Coverage to Care- New Resources!

Thousands of Wisconsinites signed up for health insurance coverage during the first Open Enrollment period and more are continuing to enroll in BadgerCare+ or in the Health Insurance Marketplace through a special enrollment period. Many of these consumers are accessing insurance coverage for the first time. A recent study by the Kaiser Family Foundation reported that nearly 60% of new enrollees were previously uninsured. With an influx of newly insured individuals into the health care market, many are confused about using their coverage.

How do I find a provider? How much does my insurance cover for my doctor’s visits? What is a deductible? Are my prescriptions covered? When should I use the Emergency Room?

Oftentimes consumers will seek out assistance from advocates, providers or enrollment assisters they have trusted in the past, meaning they will be coming back to you with their questions. Before they do, make sure you are prepared by exploring new resources from the Centers for Medicare and Medicaid Services, Coverage to Care (C2C).

C2C is a new initiative launched to answer questions consumers have about using their new health insurance. Check out their Roadmap to Better Care and a Healthier You, a comprehensive 8 page brochures which shares consumer friendly information on understanding an insurance plan, finding a provider, scheduling an appointment, and other resources to make health insurance more understandable. Additional publications and videos can be accessed here. And, if you want to order material, free of charge, do so here.

For more information and materials about health insurance access and additional outreach materials, visit http://www.ckfwi.org.

BadgerCare+ Enrollment Numbers Released

The Department of Health Services released April’s BadgerCare+ enrollment numbers today. The release of these numbers has been anticipated because the numbers reflect the effect of the April 1 BadgerCare+ eligibility changes.

Remember, the April 1 changes modified eligibility for BadgerCare+ to 100% FPL, providing access to coverage for many, but eliminating access to coverage for some.

So, what story do the numbers tell? Are more people insured? And, who’s left out?According to DHS’s data (found here), as of April 2014, 81,731 Wisconsin childless adults now have health insurance coverage through BadgerCare+. These are the childless adults who were previously ineligible, many who were uninsured and on a waitlist for coverage.

The April 1 changes ended the waitlist and opened up coverage to anyone with an income below 100%FPL ($11,670/year) for parents or for childless adults. It’s important to remember that these numbers may increase throughout the year because BadgerCare+ has continuous enrollment – meaning a person can apply for and enroll in BadgerCare+ any time throughout the year, not just during Open Enrollment.

Though good news to many new enrollees, the eligibility changes also resulted in some parents losing coverage. Because the new income limit is 100% FPL, adults with incomes between 100-200% FPL were removed from their BadgerCare+ coverage April 1. DHS reported 62,776 parents lost their BadgerCare+ coverage.

Because losing coverage is considered a qualifying event, those parents were informed they had 60 days (until May 30) to apply for new coverage in the Health Insurance Marketplace. These individuals will be eligible for financial assistance when purchasing their new plans if their income is still below 400% FPL.

There is some concern about whether these parents will apply for new coverage and whether it will be considered affordable. If you are working with individuals who lost their coverage and are looking for assistance, encourage them to seek out a Certified Application Counselor or Navigator to discuss their options. Local help can be found by dialing 2-1-1 in most parts of the state, or by contacting the National Call Center at 1-800-318-2596.  Applications can be completed online at http://www.healthcare.gov.

Check out CKF’s Fact Sheets for more information, also found at www.ckfwi.org.

 

Community Eligibility: Free Lunch and Breakfast in Eligible Wisconsin Schools

CKF has been working with Wisconsin’s Department of Public Instruction (DPI) to connect children to healthy, free school meals via direct certification (DC) since 2011. Direct Certification is the web-based process by which children are deemed eligible for free meals under the National School Lunch Program without paper applications. Now, a new and exciting opportunity called Community Eligibility is on the horizon for high poverty schools and districts in Wisconsin that will connect even more children to healthy, free school meals. 

 The Community Eligibility Provision (CEP) allows high poverty schools and districts to offer breakfast and lunch to all students at no charge. CEP was piloted in 2011-2012 and is now available to schools in all states for the 2014-2015 school year.

