On Target Insurance Literacy Presentation 2012Presentation Transcript
ON TARGET Healthcare Insurance101“Everything You Should Know About Medicare” By CIOS2011.org
ON TARGET Community Insurance Outreach Services C.I.O.S. is an non-for profit organization providing insurance related services and support to the metro Youngstown area. Our mission is to bridge the gap between insurance companies, consumers, and local government by providing education and resources. C.I.O.S. address the need for educating consumers and employers to better understand their insurance needs, assist the insurance industry with risk management, and provide employment opportunities within the insurance markets.
ON TARGET C.I.O.S. Community Insurance Outreach Services Non-profit organization Services Community based programs designed & operated by the community it serves Insurance industry sponsored initiative Outreach partnerships with other non-profits Services based on community Support Education needs which provide superior satisfaction Ohio...Let’s Start Here Employment !!!
ON TARGET Healthcare The Affordable Care Act ACA (Healthcare Reform) Access to Preventative Services and NO Lifetime Limits Pre-existing Condition Insurance Plans Parent Plan Dependent 26 Year Old Coordination of Care Secure Medicare Trust Fund Partnership for Patients
ON TARGET Medicare Everything You Need to Know……. Getting Ready for Open Enrollment October 15th 2012-December 7th 2012
ON TARGET Enrollment Periods Medicare 2012 Saturday October 15th 2011 QUICK FACTS QUICK FACTS AEP- Annual Enrollment Periods • NEW—Making changes to your coverage October 15th 2011- December 7th 2011 after December 31 Between January 1– February 14, 2011, if you’re in a Medicare Advantage Plan, you can leave your plan • You can change your Medicare health or and switch to Original Medicare. prescription drug coverage for 2012. • If your Medicare Advantage Plan Disenrollment Period includes prescription drug coverage and you join a Medicare Prescription Drug January 1st 2012- February 14th 2012 Plan, you will be disenrolled from your Medicare Advantage Plan and returned • January 1st 2012 new coverage begins if you to Original Medicare. switched or joined a plan. New costs and coverage changes also begin if you kept your existing coverage.
ON TARGET OSHIIP Ohio Senior Health Insurance Information Program 1-800-686-1578 MEDICARE EXPERTS
ON TARGET Medicaid Medicaid pays for covered medical bills, dental bills, eyeglasses, and homemakers services. Certain people covered by Medicare may qualify for full Medicaid benefits. Other will qualify for partial Medicaid, also known as “spend down”.
Medicare-Medicaid CoordinationON TARGET Medicare Premium Assistance Program Medicaid for Older Adults and People (MPAP with Disabilities This program helps people eligible Medicaid for the Aged, Blind & People with for Medicare who have limited Disabilities (ABD) Ohio Medicaid offers a span of programs for older adults and people with income and assets get help in disabilities to assist with medical expenses. These paying the cost of one or more programs provide health care coverage consisting of of the following: primary and acute-care benefit packages along with Medicare premium(s) long-term care. Medicare deductibles Medicare coinsurance To qualify for ABD Medicaid, applicants must be: age 65 or older, or Eligibility Criteria: considered legally blind, or To qualify for MPAP, applicants must be eligible for an individual with a disability (as classified by the Medicare and meet basic requirements. Social Security Administration), and must meet basic requirements. When applying for MPAP, proof of income, resources, age or disability, citizenship (if When applying for this type of Medicaid, proof of not a U.S. citizen) and other health insurance is income, resources, age or disability, citizenship (if required. not a U.S. citizen) and other health insurance is required. No face-to-face interview with the local county A face-to-face interview with the local county department of job and department of job and family services is also family services is necessary. necessary.
ON TARGET Medicaid Income Eligibility 2012 2011 HHS Poverty Guidelines Who Qualify in FPL Single Marrie Resources Persons 48 Contiguous Ohio? d Single/Marrie in Family States and D.C. Alaska Hawaii d 1 $10,890 $13,600 $12,540 Older Adults (age 64% $589 $1,011 $1,500/$2,250 2 14,710 18,380 16,930 65 or older) & 3 18,530 23,160 21,320 Disabled People (of any age) 4 22,350 27,940 25,710 5 26,170 32,720 30,100 Qualified Medicare 100% $867 $1,176 $4,000/$6,000 6 29,990 37,500 34,490 Beneficiary (QMB) 7 33,810 42,280 38,880 Specified Low- 120% $1,040 $1,400 $4,000/$6,000 8 37,630 47,060 43,270 Income Medicare For each Beneficiary (SLMB) additional 3,820 4,780 4,390 person, add Qualified Individual 135% $1,170 $1,575 $4,000/$6,000 (QI-1) Qualified Working 200% $1,734 $2,334 $4,000/$6,000 Disabled Individual (QWDI) SOURCE: Federal Register, Vol. 76, No. 13, January 20, 2011, pp. 3637-3638
ON TARGET Our Common Pledge… “Providing progress, stability, & dedication to disadvantage communities across America.” “Insurance Literacy” “Claims Assistance” “Career Pathway” Insurance Literacy Program Our “Restoring the The “Career Pathway” program provides free educational Community” program offers offers career placement and seminars on : catastrophic claims credentials in the insurance assistance and support to industry. • Basic Insurance local residents and business. • Health Insurance We provide recession –proof • Property & Auto Insurance employment opportunities by We provide advice and guidance during insurance securing our clients with an • Life & Accident Insurance state insurance license with in claim process. 90 days. We act as an authorized Our clients are vested after 5 agent and advocate, respond years of commitment and • We also provide free to denial letters, assist with provide documentation, and refer to training, credentialing, support insurance seminars local state insurance , and marketing. for business agencies for complaints.
ON TARGET For more information and event dates visit WWW.CIOS2011.ORG