1. No category

Time to Get Insured:
Learn the Who, What, Why, and How to
Enroll in Health Insurance through the
Medicaid Expansion or the State or
Federal Marketplace
February 12, 2014
http://www.promoteacceptance.samhsa.gov/
1
Archive
This Training Teleconference will be recorded. The
PowerPoint presentation, PDF version, video archive
including closed captioning, and a written transcript will
be posted to the ADS Center Web site at
http://www.promoteacceptance.samhsa.gov/teleconfe
rences/archive/default.aspx.
http://www.promoteacceptance.samhsa.gov/
2
Disclaimer
The views expressed in this training event do not
necessarily represent the views, policies, and positions
of the Center for Mental Health Services (CMHS),
Substance Abuse and Mental Health Services
Administration (SAMHSA), or the U.S. Department of
Health and Human Services (HHS).
http://www.promoteacceptance.samhsa.gov/
3
Questions
At the end of the speaker presentations, you will be able
to ask questions. You may submit your question by
pressing “*1” on your telephone keypad. You will enter a
queue and be allowed to ask your question in the order
in which it is received. On hearing the conference
operator announce your first name, you may proceed
with your question.
http://www.promoteacceptance.samhsa.gov/
4
Seeking Health Insurance
under the Affordable Care Act
Ron Manderscheid, Ph.D.
Executive Director, National Association of County Behavioral Health
and Developmental Disability Directors
Adjunct Professor, Department of Mental Health, Johns Hopkins
University Bloomberg School of Public Health
http://www.promoteacceptance.samhsa.gov/
5
The Affordable Care Act (ACA) Is Moving Ahead!
• Insurance coverage for up to 19 million poor and 20 million nearpoor citizens
• Health benefits for up to 11 million persons with behavioral
health conditions (“Statement from HHS Secretary,” 2012)
• Safe Harbor for those with severe illnesses
• New focus on prevention and promotion, not just disease care
http://www.promoteacceptance.samhsa.gov/
6
The ABCs of the ACA
• Medicaid Expansion
• Marketplaces
• Enrollment Process
• More information on these topics available at
http://www.behavioral.net.
http://www.promoteacceptance.samhsa.gov/
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Presentation Focus
The ACA is about...
coverage and access.
http://www.promoteacceptance.samhsa.gov/
8
ACA Principles
• Person-centered care—Consumer is the “true north.”
• Shared decision making—Care plans and goals are
jointly developed by consumer and provider.
• Whole health—The person’s entire health picture is
considered.
http://www.promoteacceptance.samhsa.gov/
9
Role of Parity
• Essential Health Benefit (EHB) for new private
insurance must be at parity.
• Medicaid Benchmark Benefit must be at parity.
• Parity does extend to all individual and most small
group plans after January 1, 2014.
• No individual plans will be grandfathered; private self-insured
small group plans can be grandfathered, and non-Federal
governmental small group plans can opt out.
http://www.promoteacceptance.samhsa.gov/
10
Quick ACA Overview
• Insurance Reform—Getting health insurance
• Coverage Reform—Getting better health insurance benefits
http://www.promoteacceptance.samhsa.gov/
11
ACA Medicaid Expansion
• For States that have chosen this option (now 26 + the
District of Columbia), enrollment began on October 1, 2013,
with coverage beginning on January 1, 2014.
• The expansion is designed for all uninsured adults up to
133 percent of the Federal poverty level (plus discounted 5
percent of income).
• Upper income limit is about $15,282, or $1,273 per month
for individuals.
• Enrollment process will operate continuously.
http://www.promoteacceptance.samhsa.gov/
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ACA Affordable Health Insurance Marketplace
• Enrollment began in ALL STATES on October 1, 2013. Initial insurance
coverage became effective on January 1, 2014. Scope is all uninsured
adults above 133 percent of the Federal poverty level (plus discounted 5
percent of income).
• Lower income limit is about $15,282, or $1,273 per month for individuals.
• Enrollment process will close on March 31, 2014.
• The three types of State exchanges are Federally Facilitated Exchanges,
State Partnership Exchanges, and State-Operated Exchanges.
http://www.promoteacceptance.samhsa.gov/
13
A Very Important Distinction
• If your State is NOT CURRENTLY DOING the Medicaid
expansion, then persons between 100 percent of the
Federal poverty level and 133 percent of the Federal
poverty level (plus discounted 5 percent of income) can
enroll in MARKETPLACE insurance plans.
• This income range is from about $11,490 to $15,282 per
year, or $957 to $1,273 per month for individuals.
http://www.promoteacceptance.samhsa.gov/
14
Picture of State
Medicaid
Expansion
http://www.promoteacceptance.samhsa.gov/
15
ACA New Coverage Mandates
• Certain prevention and promotion services now have
no copays or deductibles.
