Helping Consumers Understand How to Use Their Healthcare Coverage

1. Helping Consumers Understand How to Use Their Healthcare Coverage Presented by: Leigh Grauman, LSW Portico Healthnet

2. Topics for Today What we know about new enrollees What’s so important about accessing health care coverage? Confirming coverage Educating enrollees on how to use their healthcare coverage Resources Q&A

3. MNsure Enrollment Numbers Over 200,000 people enrolled in health insurance through MNsure during 2014 Open Enrollment! Source: MNsure press release 4/23/14

4. New Enrollees Want Access to Care Source: Enroll America

5. Many New Enrollees Don’t Have Usual Source of Care Source: Health Reform Monitoring Survey: Urban Institute Health Policy Center

6. 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

7. 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.

8. 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

9. What’s so Important? Cost Savings Source: CMS National Training Program 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

10. 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 Information • Help client collect important information • PMI, Case Number, Effective Date

11. 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.

12. 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

13. Scheduling Appointments Offer to assist with scheduling appointment Use of Interpreters What to bring to first appointment

14. 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?

15. Questions?

16. 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