think it's too late for health insurance?  Maybe not.  Read more about enrollment and qualifying life events that would open a Special Enrollment period.  If you have questions, call or walk-in and we will help you figure it out.

We Help People - Like You!

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2017 Open Enrollment November 1, 2016 to January 31, 2017- Don't Be Scared!

Image from demnewswire

Image from demnewswire

Healthcare.gov is open for enrollment starting November 1, 2016.

Call or come to the Washtenaw Health Plan office for a free evaluation of your insurance options.  Ask questions!  

We Help People Like You!

Monday - Friday 9am - 4pm

555 Towner, Ypsilanti, MI 48198

 

NOT SURE IF YOU QUALIFY FOR MEDICAID OR MARKETPLACE? CALL OR COME TO THE WHP OFFICE.   INCOME GUIDELINES ARE HERE.

If you currently have health insurance through the Marketplace, login to your account, update your information, and choose a new plan. 

Medicaid is always open for enrollment.  Apply here.

Don't believe the hype, affordable health insurance is available. We help people find the most affordable option and enroll.  

Washtenaw Health Plan

We Help People Like You! 

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Health Insurance Scams - How to Spot Them and What to DO

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Now that everyone is required to have health insurance or pay a penalty, scammers and evil-doers are out there trying to take your money.  Below you will find trusted sources for information and tips on how to tell the real deal from the scammers.  

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If it sounds too good to be true, it probably is. 

If someone calls you and tells you about a health insurance plan that covers everything and will only cost you $35 dollars/month, be suspicious.  First ask them for the health insurance company name and their web address.  If they won't tell you either of those, it is a scam. If someone won't give you a call back number, they probably are not from a reputable company.  

If someone starts asking you lots of questions about your health (do you have asthma, cancer, high blood pressure), it is either a scam or a short-term plan. Year-round plans during open enrollment or special enrollment periods can only ask you your age, your address, and whether or not you are a smoker. 

Healthcare.gov is the Real Deal. 

The website to visit is

HTTP://WWW.HEALTHCARE.GOV/  

NOT healthcare.com.  

If you scroll to the bottom of the webpage at healthcare.COM printed in tiny letters is the following statement:  

HealthCare.com is a PRIVATELY OWNED website that is NOT owned or operated by any state or federal government agency.

Phone Call Scams

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The Marketplace (healthcare.gov) may call you if they were unable to answer your call and you left your phone number. They may also call to remind you that it is time to enroll, but the reminder calls are recordings.  If a person calls you and you are not sure who they are, ask for a callback number.  If the person is hesitant to provide a number, they are a scam. The Marketplace phone number is 1-800-318-2596 and you can call them 24 hours a day, 7 days a week.  

All Marketplace representatives have access to your account after you identify yourself. Marketplace representatives never ask you for financial information, such as bank names and account numbers. They will never ask you to pay for insurance over the phone.

What Does A Scammer Sound Like?

This a recording of a scammer who calls and leaves a voicemail.  This same voicemail was left for hundreds of people.   Do not call this person back, they are not from Healthcare.gov and can not sign you up for real health care.  

Protect Yourself

The Coalition Against Insurance Fraud has a list of fake health plans and health care scams with 10 warning signs. To protect yourself, they suggest:

  • Slow down: Avoid signing up if you feel pressured to buy
  • Ask to read the policy
  • Call the insurance company to verify the program offered is a real plan and not just a medical discount card.

Read more here.

What to do if you are believe you are the victim of a health insurance scam

If you believe you are the victim of a health insurance scam, contact the Federal Trade Commission (FTC).  Fill in this form online: http://www.ftccomplaintassistant.gov

You can report Medicaid fraud or abuse by calling 855-MI-FRAUD (643-7283) or by filing an online complaint

To contact your local Medicaid office or find out about your Medicaid benefits, contact your local DHHS office or call the Medicaid Helpline at 1-800-642-3195. 

 

resources about healthcare scams:

Protect yourself from Marketplace fraud  https://www.healthcare.gov/how-can-i-protect-myself-from-fraud-in-the-health-insurance-marketplace/

Read about recent scams or sign up for Scam Alerts from the FTC:  http://www.consumer.ftc.gov/scam-alerts

Stop Medicare Fraud http://www.stopmedicarefraud.gov/

 

-M. Buhalis

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Help! I missed the December 17th deadline. Now what?

DON'T PANIC!

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The December 17th deadline was to get onto the Marketplace and enroll in a health plan that would start on January 1, 2016. Open Enrollment continues until January 31, 2016. Enrolling after December 15 changes the date your 2016 insurance starts.  

(medicaid is always open for enrollment.  If you qualify for medicaid, you can apply online at MiBridges.michigan.gov Anytime.  check your income here.)

 

I had Marketplace insurance in 2015 but I didn't update my application. 

If you had Marketplace insurance in 2015 and you didn't get onto the Marketplace, you have been re-enrolled into the same plan with a new tax credit based on your 2014 Tax Return.  You can still change plans before January 31, 2016.  If you waited you will have your auto-enrolled plan for January and new plan starting on February 1 (if you enroll before January 15) or March 1 (if you enroll after January 15). 

I did not have Marketplace insurance in 2015.  

If you didn't have health insurance in 2015, you still have time to enroll.  Enroll before January 15, 2015 and your coverage will start February 1.  Enroll before January 31 and your coverage will start March 1.  Not sure if you qualify for the Marketplace?  If your income is above the Medicaid income guidelines and you don't have an employer offer of coverage, you need to go on the Marketplace (healthcare.gov).

