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What health reform means for the people of Illinois

A blog by IllinoisHealthMatters.org

Saturday, December 28, 2013

Consumer Information for January 1, 2014

As the start of coverage for Qualified Health Plans in the Marketplace approaches, the Centers for Medicare and Medicaid Services (CMS) anticipates that some of the newly insured individuals will have questions about how to access healthcare services. CMS has posted information on Marketplace.cms.gov to address questions that consumers may have with the January 1 start of coverage through their selected health plan.

Individuals who have insurance for the first time or have new plans beginning on January 1 are likely to have many questions related to coverage, premiums payments, co-payments, and other issues and may need to reach their individual insurance plan. Below is information for consumers on how to access their health plans as well as education factsheets explaining how health insurance works.

Payments of Premiums
The deadline to sign up for coverage to start January 1st was December 23rd.

We want to remind you that consumers need to pay their premium directly to the insurance company in order to have coverage by January 1, 2014. Consumers can pay when invoiced by the plan, call the issuer to make payment, or pay online if the plan accepts online payment. All consumers have until at least December 31 to pay for coverage effective January 1, although some insurance companies have extended this deadline. Consumers should check with their insurance company to find out when their first premium is due in order for coverage to be effective January 1. Consumers should also confirm with the issuer that their first month’s premium has been received and that enrollment is complete.

Please note that once a consumer selects a plan through the Marketplace, it may take the health plan 48-72 hours to receive and process the enrollment, so please encourage consumers to continue to periodically check back with their selected health plan. The insurance company will also send plan information and an insurance card to consumers who have completed enrollment including payment of the premium.



(Reposted from the Champions for Coverage December 27, 2014 email)

Saturday, December 14, 2013

As Federal Website Improves, GCI Promotes a “Culture of Coverage” Across Illinois

As the federal website continues to improve, Get Covered Illinois today kicked off its first statewide TV advertising campaign, designed to raise awareness of the new state of healthcare that becomes a reality in 2014, with the opportunity to purchase a health care plan through the Illinois Health Insurance Marketplace.

“Now that the federal website has improved, we are shifting from educating consumers to the next phase of encouraging enrollment. We are urging thousands of uninsured residents in Illinois to get covered in this new state of healthcare that we are entering in 2014,” Jennifer Koehler, Executive Director of Get Covered Illinois said. “If you visited GetCoveredIllinois.gov before but didn’t select a plan, come back and try again. With the upgrades to the federal website that were recently put in place, the enrollment system is working much more smoothly. Now is the time to select a plan and get covered.”

In addition to the TV ad launch, Get Covered Illinois is ramping up its outreach efforts for an enrollment push leading up to Dec. 23, the first of a series of key enrollment dates under the federal Affordable Care Act (ACA). Consumers must enroll in a health plan by Dec. 23, and have paid a premium by Dec. 31, in order to have coverage on Jan. 1 through the plans offered on the Illinois Health Insurance Marketplace, which is accessed through healthcare.gov. The full open enrollment period for the Marketplace runs through March 31, 2014.

The Get Covered Illinois advertising campaign is designed to educate those who need insurance on the essential benefits and financial assistance available through the Marketplace, and to drive enrollment for coverage starting as soon as Jan.1. The advertising includes TV, radio, digital and social media, with an emotional connection to reach broader, multicultural populations of Illinoisans to encourage them to take action.

The nearly $1-million TV ad buy includes the eight major-media markets in Illinois, and is targeted to reach Illinois’ uninsured population. The campaign features one 30-second ad that highlights the all-inclusive nature of the new state of healthcare across Illinois; and two 15-second spots: one that highlights the fact that insurers can no longer deny coverage because of pre-existing conditions, and one that features a mom-to-be.

The TV advertising builds on the radio and digital banner advertising that began on Nov. 18 and is similarly targeted at Illinois’ uninsured population.

In addition to the statewide ad push, Get Covered Illinois and its more than 250 community partners are planning about 300 events to drive coverage around the state before Dec. 23. For planned enrollment events in your area, including those on Dec. 14, visit GetCoveredIllinois.gov and click on the events tab.