 CEP is a 4-year reimbursement option for eligible schools participating in both the National School Lunch Program (NSLP) and School Breakfast Program (SBP) that wish to offer free school meals to all children in high poverty schools without collecting household applications. To participate in CEP, schools or districts must have a student population where at least 40 percent are eligible for free school meals without an application. Those eligible without an application include students that are in Head Start, students classified as homeless or migrant, and students directly certified for free meals because they are living in a household that receives FoodShare or W-2 cash assistance or based on their status as a foster child. 

 Schools or districts have until June 30, 2014, to apply for CEP for the 2014-2015 school year.

 Here’s a list of Wisconsin schools eligible to participate in CEP: 

 For further information and to download the CEP Application Form, please visit DPI’s Community Eligibility webpage http://fns.dpi.wi.gov/fns_cep.

CEP Report.

Small Doses About the Role of Tax Credits When Obtaining Health Insurance on the Markeplace Seen on IRS YouTube Videos

The Internal Revenue Service (IRS) has posted four Tax Credit videos on YouTube – three explain the Advanced Premium Tax Credit (APTC) in English, Spanish and American Sign Language, in under 2 minutes. If you purchase health insurance through the Health Insurance Marketplace, you may be eligible for the tax credit. The fourth video explains the Small Business Tax Credit in English in 2 1/2 minutes.

Premium Tax Credit – IRS English YouTube Video

Premium Tax Credit – IRS Spanish YouTube Video

Premium Tax Credit – IRS ASL (American Sign Language) YouTube Video

Small Business Health Care Tax Credit

Open Enrollment Ends But the Work Continues…

It’s been a very busy three months for us at Covering Kids & Families- so busy that we have neglected our blog! Although we’ve posted through our Facebook and various other project list serves, we wanted to make sure we keep you all connected through this tool as well. We’ll be back to posting regularly so be sure to send any requests for additional information to info@ckfwi.org.

This is Danielle writing, so I’m going to give you a quick update on outreach, education and enrollment assistance efforts through the Milwaukee Enrollment Network (MKEN),  MKENa regional collaboration of 100+ organizations focused on health insurance enrollment. Stay tuned next week for an update on a different topic from one of my colleagues.

On March 31st (or April 15th, depending on how you look at it), we saw an end to the first Health Insurance Marketplace Open Enrollment period. Covering Kids & Families, one of the co-conveners MKEN, was busy providing training, event coordination, resources and materials to local organizations in order to ensure consumers were connected to coverage. Other MKEN member organizations including local Navigators, Certified Application Counselor agencies, agents, brokers and other public benefit assisters spent the last six months trying to put a dent in Milwaukee’s 13% uninsured rate and enroll eligible consumers into Marketplace or BadgerCare+ coverage. MKEN members met regularly to share updates, discuss strategies and best practices, and plan outreach events and enrollment activities.

So, we are still waiting on Wisconsin-specific data, but nationwide, Health and Human Services reported that roughly 7.5 million people signed up for health insurance coverage in the Marketplace as of the end of March, and that that millions more signed up through private plans or through their state’s Medicaid program. Also, because some consumers will be eligible for Special Enrollment Periods and BadgerCare+ enrollment is year-round, we hope to see the insured rate increase over time. We will be sure to pass along the most recent data on the number of Wisconsin’s successful enrollments as they are made available – so stay tuned!

If you are interested in learning more about or getting involved in MKEN, check out www.mkehcp.org/mken. For folks outside of Milwaukee, check out the Department of Health Services’ website for contact information on your regional enrollment network. Efforts are already underway to prepare for the next Open Enrollment period which begins November 15th!

Wisconsin BadgerCare+ Waiver Approved: An Update on BadgerCare+ Policy

Waiver Approval

Today, the Department of Health Services (DHS) announced a final agreement with the federal Centers for Medicare and Medicaid Services (CMS) on the waiver to make changes to BadgerCare+. Though the state changes to the program were proposed and enacted through the biennium budget in June 2013, BadgerCare+ is a joint state and federal program, so all changes had to be negotiated and approved by CMS.

