Every Dancer Insured in minneapolis /St. Paul

1. Every Dancer Insuredin minneapolis/St. Paul The Dancers Health Insurance Resource Center a program of The Actors Fund with funding from The Doris Duke Foundation

2. www.dhirc.org

3. www.springboardforthearts.org

4. How can I get insurance? • Employment-related coverage • Private, direct-purchase plans • Government-subsidized programs

5. What are my protections and limitations? • Right to receive care in a life-threatening emergency at any hospital regardless of insurance status • Adults can be refused insurance coverage except in certain situations (HIPAA & PCIP) • Children up to age 19 w/ pre-existing conditions can’t be denied coverage • Insurers can’t retroactively cancel coverage

6. What are my protections and limitations? • Insurers can’t impose lifetime limits on coverage • Look back period: individuals: 6 months; individuals in group plans: 6 months • Pre-existing condition exclusion period: individuals: 18 months; individuals in group plans: 12 months • Credit towards pre-existing condition exclusion period if less than 63 day lapse in coverage

7. What are my protections and limitations? HIPAA protection You can’t be denied coverage if: • you’ve had at least 18 mo of continuous coverage, the last day of which was under a group plan; and • you’ve exhausted any COBRA coverage; and • you aren’t eligible for any public or group health plans

8. Words to know • Co-pay • Co-insurance • Deductible • HMO • PPO • Premium • Reasonable & customary charges • Out of pocket maximum

9. Employment-related options • Job or spouse/domestic partner’s job • COBRA • Guarantees right to continue same coverage • Employer must have 20 or more employees • Lasts 18 months • 60 days to sign up (from date of letter) • Full premium (at group rate) + 2%

10. Employment-related options Unions SAG www.sagph.org/index2.html • Plan 1: $30,750 earned in 4 quarters; Plan 2: $15,100 or 76 days of employment • $273-$414 quarterly • Blue Cross Blue Shield PPO AEA www.equityleague.org • 12 weeks worked = 6 months coverage; 20 weeks worked = 1 yr coverage • $100 quarterly premium • CIGNA PPO, Medica HMO

11. Employment-related options Small business insurance • Guaranteed access to insurance (2-50 employees) • www.health.state.mn.us/hmo/smallmarkt.htm Small Business Health Care Tax Credit • Fewer than 25 FTE employees who make less than $50K on average • Employer must pay 50% of premium • Tax credit: 35% (for profit), 25% (non-profit)

12. Employment-related options Small business will file Form 8941 when they file income tax returns Tax exempt organizations will claim the tax credit on a revised Form 990-T www.irs.gov/newsroom/article/0,,id=223666,00.html FAQ: www.irs.gov/newsroom/article/0,,id=220839,00.html

13. Options for students & those under 26 Colleges & Universities U of MN Twin Cities: Student Conversion Plan (reduced-cost coverage for recent grads) www.shb.umn.edu/2010-2011/twincities/ahc-students.htm Adult children under age 26 can enroll in their parents coverage regardless of marital status, dependent status, or student status

14. I can afford private insurance, but I don’t know what type of plan to get. Consider your medical & financial risk limits Choose carrier & type of policy HMO PPO High deductible (“catastrophic”) HSA Short-term insurance www.ehealthinsurance.com

15. I can afford private insurance, but I don’t know what type of plan to get. New private insurance policies (start date: after Sept. 23, 2010) must cover certain preventive & early detection services for free: • Blood pressure, diabetes & cholesterol tests • Vaccines & immunizations • STD & HIV tests • Colorectal, breast and cervical cancer screenings

16. What if I have a pre-existing condition? Pre-existing Condition Insurance Program • Must have a pre-existing condition & be uninsured for 6 months or more • Comprehensive coverage • Premiums: $97-$311, depending on your age • Deductibles: $2000 medical; $500 drug • Out of pocket maximum: in-network: $4000; out of network: $7000 www.pciplan.com

17. What if I have a pre-existing condition? Minnesota Comprehensive Health Assoc. • Private coverage for those rejected due to pre-existing conditions • More expensive than PCIP www.mchamn.com Other programs that offer immediate coverage of pre-existing conditions: Medical Assistance, Minnesota Care, General Assistance, ADAP, Program HH, and COBRA and HIPAA protection

18. Federal Poverty Guidelines

19. Government programs Medical Assistance • Comprehensive • No premiums for most enrollees • Very limited income and assets and one of the following: disabled, blind, 65 or older, pregnant, child under 21, or parent of child under 21 http://mn.bridgetobenefits.org/Medical_Assistance_MA2.html

20. Government programs MinnesotaCare • Adults without dependents, pregnant women, families & kids • Limited income and assets (250-275% FPL) • Not eligible if you had insurance in last 4 months or can get it thru your job • Comprehensive • Low premiums & co-pays http://mn.bridgetobenefits.org/MinnesotaCare2.html

21. Government Programs Healthy Minnesota Contribution Program • Must have been without insurance for 4 months and be 21 or older, without kids, or pregnant • Income limits: 200-250% FPL • HMCP will help pay private premiums up to monthly defined limit, based on sliding fee scale. Enrollee must make up the difference • http://mn.bridgetobenefits.org/MinnesotaCare2.html

22. Government programs Medicare • 65 years old or disabled • Part A: hospitalization • Part B: outpatient services • Part D: medications • Parts B & D require premiums www.medicare.gov

23. I have a special health condition. Are there any programs that cover it? ADAP and Program HH • HIV+ and meet income & asset guidelines • Pays for meds and insurance premiums www.mnaidsproject.org/services/support-services/benefits-guide/program-hh.php SAGE Screening Program • Free mammos & pap tests at participating providers • Must be uninsured with income below 250% FPL www.health.state.mn.us/divs/hpcd/ccs/screening/sage/index.html

24. Non-insurance options Springboard for the Arts: Artists’ Access to Healthcare Two $40 vouchers for medical services at these clinics: • NIP Community Clinic • People’s Center Health Services • United Family Medicine • Family Dental Care • Everspring Health www.springboardforthearts.org/health/healthcare-vouchers

25. Non-insurance options Sliding-scale clinics The Health Center Program http://findahealthcenter.hrsa.gov The Guide to Healthcare for Minnesota Artists has an extensive listing of local clinics www.springboardforthearts.org/health/healthcare-guides Retail clinics NOW Medical Centers (Cubs), Minute Clinics (CVS)

26. How can I get low-cost or free medications? Needy Meds • Info on patient assistance programs, discount drug cards, low-cost clinics, & financial assistance • www.needymeds.org Minnesota RxConnect • Info on Canadian pharmacies & programs to help pay for meds • 800-333-2433 Minnesota Drug Card • Discount card for medications at participating pharmacies • www.mndrugcard.com/index.php

27. Low-cost or free medications $4 Generic Drug programs • Wal-Mart, Target FamilyWize Prescription Drug Discount Card • Discount card for medications • www.familywize.org

28. I have dental problems but no insurance. What do I do? • Dental discount plans and dental insurance • Dental schools U of MN School of Dentistry www.dentistry.umn.edu • Dental clinics www.mndental.org/public_home/about_us/give_kids_a_smile/twin_cities_metro_area_clinic_list Negotiate with your dentist