Helping Consumers Understand How to Use Their
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Transcript Helping Consumers Understand How to Use Their
Helping Consumers Understand
How to Use Their Healthcare
Coverage
PRESENTED BY:
LEIGH GRAUMAN, LSW
PORTICO HEALTHNET
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
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
Many New Enrollees Don’t Have Usual Source of
Care
Source: Health Reform Monitoring Survey: Urban Institute Health Policy Center
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 Information
Help 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/gettraining.html
HealthCare.Gov (Spanish and English)
https://www.healthcare.gov/using-your-newmarketplace-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/publiceducation/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-NewlyInsured.html