• Guaranteed issue means insurance is available to
people regardless of pre-existing conditions or
age.
• Those up to age 26 can now remain covered by
family policies.
• Insurance no longer has an annual or lifetime limit.
http://www.promoteacceptance.samhsa.gov/
16
Who Can Help You to Enroll?
•
•
•
•
•
•
Health Insurance Navigators
Federally Qualified Health Centers
Peers in Your Community
Certified Application Counselors
Authorized Representatives
In-Person Assisters
All will be unbiased and impartial.
To find help in your area, call 1–800–318–2596 or TTY: 1–855–889–4325
or visit https://localhelp.healthcare.gov.
http://www.promoteacceptance.samhsa.gov/
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Resources
•
•
ACA Overview Article
¬ Manderscheid, R. (in press). The Affordable Care Act: Overview and implications for
county and city behavioral health and intellectual/developmental disability programs.
Journal of Social Work in Disability and Rehabilitation. Accessible from
http://nacbhdd.trilogyir.com/content/ACA%20Article%2011-18-12.pdf [PDF 103 Kb]
We begin by reviewing the five key intended actions of the ACA—insurance reform,
coverage reform, quality reform, performance reform, and information technology
reform. This framework provides a basis for examining how populations served and
service programs will change at the county and city level as a result of the ACA, and
how provider staff also will change over time as a result of these developments. We
conclude by outlining immediate next steps for county and city programs.
Statement from HHS Secretary Kathleen Sebelius on Mental Health Month [News
release]. (2012, May 11). HHS Newsroom. Retrieved from
http://www.hhs.gov/news/press/2012pres/05/20120511b.html
http://www.promoteacceptance.samhsa.gov/
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Contact Information
Ron Manderscheid, Ph.D.
Executive Director, National Association of County Behavioral Health and
Developmental Disability Directors (NACBHDD)
Adjunct Professor, Department of Mental Health, Bloomberg School of Public
Health, Johns Hopkins University
http://www.nacbhdd.org
NACBHDD
The Voice of Local Authorities in the Nation’s Capital!
25 Massachusetts Ave., NW, Suite 500
Washington, DC 20001
Office: 202–942–4296; Cell: 202–553–1827
Email: [email protected]
http://www.promoteacceptance.samhsa.gov/
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Connecting to Coverage
in Colorado
Adela Flores-Brennan, J.D.
Assistance Network Manager
Connect for Health Colorado
http://www.promoteacceptance.samhsa.gov/
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Colorado’s State-Based Marketplace
Connect for Health Colorado is a State-based Marketplace.
• Authorizing legislation passed in 2011
• 150 health plan and 22 dental plan options
• More than 60,000 people enrolled as of January 15,
2014
• http://www.connectforhealthco.com
Colorado approved and implemented the Medicaid expansion.
http://www.promoteacceptance.samhsa.gov/
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How to Get Help
• 855–PLANS–4–YOU
(855–752–6749)
• Certified Brokers or Certified
Health Coverage Guides
Located in Communities
around the State
• Certified Application
Counselors
• Online Chat with a Service
Representative
http://www.promoteacceptance.samhsa.gov/
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What to Bring
• Contact information
• Social Security numbers (document numbers for lawfully
present immigrants) for each applicant
• Birth dates
• Employer information and employer coverage
information
• Income information (tax returns, pay stubs, W-2s)
• Preferred healthcare providers
http://www.promoteacceptance.samhsa.gov/
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Getting Started
• Shop and compare plans
anonymously.
• Estimate eligibility for
financial assistance.
• Use online tools to learn
more.
http://www.promoteacceptance.samhsa.gov/
24
Advanced Premium Tax Credit (APTC)
•
•
•
•
•
This credit offsets the cost of the monthly premium.
Bob from Denver, age 35, makes $22,000 per year.
He qualifies for an APTC of $131 per month.
He finds a Colorado HealthOp Bronze plan for $194 per month.
With the APTC applied, Bob pays about $63 per month.
http://www.promoteacceptance.samhsa.gov/
25
Cost Sharing Reduction
• This reduction comes in the form of an upgraded health plan
that has lower deductibles and copays.
• Individuals are eligible at up to 250 percent of poverty ($28,725
per year).
• A Silver level plan must be purchased.
• In Bob’s example, he is at about 200 percent of the Federal
poverty level. With an ordinary Silver plan he would have to pay
about 30 percent of the cost sharing, but with the Cost Sharing
Reduction plan he pays about 13 percent.
http://www.promoteacceptance.samhsa.gov/
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Application Process
Shop and
Compare; Apply
for Financial
Help
Medicaid Denial
Advanced
Premium Tax
Credit/Reduced
Cost Sharing
Pick Plan and
Make Payment
http://www.promoteacceptance.samhsa.gov/
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How to Apply
• From homepage click “Shop
Now” and create an
account.
