PRESENTED BY: LEIGH GRAUMAN, LSWPORTICO HEALTHNET

Helping Consumers Understand How to Use Their Healthcare

Coverage

Topics for Today

What we know about new enrollees What’s so important about accessing health

care coverage?Confirming coverageEducating enrollees on how to use their

healthcare coverageResourcesQ&A

MNsure Enrollment Numbers

Over 200,000 people enrolled in health insurance through MNsure during 2014 Open Enrollment!

Total 200,174

Medical Assistance 108,675

MinnesotaCare 41,403

Qualified Health Plan 50,096

Source: MNsure press release 4/23/14

New Enrollees Want Access to Care

Source: Enroll America

Source: Health Reform Monitoring Survey: Urban Institute Health Policy Center

Many New Enrollees Don’t Have Usual Source of Care

Knowledge Gaps in Health Literacy

Health literacy is the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions.Source: Enroll America

What’s so Important? Primary Care

Ability to get care when you need it without having to worry about cost

Primary Doctor gets to know you and your family and your medical history

Referrals to Specialists“Everyday” care

Cold Flu Earache etc.

What’s so Important? Preventative Care

Detect problems early Health care law

makes many preventative services free! Screening

mammograms Flu shots

Reduce number of work days missed due to illness

What’s so Important? Cost Savings

Don’t have to worry about getting stuck with a large medical expense

Insurance companies negotiate rates with providers which lowers costs for enrollees (generally 40% savings)

If you go without Minimum Essential Coverage you may have to pay a penalty when you file your 2014 Federal tax return

Source: CMS National Training Program

Confirming Coverage

MNsure online eligibility determination is preliminary- important to confirm coverage

How to confirm depends on program Assistor Resource Center (for certified Navigators) DHS Member Helpdesk MNsure Contact Center Health Plans for QHP Counties

Permission to Share InformationHelp client collect important information

PMI, Case Number, Effective Date

Choosing a Health Plan: Public Programs

Completing Health Plan Enrollment Form Form must be returned within 30 days or client will be

enrolled in a default plan Amount of paperwork from health plans can be

overwhelming for clients Important to explain that MA and MNCare plans have

basic services that must be covered- coverage very similar from plan to plan.

Choosing a Health Plan: Public Programs

Do you have a regular Doctor or clinic? Listing for each network’s

clinics on DHS edocs website

Can also call plan’s customer service numbers

Things to consider when choosing plan: Is my clinic in network? Is there a clinic close to

my home? Language and cultural

needs

Scheduling Appointments

Offer to assist with scheduling appointment

Use of Interpreters

What to bring to first appointment

Resources

CMS Presentation on Health Literacy: http://marketplace.cms.gov/training/get-training.html

HealthCare.Gov (Spanish and English) https://www.healthcare.gov/using-your-new-marketplace-coverage/

Other suggestions? Languages? Things you have created or use?

Questions?

Sources

Enroll America: The Affordable Care Act’s First Open Enrollment Period: Why Did Some People Enroll and Not Others? conducted by PerryUndem Research/Communication and funded by the Robert Wood Johnson Foundation and The California Endowment:http://www.enrollamerica.org/resources/public-education/why-did-some-people-enroll-and-not-others/

Health Reform Monitoring Survey, Urban Institute Health Policy Center: http://hrms.urban.org/briefs/Who-Are-the-Newly-Insured.html