Presentation Transcript

1. 25th Annual “Meryl’s Conference” June 28, 2013 Consumers for Affordable Health Care’s Consumer Assistance Program Emily Brostek, MPH, CHES Consumer Assistance Program Manager 1-800-838-0388 1-1-877-362-7045 (TTY) www.mainecahc.org consumerhealth@mainecahc.org
2. Introduction to Consumers for Affordable Health Care and the Consumer Assistance Program www.mainecahc.org
3. PO Box 2490 Augusta, ME 04338-2490 www.mainecahc.org 1-800-838-0388 www.mainecahc.org
4. About Consumers for Affordable Health Care (CAHC) Non-profit, non-partisan mission driven advocacy organization since 1988 Mission: To advocate the right to quality, affordable health care for every man, woman, and child in Maine. Policy Research and Advocacy Consumer Assistance Program www.mainecahc.org
5. Policy Advocacy Research and reporting on health care and insurance issues Monitor Statehouse and Washington activities Speak on behalf of consumers at state level Founding member of the Health Care for Maine Alliance (HC4ME) www.mainecahc.org
6. Consumer Assistance Program CAHC is Maine’s designated Consumer Assistance Program (CAP) Part of the Affordable Care Act Help people with problems or questions about health coverage CAHC integrated new CAP functions with existing HelpLine and Outreach Programming As Maine’s CAP, our HelpLine is on all Explanation of Benefits (EOB) in the state www.mainecahc.org
7. Consumer Assistance Program HelpLine Help with Coverage Disputes Online Navigating Health Care Guide™ Workshops and Presentations
8. Consumer Assistance Program HelpLine (1-800-965-7476) We do not sell insurance; we are not agents/brokers; we do not get commissions or fees. We are a non-profit, not a government office. We give FREE information, help, and referrals on health coverage and health care and drug costs. All calls are private and confidential. Individuals call for help for themselves; and professionals call on behalf of clients or patients.
9. Options We Discuss with HelpLine Callers MaineCare and CHIP (CubCare) Eligibility Coverage My Maine Connection Other options
10. Options We Discuss with HelpLine Callers “Non-insurance” Programs Hospital Free Care Prescription Assistance Programs Sliding-Scale Health and Dental Centers Medicare Savings Programs Area Specific Programs
11. Options We Discuss with HelpLine Callers Private Insurance CoverageOptions: comprehensive v. catastrophic How does it work? Out-of-pocket costs? (e.g. premiums, copays, deductibles, etc.) What does it mean? (Health Insurance Literacy) What are my rights? Who can help me?
12. Consumer Assistance Program Online Navigating Health Care Guide™(www.mainecahc.org) The Online Navigating Health Care Guide™ gives a basic idea of health coverage options and programs that help with health care costs. You can call our Toll-free HelpLine if you have questions about anything in the guide. 1-800-965-7476
13. Online Navigating Health Care Guide™ www.mainecahc.org Health Care Guide was started in 2001 as a paper and online publication The Online Health Care Guide has since been updated every year, but we no longer provide a print copy
14. Consumer Assistance Program Help with Coverage Disputes(1-800-965-7476) Our HelpLine and legal staff can help you figure out your coverage and rights. We focus on getting bills paid, and helping you understand your options. We can represent you in first level appeals, second level appeals, external reviews, and submit complaints on your behalf.
15. Consumer Assistance Program Workshops and Presentations(1-800-965-7476) Train social service and health care professionals on MaineCare, private insurance, and other options. Customized workshops and presentations available by request. Some workshops are free and others are low-cost. Scholarships are available.
16. Statewide Reach of HelpLine and Outreach Activity www.mainecahc.org
17. Successes in 2012 Handled over 3,000 incoming HelpLine calls Trained over 1,140 social service and health care professionals Almost 1.5 million hits in 2012 Recovered over $67,000 in denied health insurance benefits www.mainecahc.org
18. What’s Coming in 2013…Health Insurance Marketplace – Navigators Navigators – Specific duties outlined in law: Conduct public education to raise awareness of Qualified Health Plans (QHPs) and public programs Distribute fair and impartial information concerning enrollment in QHPs, premium tax credits, and cost sharing reductions Facilitate enrollment in QHPs Provide referrals to office of health insurance consumer assistance, or appropriate agencies for grievances, complaints, or questions Provide information in a culturally and linguistically appropriate manner www.mainecahc.org
19. How We Can Help You Call: 1-800-965-7476 TTY: 1-877-362-9570 Maine Relay: 711 Email: consumerhealth@mainecahc.org www.mainecahc.org
20. Questions? Consumers for Affordable Health CarePh: 1-800-838-0388 HelpLine: 1-800-965-7476 Web:www.mainecahc.org “Like” us on Facebook: facebook.com/MECAHCRead our blog: mecahc.blogspot.com Follow us on Twitter: @MAINECAHC www.mainecahc.org
21. Thank You! www.mainecahc.org