My employer offers insurance but I think it is too expensive.

Employer coverage tool from healthcare.gov  

Employer coverage tool from healthcare.gov 

If you have an offer of insurance from your employer, you must enroll if it is considered affordable.  The rules are slightly complicated, so you may want to visit an organization that can help you figure this out. Before you come to an appointment or call, have your employer fill out an employer coverage tool.  Having complete information about your employer's insurance offer is necessary in determining your options.  Find an agency here.

If the insurance meets minimum standards, and the cost of the insurance for the individual is less than 8% of the household income, it will definitely be considered affordable.

To find out if your employer insurance is affordable, have your employer fill out an employer coverage tool.  

I don't know what health coverage is right for me.  What do I do? 

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Find an agency who assists with health care and call them.  Nonprofit agencies in Washtenaw County are listed  Looking throughout Michigan? Look here.

Call the Marketplace (1-800-318-2596) or go to their website healthcare.gov/see-plans.

Start here to see what you and your family may qualify for.  It is not unusual for parents to be on the Marketplace and children to qualify for Medicaid or MIChild.

M. Buhalis


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Get Ready for Marketplace OE3! Open Enrollment Begins November 1, 2015

Open Enrollment 3 on the Marketplace at healthcare.gov starts November 1!

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If you don't have health insurance:

Almost anyone who does not have health insurance is required to sign up for health care.  If you or your family members do not qualify for Medicaid or have affordable insurance from your employer, now is the time to sign up on the Marketplace (healthcare.gov).

If you already have health insurance through the Marketplace (healthcare.gov):

Sign into your account or contact the Marketplace to change your plan and update your income.  Report your 2016 income and make sure your Advance Premium Tax Credit is correct.  Open Enrollment is the only time of year you can change your health plan without a qualifying life event.  Health plans change each year and new plans--both medical and dental--will be available.  Check to make sure your health plan matches your health needs.

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If you are unsure about your eligibility for Marketplace or Medicaid:

MAKE AN APPOINTMENT between November 1, 2015 and January 31, 2016 with a local non-profit to figure out what the healthcare coverage you and your family are eligible for.  If you just have questions, call and we can help.  If you need help applying, we will help you.  You will need to know who is in your tax household and estimate your income for 2016.  

If you do not have health insurance or healthcare in 2016, you will pay a tax penalty.  The tax penalty for not having insurance in 2016 is $695/person or 2.5% of your income, whichever is higher.

Example 1: For a family of four making $52,000 for the year, 2.5% is $1300.  But $695 per adult and $347.50 per child or $2085.  This family's penalty would be $2085. On the other hand, the children would likely qualify for MIChild health insurance, an affordable health plan costing $10/month, and the adults would likely qualify for subsidized Marketplace plans.

Example 2: If you are single and you make $20,000 and you do not have health insurance, you will pay $695 in a penalty or you could get health insurance for approximately $17/month.  Get insurance for $204 dollars or pay $695?  You decide. 

i'm healthy, why do I need health insurance?

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With all health insurance plans, your annual physical is FREE.  Read about those services here and here 

Accidents happen and people get sick. With health insurance or health care coverage, you will be covered and get help from doctors and hospitals.  

It's the law.

Important dates for 2016 enrollment

  • November 1, 2015: Open Enrollment starts — first day you can enroll in a 2016 insurance plan through the Health Insurance Marketplace. Coverage can start as soon as January 1, 2016.
  • December 15, 2015: Last day to enroll in or change plans for new coverage to start January 1, 2016.
  • January 1, 2016: 2016 coverage starts for those who enroll or change plans by December 15.
  • January 15, 2016: Last day to enroll in or change plans for new coverage to start February 1, 2016
  • January 31, 2016: 2016 Open Enrollment ends. Enrollments or changes between January 16 and January 31 take effect March 1, 2016.

If you don’t enroll in a 2016 health insurance plan by January 31, 2016, you can’t enroll in a health insurance plan for 2016 unless you qualify for a Special Enrollment Period.

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Nonprofit agencies in Washtenaw County that can help you get health care coverage or health insurance.  Here are the local agencies that can help you apply:  Call today and make an appointment or ask the questions you need answers to.

  • Aid in Milan  734-439-8420
  • Corner Health Center  734-484-3600 
  • Faith in Action  734-475-3305 
  • HARC/APM 734-961-1088 
  • Manchester Community Resource Center  734-428-7722 
  • Michigan Medicare/Medicaid Assistance Program (MMAP)  800-803-7174 
  • Packard Health 734-971-1073 
  • Regional Alliance for Healthy Schools 734-998-5795 
  • Saline Area Social Services 734-429-4570
  • St. Joseph Mercy Health System (Ann Arbor, Chelsea and Howell locations) 855-753-4726
  • University of MI Health System (Ann Arbor, Brighton and Ypsilanti locations) 877-326-9155
  • Washtenaw Health Plan 734-544-3030

Resources:

Marketplace Information

Healthcare.gov

Medicaid, MIChild and MiBridges to apply for Medicaid online

-M. Buhalis

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HMP Year One: a Look Back

Medicaid Expansion Year One: a Look Back

Here we are, just over one year after the implementation of Michigan’s Medicaid Expansion- the Healthy Michigan Plan! It was much quieter this morning, which provided our hard working assistors with some relief as we all remembered the long lines of people pouring out of our small lobby nearly every weekday of April 2014.

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Special Enrollment Period March 15 - April 30, 2015

Special Enrollment Period (SEP) for healthcare.gov March 15 to April 30. Find out if you qualify.

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