Three-Month Delay

Due to technical issues with the federal Marketplace website, the changes to BadgerCare+ coverage have essentially been delayed for three months through state legislation passed in December. We blogged in December about the delay in coverage of childless adults under BadgerCare+ and the transition of parents/caretakers with income above 100% FPL to the Marketplace as it was passed into law. The waiver language confirms this- that childless adults with incomes below 100% FPL will be eligible for BadgerCare+, without an enrollment cap, on April 1, 2014.

CKF’s 10 Things to Know document summarizes the effects of the 2014 changes to BadgerCare+.

Benefits

The waiver also ensures that all BadgerCare+ enrollees (including children) will have access to the full Standard Plan benefit package, which is more robust than the current Benchmark and Core Plan benefits.

MAGI

The agreement between the state and federal government also updates progress on the state’s transition to assessing eligibility under the new Modified Adjusted Gross Income (MAGI) standard – which will apply to BadgerCare+ enrollees, and not the Elderly, Blind, and Disabled Medicaid population. The MAGI system will be operational February 1, 2014. In order to assess currently eligible BadgerCare enrollees for future eligibility using the new standard, the state is asking all current BadgerCare enrollees to complete this form and return it by January 17, 2014. This will take an amendment to state law that has been approved by the Wisconsin Joint Finance Committee, and will need full legislative approval.

Here are a couple things to know about the MAGI transition and key eligibility dates:

·        January 17th – Current BadgerCare+ enrollees who received this letter should return the tax filer information form to have their eligibility reassessed under MAGI.

·         February 1st – MAGI will be implemented and all newly enrolling adults/caretakers will be assessed under MAGI with the BadgerCare+ adult income standard at 100% FPL instead of the current 200% FPL.

·         March 15th – Currently enrolled BadgerCare+ parents/caretakers with incomes above 100% FPL should enroll in a Marketplace plan with federal subsides to help afford coverage. If these individuals fill out the tax filer information form and are found to have income above 100% FPL under MAGI rules, their information should have been automatically transferred to the Marketplace.

·         April 1st – Currently enrolled BadgerCare+ parent/caretakers with incomes above 100% FPL will no longer be eligible for BadgerCare+.

·         April 1st – Newly eligible childless adults with income less than 100% FPL will be eligible to start BadgerCare+ coverage. Current BadgerCare+ Core Plan members with incomes below 100% FPL will be automatically transferred to the full Standard Plan.

More details about the MAGI transition and agreement can be found in the Legislative Fiscal Bureau papers on the technical bills currently before the legislature.

Further Waiver Policy – Transitional Medical Assistance (TMA)

Wisconsin currently charges premiums to TMA adults with incomes above 133% FPL, and requested, through the waiver, to charge premiums to all TMA adults above 100% FPL. However, the final agreement allows Wisconsin to charge scaled premiums to adults between 100% and 133% FPL only after six months on TMA. This may become a moot point if congress doesn’t reauthorize the option of providing TMA to some adults for 12 months (as Wisconsin currently provides). To learn more about that federal discussion, see the Center on Budget and Policy Priorities recent report.

If you want to read more on the technical details of the waiver agreement, the special terms and conditions can be found here.

Sara

State and Feds Approve BadgerCare+ Effective Date Changes

2014 marks significant changes to health insurance options for Wisconsin residents – including those who use BadgerCare+ (Wisconsin’s Medicaid program) for coverage. Wisconsin did not accept funding for Medicaid expansion as part of the Affordable Care Act’s implementation. Instead, the original state proposal was to change BadgerCare+ eligibility, sending some currently eligible BadgerCare+ enrollees to the Health Insurance Marketplace, where they could ideally receive subsidies to purchase insurance and opening BadgerCare+ enrollment to adults living at 100% or below the federal poverty level – including those without dependent children. These changes were originally slated to take effect January 1, 2014.  