• Want help paying for health
insurance?
• If yes, customers will be
directed into the State’s
Medicaid application.
http://www.promoteacceptance.samhsa.gov/
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How to Apply (cont.)
• In the online Medicaid application, create an
account and answer questions.
• If denied Medicaid, then customers are
directed back into the Marketplace.
• Answer a few more questions, and see
eligibility results for the Advanced Premium
Tax Credit and Cost Sharing Reduction.
http://www.promoteacceptance.samhsa.gov/
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How to Apply (cont.)
• Shop for a health
plan.
– Use the provider
search tool.
– Filter and sort on cost,
coverage level,
quality.
– Select and compare.
http://www.promoteacceptance.samhsa.gov/
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Important Deadlines
Coverage
began
Open
enrollment
began
10/1/13
Signup deadline
to have
coverage by 3/1
Signup deadline
to have coverage
by 2/1
1/1/14
Open enrollment
ends
1/15/14
2/15/14
Signup deadline
to have
coverage by 4/1
3/15/14
Signup deadline
to have coverage
by 5/1
3/31/14
Open enrollment continues through March 31, 2014. Individuals must enroll by March
31 to avoid penalties but can enroll after April 1 with a qualifying life change event.
http://www.promoteacceptance.samhsa.gov/
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Resources
•
Connect for Health Colorado, http://www.connectforhealthco.com
– Searchable Frequently Asked Questions,
https://connectforhealthco.custhelp.com/app/home/portal/individual
– Insurance Basics, http://connectforhealthco.com/insurance-basics
http://www.promoteacceptance.samhsa.gov/
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Contact Information
Adela Flores-Brennan, J.D.
Assistance Network Manager
Connect for Health Colorado
3773 Cherry Creek N. Dr., Suite 1025
Denver, CO 80209
Office: 720–496–2545
Email: [email protected]
http://www.promoteacceptance.samhsa.gov/
33
Implementing the Affordable Care Act
in North Carolina: Reaching out to
Substance Abuse and Mental Health
Services Consumers
Nyi Myint, M.S.W., M.B.A.
Program Manager
Alcohol/Drug Council of North Carolina
http://www.promoteacceptance.samhsa.gov/
34
About ADCNC
Who we are:
•
•
•
The Alcohol/Drug Council of North Carolina (ADCNC) is a 501(c)(3) nonprofit agency that provides
information and referral for alcohol and drug treatment. ADCNC was established in 1955.
Via Project Jumpstart, ADCNC provides official Navigator assistance for enrolling and applying for
Affordable Care Act (ACA) health insurance coverage to the recovery community.
ADCNC is one of the four ACA grantees in North Carolina and one of a few grantees in the nation to
serve the recovery community.
Project Jumpstart’s mission:
•
•
•
Educate 110,000 North Carolina consumers about the ACA
Enroll 5,800 targeted North Carolina substance abuse and mental health consumers into the
Marketplace
Be poised to advance substance abuse services within North Carolina through expansion of provider
panels
Our goal is to assist people in recovery by educating them about the value of health care and to
help to enroll them in the Marketplace for affordable healthcare insurance.
http://www.promoteacceptance.samhsa.gov/
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Why Enrolling Is Important
Health insurance gives you
access to treatment. Access to
treatment gives you a better
chance of recovery.
http://www.promoteacceptance.samhsa.gov/
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Outreach Strategies
Stakeholder
Outreach Method
Burke Council on Alcoholism &
Chemical Dependency
•
•
Operation of a Fixed Site
Training and Resourcing of Field Navigators
Call Center
•
•
Management of an Operations Center
Support for Navigators across the State
Field Navigators
•
•
•
•
•
Specific Outreach to Public and Private Agencies
Presentations and Individual Navigation Support
Methadone Clinics
Community Colleges with Substance Abuse Programs
Substance Abuse/Mental Health Conferences—RecoveryNC, Carolina’s Conference on
Addiction and Recovery, Community of Programs
Oxford House Navigators
•
Targeted Engagement of Oxford Houses across North Carolina
Treatment Accountability for Safer
Communities (TASC)
Navigators
•
Strategy in coordination with the North Carolina Division of Mental Health, Developmental
Disabilities, and Substance Abuse Services
Fixed-Site Navigators
•
Locations (Durham [2], Fayetteville, Greenville, Wilmington, Lexington)
Navigator Partners
•
•
Treatment Providers across the State
Recovery Communities of North Carolina, the Governor’s Institute
http://www.promoteacceptance.samhsa.gov/
37
Communication Strategies
• Targeted Messaging
– Specific Communication and Messaging
Targeted to People in Recovery
– Emphasis of the Importance of Health
Care to “Enroll for Health Insurance.
