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Every Dancer Insured in minneapolis /St. Paul . The Dancers Health Insurance Resource Center a program of The Actors Fund with funding from The Doris Duke Foundation. www.dhirc.org. www.springboardforthearts.org. How can I get insurance?. Employment-related coverage

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every dancer insured in minneapolis st paul

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

how can i get insurance
How can I get insurance?
  • Employment-related coverage
  • Private, direct-purchase plans
  • Government-subsidized programs
what are my protections and limitations
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
what are my protections and limitations1
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
what are my protections and limitations2
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
words to know
Words to know
  • Co-pay
  • Co-insurance
  • Deductible
  • HMO
  • PPO
  • Premium
  • Reasonable & customary charges
  • Out of pocket maximum
employment related options
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%
employment related options1
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
employment related options2
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)
employment related options3
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

options for students those under 26
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

i can afford private insurance but i don t know what type of plan to get
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

i can afford private insurance but i don t know what type of plan to get1
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
what if i have a pre existing condition
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

what if i have a pre existing condition1
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

government programs
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

government programs1
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

government programs2
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
government programs3
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

i have a special health condition are there any programs that cover it
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

non insurance options
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

non insurance options1
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)

how can i get low cost or free medications
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
low cost or free medications
Low-cost or free medications

$4 Generic Drug programs

  • Wal-Mart, Target

FamilyWize Prescription Drug Discount Card

  • Discount card for medications
  • www.familywize.org
i have dental problems but no insurance what do i do
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