In response to issues with Health Insurance Marketplace’s initial functionality, the governor and state legislature proposed changing the effective date of these changes to April 1, 2014. This proposal has been accepted and the changes are now in force.

The changes are summarized in this CKF 10 Things to Know document. 

The health insurance changes over the past year have kept consumers, advocates, assistance professionals, agents, brokers and providers on their toes as everyone seeks to provide accurate and timely advice. Insurance is not an easy topic to understand, despite its key link to health. It can be especially difficult with the many changes that have taken place as the nation undergoes the first year of health reform.

We’re encouraging anyone who interacts with people who are insured through BadgerCare+ now, or may be in the future, to pay close attention to all communications from the Wisconsin Department of Health Services as it seeks to inform BadgerCare enrollees and provide them with key instructions to maintain BadgerCare+ coverage or seek insurance on the Marketplace. 

Keep an eye on the DHS website and Covering Kids & Families website to stay informed about these changes – and others that may come in 2014.

NEW! Milwaukee Area Events and Enrollment Directory Published

MORE OUTREACH AND EDUCATION EVENTS SCHEDULED

TO MEET HEALTH INSURANCE MARKETPLACE ENROLLMENT DEADLINE

 

MILWAUKEE (December 11, 2013) – The Milwaukee Enrollment Network (MKEN) is promoting almost daily education and enrollment events this month to build awareness and assist with reviewing insurance options available through the Health Insurance Marketplace.  While open enrollment will continue through March 31, 2014, December 23 is the last day individuals can enroll to ensure insurance coverage by January 1, 2014.

Open to the general public, the enrollment events include information, education and often, assistance enrolling in BadgerCare Plus or the Health Insurance Marketplace.  For the most up-to-date list of enrollment events and assistance locations, individuals should dial 2-1-1.

Statewide events 

(click list to see full list of events by date)

Milwaukee area events

MKEN is a consortium of more than 100 organizations committed to promoting adequate and affordable health insurance coverage, with a focus on low-income uninsured and underinsured people in Milwaukee County. Its members are implementing a number of strategies to help individuals understand, buy and keep health insurance.  The consortium includes federally funded Navigators as well as Qualified Health Plans, insurance agents and Certified Application Counselors.  It has helped recruit, train and deploy more than 120 enrollment assisters in the community.  MKEN recently published the Milwaukee County Enrollment Directory, which lists more than 36 organizations that provide in-person or over the phone enrollment assistance for patients, clients and the public.  MKEN members and Qualified Health Plans have already hosted more than 100 outreach and education events across the community since August and will continue to coordinate enrollment activities in the New Year.

Milwaukee Enrollment Directory

Milwaukee Marketplace Assistance fact sheet

MKEN is co-convened by Covering Kids & Families Wisconsin, the Milwaukee Health Care Partnership and the Wisconsin Department of Health Services.  Significant funding for MKEN’s outreach efforts has been provided by the Greater Milwaukee Foundation, the United Way of Greater Milwaukee and the Milwaukee County Department of Health and Human Services.

BadgerCare+ and Health Insurance Marketplace Updates (11/27/13)

downloadMany changes are coming in the way individuals and families access health care in our community due to the Affordable Care Act and changes to Wisconsin’s BadgerCare+ program. Covering Kids & Families (CKF) joins many other local, state and national organizations working to inform the community about these changes to ensure residents have appropriate access to coverage and care.

BadgerCare+: Governor Walker has proposed delaying changes to the BadgerCare+ program from January 1st, 2014 to April 1, 2014.  If approved, this would mean:

  • individuals who are currently enrolled in BadgerCare+ would maintain their eligibility and enrollment in the program until April1st,
  • childless adults (many of whom were on the BadgerCare+ Core waitlist) would not be able to access BadgerCare+ benefits until April 1st, and
  • individuals in HIRSP plans will have the option to continue in their current plan until April 1st, or transition to a new plan through the Health Insurance Marketplace (see the HIRSP FAQ here).