Increase Your Chance of Recovery”
• Dedicated Resources
– http://healthcarencnow.org
– https://www.facebook.com/HealthCareNC
– https://twitter.com/HealthCareNCNow
http://www.promoteacceptance.samhsa.gov/
38
Enrollment in a Non-Expansion State
• North Carolina did not expand Medicaid. As a result,
there is a “gap” in coverage for certain North Carolinians.
• North Carolina does not have a centralized State-run
ACA point of entry.
• Block grants, which fund much of the public substance
abuse and mental health treatment, are limited.
• Subsidies help those within 100 to 400 percent of the
Federal poverty level (FPL).
http://www.promoteacceptance.samhsa.gov/
39
Non-Expansion States
http://www.promoteacceptance.samhsa.gov/
40
Subsidies in a Non-Expansion State
•
•
•
Family Size
Income Level
Family Size of One
• $11,490 = 100% of FPL
• $45,960 = 400% of FPL
Family Size of Four
• $23,550 = 100% of FPL
• $94,200 = 400% of FPL
These subsidies are designed for income levels of 100 to 400 percent of the FPL.
If you make less than $11,490 you are not eligible for a subsidy, nor are you eligible for
Medicaid (because North Carolina did not expand Medicaid) services.
There are two kinds of subsidies:
–
–
Advanced Premium Tax Credits (APTCs) reduce premiums.
Cost Sharing Reductions (CSRs) help pay for copayments, deductibles, and coinsurance (100 to
250 percent of the FPL).
http://www.promoteacceptance.samhsa.gov/
41
How Do I Enroll?
You can apply online, in person, by phone, or through the mail.
• Online: http://www.healthcare.gov
• Phone: 1–800–318–2596 or TTY: 1–855–889–4325
• Mail: Health Insurance Marketplace, Dept. of Health and Human Services, 465 Industrial
Blvd., London, KY 40750-0001
• In person: Find out about Local Enrollment Assistance, https://localhelp.healthcare.gov
How to Apply In North Carolina
• ADCNC offers official Navigator assistance for enrolling and applying for ACA individual
and family health insurance coverage.
• Navigators can assist with both online and paper applications.
Call us at 1–855–726–2559 (toll free) for help or to set up an appointment. We offer
both day and evening appointments.
http://www.promoteacceptance.samhsa.gov/
42
What Do I Need to Apply?
• Social Security number (or document numbers for legal
residents) for everyone in your household who needs
coverage
• Employer and income information (pay stubs, W-2 forms)
• Detailed information about your employer’s insurance (if
offered)
• Providing accurate and complete information is very
important to avoid delays in processing your application
http://www.promoteacceptance.samhsa.gov/
43
What Healthcare Plans Are Available?
• Platinum: Insurance pays 90
percent of covered medical
expenses.
• Gold: Insurance pays 80 percent
of covered medical expenses.
• Silver: Insurance pays 70 percent
of covered medical expenses.
• Bronze: Insurance pays 60
percent of covered medical
expenses.
http://www.promoteacceptance.samhsa.gov/
44
What if I Don’t Qualify for Medicaid?
How Can I Get Help?
• Programs vary from State to State.
• Resources in North Carolina include the following:
• Medicaid/Children’s Health Insurance Program (CHIP)
• Integrated Payment and Reporting System (IPRS)
• Division of Social Services
• Division of Public Health
• Charity Care Program of the University of North Carolina Hospitals
Reach out to your State’s public health department to find out what
programs are available to you.
http://www.promoteacceptance.samhsa.gov/
45
Process and Timeline for Getting Insured
•
Step 1: Set up an account on http://www.HealthCare.gov. First you'll provide some
basic information. Then choose a user name, password, and security questions.
•
Step 2: Fill out the online application. You'll provide information about you and your
family, like income, household members, current health coverage information, and
more. This will help the Marketplace find options that meet your needs.
•
Step 3: Review your application results. You will receive a response back from the
Health Insurance Marketplace explaining the results of your application, including any
tax credits that can be used to lower your monthly premium.
•
Step 4: Go to the Health Insurance Marketplace at http://www.HealthCare.gov to
review the plan options and compare rates.
•
Step 5: Choose a health plan.
•
Step 6: Make your first month’s payment.
http://www.promoteacceptance.samhsa.gov/
46
Challenges for North Carolina
Subsidies/Getting Help with Coverage When Your Income Is under $11,490
•
•
•
•
•
Because North Carolina did not expand Medicaid, there are a number of people who fall into the
“gap” where there is neither subsidy nor Medicaid coverage.
Identifying the number of people who fall into the “gap” is important.
The subsidies program was designed to help people with income levels between 100 and 400
percent of the FPL.
Medicaid was supposed to help the people who fell below the 100 percent level. If you report
less than $11,490 you will not receive a subsidy, nor will you have access to Medicaid.
Estimating income accurately is critical.
What Can You Do?