“We are encouraged that after two months of education and engagement by our more than 1,500 trained and certified Navigators assisting people to enroll across the state, there is steady feedback that residents are successfully buying Marketplace plans,” said Brian Gorman, Director of Outreach and Consumer Education for Get Covered Illinois. “We want to encourage people to sign up starting at our website, or work directly with a Navigator in your area, or call the help desk. All services are free.”

Get Covered Illinois is also further strengthening its Social Media presence to reach the uninsured through Facebook (www.facebook.com/coveredillinois) and Twitter (@CoveredIllinois). GCI recently launched a series of info graphics on social media that feature “30 Days, 30 Benefits.” The 30 pieces describe how the 10 Essential Health Benefits included in all Marketplace plans link directly to the real-life health needs people confront in their daily lives. GCI will also share testimonials of Illinois residents who have successfully enrolled in the Health Marketplace across social channels. These videos highlight what having health coverage will now mean for their lives.

The following is an operations, engagement and enrollment update from Get Covered Illinois >>

The U.S. Department of Health and Human Services (HHS) has released numbers for the first two months of enrollment under the ACA that indicate 67,936 applications on behalf of 124,252 individual people have been completed from Illinois and that 7,043 people have selected a private health care plan through the healthcare.gov website since Oct. 1.

Traffic on the Getcoveredillinois.gov website has remained steady, with 529,650 website visits since Oct. 1 and more than 245,800 users of the screening tool that leads users either to the federal website or the state’s new Medicaid eligibility site, ABE.illinois.gov (Application for Benefits Eligibility). The ABE site has received more than82,000 applications.

GCI encourages uninsured residents to:
  • Visit the website where you can find out if you qualify for a subsidy and compare health plans side-by-side (there is also a Spanish-language version of the website).
  • Sit with a specially trained Navigator at one of the hundreds of partner sites across the state; find a Navigator nearby through the website by entering a zip code. Bi-lingual Navigators are available.
  • Call the help desk at 866-311-1119. Operators are available to help you each day from 8 a.m. to 8 p.m. Spanish-language assistance is available on the phone.
(Published on Friday, December 13 at Get Covered Illinois)

Tuesday, December 3, 2013

ACA Success Story in Southern Illinois

Laura Olmsted, a Certified Application Counselor (CAC), from Shawnee Health Services, had the great pleasure of helping Bill*, a 53 year old from Marion, Illinois, understand what the Affordable Care Act is all about.

Bill is a hardworking self-employed contractor -- making $23,000/year -- who works independent construction jobs, and has not been able to afford health insurance. However, health insurance is something that Bill desperately requires. In the past year and a half, he has suffered not one, but three heart attacks and a broken femur. Mounting medical bills are causing him incredible financial burden, and preventing him from accessing care that he needs.

Luckily, Bill recently met Laura, who helped him to complete an application on Healthcare.gov once he went through the Get Covered Illinois screener. Bill received great news: not only was he eligible for insurance, but he had options, ranging from the low end of paying nothing for a Bronze level or lower end Silver plan, to only $180 per month for a high-end Silver plan after the premium tax credit was factored in.

Laura’s client considered his choices and selected a Silver Multi-State plan through Blue Cross Blue Shield of Illinois where he pays only pocket change - $4.53 per month - for his premium. The plan has a $250 deductible and an out of pocket max of only $2,000 per year. Bill plans to pay for the premiums up front since the price was so affordable.

Should Bill have looked into buying health insurance prior to the enactment of Obamacare (the Affordable Care Act), he would have encountered a very different situation:
  • No certified enrollment specialist would have helped him find and understand his health insurance options;
  • Unless he was connected with an insurance broker, Bill would have had to shop for plans on his own, rather than being able to compare them all in one place;
  • No tax credits or subsidies would be available to help him afford his premium;
  • Bill may have been denied coverage based upon pre-existing conditions; and
  • If Bill did find coverage, prior to Oct. 1 of this year, he likely would have found a plan with higher premiums and without the requisite 10 essential health benefits like the qualified health plan that he recently purchased.
Because of his new options through the Illinois Health Insurance Marketplace, Bill will now be able to receive the health care necessary to get well, and continue living a healthy, productive life in Illinois.
(*Bill is a fictional name to protect the client's anonymity)