This delay is not effective until approved by Wisconsin State Legislature and the Centers for Medicaid and Medicare Services.  The Legislature will hold a special session on this topic December 2nd, 2013 at 11:00 am.  Interested individuals can attend and testify at this public hearing held in room 412 East at the State Capitol building.  More information on the proposed changes can be found at the Department of Health Services website: http://www.dhs.wisconsin.gov/health-care/.

Marketplace Coverage Deadline: In order for coverage selected in the Marketplace to begin January 1st, 2014, the application must be submitted and the first premium paid by December 23rd.   Originally the date was December 15, 2013.  Applicants can also apply for coverage through the Marketplace by calling 1-800-318-2596.

Uninsured individuals and families and those seeking new coverage should continue to apply at the Health Insurance Marketplace at www.healthcare.gov.  For in-person application assistance, check out the enrollment directory at www.e4healthwi.org.  Residents in Milwaukee and southeastern Wisconsin can also call 2-1-1 for a list of local supports.

Please visit the CKF website, blog and Facebook at www.ckfwi.org  or email us at info@ckfwi.org for more resources and training material.

BadgerCare+ Members Notified of Changes; Now What?

The Department of Health Services (DHS) recently released data on the informational letters mailed to Wisconsin residents potentially affected by the January 1, 2014, BadgerCare+ changes.  The data outlines the number of parents/caretakers, children and childless adults in each county who were mailed one of four letters.  DHS released the following descriptions of each letter and the criteria used to select the member/individual:

·         Letter 1 – includes those transitioning adults (parents/caretaker relatives and childless adults) whose household income exceeds 100% of the federal poverty level (FPL), and transitioning children in households whose income exceeds 300% FPL.

·         Letter 2 – includes those parents/caretaker relatives who are currently in transitional medical assistance (TMA) and eligible for BadgerCare Plus+ for 12 months, also called an extension, whose household income is between 100% and 133% FPL. They will be required to pay premiums starting January 1, 2014.

·         Letter 3 – includes those childless adults that are currently enrolled in the BadgerCare Plus Basic Plan.

·         Letter 4 – includes those childless adults that were on the Core Plan waitlist as of September 20, 2013.

The letters can be viewed at the DHS website: http://www.dhs.wisconsin.gov/health-care/.

A total of 257,434 individuals statewide may be impacted by the BadgerCare+ changes.  Beginning January 1, 2014, individuals below 100%FPL will be newly eligible for BadgerCare+, individuals above 100%FPL will lose their BadgerCare+ and a third group of individuals will be required to pay premiums to retain their BadgerCare+ coverage.  Individuals transitioning off of BadgerCare+ are advised to go to the Health Insurance Marketplace at www.healthcare.gov to apply for new coverage.

Covering Kids & Families, in partnership with the Wisconsin Primary Health Care Association, the Department of Health Services and Regional Enrollment Networks throughout the state, is working hard to ensure that residents affected by the changes in BadgerCare+ understand them and know what to do next to secure healthcare coverage for their families.  A website called Enrollment for Health Wisconsin (www.e4healthwi.org) was created to keep the community informed.  The e4health website houses a calendar of over 200 informational sessions, trainings, and enrollment events for consumers, enrollment assisters and health care professionals and has a downloadable directory of enrollment supports (http://e4healthwi.org/wp-content/uploads/Enrollment-Directory_10_23_20131.pdf) to inform consumers where to go locally for application assistance.  Additionally, the Wisconsin Office of the Commissioner of Insurance has provided a list of licensed agents (http://ocidev.wi.gov/healthcare_reform.htm#badgercare-ce) who have received training to assist transitioning BadgerCare+ members in selecting health insurance from the Marketplace.

CKF is furthering its educational and outreach efforts in the community – training community-based organizations on the basics of the health care reform, distributing information to consumers affected by the Medicaid changes, informing school district staff of new health care options available to families and providing technical support, referrals and resources to those calling or emailing us.

For more information or to request CKF assistance, contact us at info@ckfwi.org.