•
Report any and all income (babysitting, mowing lawns, eBay sales, etc.). In order to receive a
subsidy, you must report an income of $11,490 or more. If it is less you will not receive a
subsidy. Report your income accurately.
http://www.promoteacceptance.samhsa.gov/
47
Challenges for North Carolina (cont.)
Expanding Provider Panels in North Carolina—Why Is This Important?
•
•
•
North Carolina has 100 counties and only two insurance providers under the ACA
Marketplace.
– Blue Cross Blue Shield has 26 plans in 100 counties.
– Coventry has 25 plans in 39 counties.
If you live in a rural part of North Carolina, you may not have access to a local provider
and may need to drive a far distance to get medical care.
The availability of multiple providers, including those who have addiction-specific training,
is important to preserve consumer choice and increase the likelihood of successful
treatment outcomes.
Outreach as Case Management in North Carolina—Why Is This Important?
•
Integration of outreach into case management is the new standard of care for access to
resources.
http://www.promoteacceptance.samhsa.gov/
48
Defining Parity
• Federal parity law is defined by the Mental Health Parity and
Addictions Equity Act (MHPAEA), the Affordable Care Act, and the final
rule to implement MHPAEA.
• Insurance companies each have the duty to ensure that they structure
their benefit packages in compliance with parity.
• Oversight for parity compliance is shared by State insurance
commissioners, the U.S. Department of Labor, and the U.S.
Department of Health and Human Services.
• Lawsuits have been filed over certain aspects, and further litigation
may be expected.
http://www.promoteacceptance.samhsa.gov/
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Resources
•
Faces & Voices of Recovery (Producer), and Williams, G. D. (Director).
(2013). The anonymous people: Official trailer [Motion picture]. Available from
http://www.youtube.com/watch?v=bqoEtUn0Agw
•
Healthcare NC Now, http://healthcarencnow.org
•
Local Enrollment Assistance, https://localhelp.healthcare.gov
http://www.promoteacceptance.samhsa.gov/
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Contact Information
Nyi Myint, M.S.W., M.B.A.
Navigator Project Manager
Alcohol Drug Council of North Carolina
600 East Main Street
Durham, North Carolina 27701
Office: 919–493–0003
Email: [email protected]
http://www.promoteacceptance.samhsa.gov/
51
Additional Resources for Service Recipients
•
Health Insurance Marketplace, https://www.healthcare.gov
–
–
–
–
Get Insurance, https://www.healthcare.gov/marketplace/individual
Glossary, https://www.healthcare.gov/glossary
Find Local Help, https://localhelp.healthcare.gov
What Are the Key Dates for the Health Insurance Marketplace, https://www.healthcare.gov/whatkey-dates-do-i-need-to-know
Important Health Insurance Marketplace Dates
You can generally buy health insurance only during the annual open enrollment period. Here are some
upcoming dates to know:
•
•
•
March 31, 2014: End date for 2014 open enrollment
November 15, 2014: Proposed date for 2015 open enrollment to start
January 15, 2015: Proposed date for 2015 open enrollment to end
To buy insurance outside open enrollment, you must qualify for a special enrollment period due to
a qualifying life event such as marriage, divorce, birth or adoption of a child, or loss of a job.
http://www.promoteacceptance.samhsa.gov/
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Additional Resources for Service Recipients (Cont.)
•
Centers for Medicare & Medicaid Services, http://www.cms.gov
– Health Insurance Marketplace Resources, http://marketplace.cms.gov
• Publications & Articles, http://marketplace.cms.gov/getofficialresources/publications-andarticles/publications-and-articles.html
– Marketplace applications
– Exemption applications
– Eligibility appeal forms
– Open enrollment resources
– Fact sheets
– Articles
• Spanish Materials, http://marketplace.cms.gov/getofficialresources/spanish-materials/spanishmaterials.html
• American Indian & Alaska Native Publications,
http://marketplace.cms.gov/getofficialresources/publications-and-articles/
american-indian-and-alaska-native-publications.html
• Materials in Other Languages, http://marketplace.cms.gov/getofficialresources/otherlanguages/other-languages-materials.html
http://www.promoteacceptance.samhsa.gov/
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Additional Resources for Service Recipients (Cont.)
•
Centers for Medicare & Medicaid Services Fact Sheets for Consumers
–
–
–
–
–
–
–
What You Should Know About Seeing your Doctor, http://marketplace.cms.gov/getofficialresources/
publications-and-articles/seeing-your-doctor.pdf [PDF 273 Kb]
What To Know About Getting Your Prescription Medications,
http://marketplace.cms.gov/getofficialresources/publications-and-articles/getting-your-prescription-medications.pdf
[PDF 325 Kb]
Appealing Your Insurer’s Decision Not To Pay, http://marketplace.cms.gov/getofficialresources/
publications-and-articles/appealing-your-insurers-decision-not-to-pay.PDF [PDF 292 Kb]
I Signed Up, But Don't Have Health Coverage. What Should I Do?,
http://marketplace.cms.gov/getofficialresources/publications-and-articles/signed-up-but-no-coverage.pdf [PDF 281 Kb]
Getting Emergency Care, http://marketplace.cms.gov/getofficialresources/publications-and-articles/getting-emergencycare.pdf [PDF 248 Kb]
What You Should Know About Early Renewal Of Health Coverage,
http://marketplace.cms.gov/getofficialresources/publications-and-articles/early-renewal-of-coverage.pdf [PDF 303 Kb]
What You Should Know About Provider Networks, http://marketplace.cms.gov/getofficialresources/publications-andarticles/what-you-should-know-provider-networks.pdf [PDF 227 Kb]
http://www.promoteacceptance.samhsa.gov/
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Additional Resources for Service Recipients (Cont.)
• U.S. Department of Health and Human Services, http://www.hhs.gov
– HealthCare Section, http://www.hhs.gov/healthcare
– About the Law, http://www.hhs.gov/healthcare/rights/index.html
– Prevention and Wellness,
http://www.hhs.gov/healthcare/prevention/index.html
http://www.promoteacceptance.samhsa.gov/
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Additional Resources for Service Recipients (Cont.)
•
Enroll America, http://www.enrollamerica.org
– Navigating the New Health Insurance Marketplaces: In-Person Assistance Options
for Consumers, http://www.enrollamerica.org/in-person-assistance-options-forconsumers
– Get Covered Guide: Understanding the New Health Insurance,
http://www.enrollamerica.org/wp-content/uploads/2013/12/GetCoveredGuide.pdf
[PDF 1,966 Kb]
•
Get Covered America, http://www.getcoveredamerica.org
– Get Covered 101, http://www.getcoveredamerica.org/get-covered-101
– Find Help Near You, http://www.getcoveredamerica.org/locator
– Get Covered Calculator: Estimate Your Costs, http://staging.getcoveredamerica.org/
calculator
– Personal Stories, http://www.getcoveredamerica.org/stories
http://www.promoteacceptance.samhsa.gov/
56
Additional Resources for Service Recipients (Cont.)
•
•
National Navigator Grant Recipients, http://www.cms.gov/CCIIO/Programsand-Initiatives/Health-Insurance-Marketplaces/Downloads/navigator-list-10-182013.pdf [PDF 730 Kb]
The Henry J. Kaiser Family Foundation, Health Reform Section,
http://kff.org/health-reform
– For Consumers: Understanding Health Reform, http://kff.org/aca-consumerresources
– Health Reform Frequently Asked Questions, http://kff.org/health-reform/faq/healthreform-frequently-asked-questions
– Subsidy Calculator, http://kff.org/interactive/subsidy-calculator
http://www.promoteacceptance.samhsa.gov/
57
Additional Resources for Assisters
•
Centers for Medicare & Medicaid Services, http://www.cms.gov
–
–
–
•
Resources for Assisters, http://marketplace.cms.gov/help-us/2-partner-with-us.html
Training Materials and Presentations, http://marketplace.cms.gov/training/get-training.html
The Center for Consumer Information & Insurance Oversight,
http://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Marketplaces/index.html
• In-Person Assistance in the Health Insurance Marketplace,
http://www.cms.gov/cciio/programs-and-initiatives/health-insurancemarketplaces/assistance.html
U.S. Department of Health and Human Services
–
–
HealthCare Section, http://www.hhs.gov/healthcare
The Affordable Care Act and Your Community, http://www.hhs.gov/partnerships/
aca_act_and_community/index.html
The section titled “Information on the Navigators, Certified Assistance Counselors, In-Person
Assisters, Educator Programs” contains especially useful information for assisters.
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Additional Resources for Assisters (cont.)
•
Enroll America, http://www.enrollamerica.org
– Outreach, http://www.enrollamerica.org/resources/toolkits/outreach
– Enroll America. (2013, December). Application assistance 101: Helping individuals
sign up for health insurance. Retrieved from http://www.enrollamerica.org/wpcontent/uploads/2013/12/Factsheet-Application-Assistance.pdf [PDF 83 Kb]
•
National Disability Navigator Resource Collaborative,
http://www.nationaldisabilitynavigator.org
– National Disability Navigator Resource Collaborative. (2013, December). Guide to
disability for Healthcare Insurance Marketplace Navigators. Retrieved from
http://www.nationaldisabilitynavigator.org/wp-content/uploads/Materials/DisabilityGuide.pdf [PDF 789 Kb]
http://www.promoteacceptance.samhsa.gov/
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Additional Resources for Communities
• U.S. Department of Health and Human Services
– HealthCare Section, http://www.hhs.gov/healthcare
– The Affordable Care Act and Your Community, http://www.hhs.gov/partnerships/
aca_act_and_community/index.html
• Scroll down to see the Health Care Law Toolkit for Faith and Community-Based Organizations.
• How the Health Care Law Helps your Community: A Fact Sheet for Faith and Community Leaders,
http://www.hhs.gov/partnerships/aca_act_and_community/acafbnpfactsheet.pdf [PDF 206 Kb]
• Health Care Law Talking Points For Faith and Community-Based Organizations,
http://www.hhs.gov/partnerships/aca_act_and_community/acafbnptalkingpoints.pdf [PDF 251 Kb]
• What You Can Do To Help People Who Are Uninsured,
http://www.hhs.gov/partnerships/aca_act_and_community/whatyoucando.pdf [PDF 186 Kb]
http://www.promoteacceptance.samhsa.gov/
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Additional Resources for Communities (cont.)
•
•
The SHOP Marketplace for Small Businesses, https://www.healthcare.gov/smallbusinesses
National Council for Behavioral Health
– Healthcare Reform Section, http://www.thenationalcouncil.org/topics/healthcarereform
– National Council for Behavioral Health (Producer). (2013). The ABCs of open
enrollment for behavioral health providers [Webinar]. Retrieved from
https://www2.gotomeeting.com/register/781623570
http://www.promoteacceptance.samhsa.gov/
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Other Resources
•
•
•
•
The Kaiser Commission on Medicaid and the Uninsured. (2013, October 23). The
coverage gap: Uninsured poor adults in States that do not expand Medicaid. Retrieved
from http://kff.org/health-reform/issue-brief/the-coverage-gap-uninsured-poor-adults-instates-that-do-not-expand-medicaid
Manderscheid, R. (2013, August 14). State Health Insurance Marketplaces provide us
unparalleled opportunity. Retrieved from http://www.behavioral.net/blogs/ronmanderscheid/state-health-insurance-marketplaces-provide-us-unparalleled-opportunity
Manderscheid, R. (2013, August 21). The Medicaid Expansion promotes social justice
through equity. Retrieved from http://www.behavioral.net/blogs/ronmanderscheid/medicaid-expansion-promotes-social-justice-through-equity
Manderscheid, R. (2013, December 29). Essential new roles for peers and service
recipients in the whole-health era. Retrieved from http://www.behavioral.net/blogs/ronmanderscheid/essential-new-roles-peers-and-service-recipients-whole-health-era
http://www.promoteacceptance.samhsa.gov/
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Other Resources (cont.)
•
•
•
Perry Undem Research/Communication. (2014, January 9). The uninsured midway
through ACA open enrollment : Results from a national survey of uninsured adults 18 to
64; Conducted December 12–22, 2013. Retrieved from http://www.enrollamerica.org/wpcontent/uploads/2014/01/Perry_Undem_Uninsured_Survey.pdf [PDF 456 Kb]
Swarbrick, M. A. (2013, August 1). Integrated care: Wellness-oriented peer approaches;
A key ingredient for integrated care. Psychiatric Services, 64(8). Retrieved from
http://ps.psychiatryonline.org/article.aspx?articleid=1718823
Vestal, C. (2013, September 11). ‘Peers’ may ease mental health worker shortage under
Obamacare. USA Today. Retrieved from http://www.usatoday.com/story/news/nation/
2013/09/11/stateline-mental-health/2798535
http://www.promoteacceptance.samhsa.gov/
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Questions
You may now submit your question by pressing “*1” on
your telephone keypad. You will enter a queue and be
allowed to ask your question in the order in which it is
received. On hearing the conference operator announce
your first name, you may proceed with your question.
http://www.promoteacceptance.samhsa.gov/
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For More Information, Contact
• Ron Manderscheid, [email protected], 202–942–4296
• Adela Flores-Brennan, [email protected], 720–496–2545
• Nyi Myint, [email protected], 919–493–0003
http://www.promoteacceptance.samhsa.gov/
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Speakers
Ron Manderscheid, Ph.D.
Ron Manderscheid, Ph.D., serves as Executive Director of the National Association of County Behavioral Health and
Developmental Disability Directors (NACBHDD). The NACBHDD represents county and local authorities in Washington, DC,
and provides a national program of technical assistance and support. Concurrently, he is Adjunct Professor in the Department
of Mental Health at the Johns Hopkins University Bloomberg School of Public Health, and Immediate Past President of
ACMHA—The College for Behavioral Health Leadership. Dr. Manderscheid serves on the boards of the Employee Assistance
Research Foundation, the Danya Institute, the FrameWorks Institute, the Council on Quality and Leadership, the International
Credentialing and Reciprocity Consortium, and the National Research Institute. He also serves as Co-Chair of the Coalition for
Whole Health. Previously, he was Director of Mental Health and Substance Use Programs at the Global Health Sector of SRA
International and held several leadership roles in the U.S. Department of Health and Human Services (HHS). Throughout his
career, he has emphasized and promoted peer and family concerns. During the national healthcare reform debate under the
Clinton Administration, he served as Senior Policy Advisor on National Health Care Reform in the HHS Office of the Assistant
Secretary for Health. At the same time, he was a member of the Mental Health and Substance Abuse Work Group of the
President's Task Force on Health Care Reform. He has continued this work in support of the implementation of the Affordable
Care Act of 2010. His writing and editing credits include co-editing a new text, Outcome Measurement in the Human Services:
Cross-Cutting Issues and Methods in the Era of Health Reform, and preparing a monthly commentary for Behavioral
Healthcare. He has received many awards, including the HHS Secretary's Distinguished Service Award in five different years;
the American Public Health Association's Mental Health Section Award; and the National Association of State Mental Health
Program Directors’ Career Distinguished Service Award.
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Speakers
Adela Flores-Brennan, J.D.
Adela Flores-Brennan, J.D., joined Connect for Health Colorado in November 2012 as the
Assistance Network Manager. She is responsible for implementing statewide programs for
local application and enrollment assistance. She comes to the Marketplace from the Colorado
Center on Law and Policy. While there she spent more than 5 years working on a range of
health policy, Federal policy, and legal issues including health reform implementation, and
Medicaid and Children’s Health Insurance Program eligibility and enrollment issues. She also
spent 3 years working on tax and budget policy. Ms. Flores-Brennan has 12 years of
experience in law and public policy in Colorado and is a graduate of the University of Colorado
School of Law. She also received bachelor's and master's degrees in international studies
from the University of Denver.
http://www.promoteacceptance.samhsa.gov/
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Speakers
Nyi Myint, M.S.W., M.B.A., LCSW-A, LCAS-A
Nyi Myint, M.S.W., M.B.A., LCSW-A, LCAS-A, is Navigator Project Manager with Project Jumpstart of the
Alcohol/Drug Council of North Carolina (ADCNC). Project Jumpstart is supported by a grant from the Centers
for Medicare and Medicaid Services awarded to the ADCNC in August 2013 to provide Affordable Care Act
Navigation services specifically to people in recovery in North Carolina. The project is providing outreach to
people and assisting them with enrolling in the Federal Health Insurance Marketplace. Mr. Myint is providing
leadership to the project’s network of navigators, who are primarily people in recovery or clinical specialists in
behavioral health who are committed to improving people’s access to whole-health services through access to
healthcare insurance. Mr. Myint joined the staff of the ADCNC in 2013, becoming the Clinical Program
Manager on a project that provides no-cost substance abuse assessments and brief intervention services to
members of the North Carolina National Guard. He has worked clinically as a substance abuse counselor at
the Freedom House Recovery Center. He is also a paramedic and trained in the treatment of posttraumatic
stress disorder. Mr. Myint served in the U.S. Army for 25 years, retiring at the rank of major to pursue a career
in human services. He is a veteran of Operation Desert Storm and Operation Iraqi Freedom, and he did a tour
of duty in Bosnia. He has a master of business administration from Pfeiffer University, a master of social work
degree from the University of North Carolina at Charlotte, and a graduate certificate in substance abuse from
the School of Social Work of the University of North Carolina at Chapel Hill.
http://www.promoteacceptance.samhsa.gov/
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Survey
We value your suggestions. Within 24 hours of this teleconference, you will receive
an e-mail request to participate in a short, anonymous online survey about today’s
training material which will take 5 minutes to complete. Survey results will be used
to determine resources and topic areas to be addressed in future training events.
Survey participation requests will be sent to all registered event participants who
provided e-mail addresses at the time of their registration. Each request message
will contain a Web link to our survey tool. Please call 1–800–540–0320 if you have
any difficulties filling out the survey online. Thank you for your feedback and
cooperation.
Written comments may be sent to the ADS Center via e-mail at
[email protected].
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Archive
This Training Teleconference was recorded. The
PowerPoint presentation, PDF version, video archive
including closed captioning, and a written transcript will be
posted to the ADS Center Web site at:
http://www.promoteacceptance.samhsa.gov/teleconfer
ences/archive/default.aspx.
http://www.promoteacceptance.samhsa.gov/
70
Also of Interest
If you enjoyed this training teleconference, we encourage
you to:
Join the ADS Center listserv to receive further
information on recovery and social inclusion activities and
resources including information about future
teleconferences.
http://promoteacceptance.samhsa.gov/main/listserve.aspx
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Contact Us
ADS Center
4350 East West Highway, Suite 1100
Bethesda, MD 20814
Toll-free: 1–800–540–0320
Fax: 240–744–7004
Web: http://www.promoteacceptance.samhsa.gov
E-mail: [email protected]
The moderator for this call was Jane Tobler.
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