Friday, September 30, 2016

Understanding Health Insurance (3-Part Series): Part 3-Medicaid Plans

By Beth Sullivan, CIN, CAC, SHIP Counsellor

We have talked about The Federal Marketplace, Medicare, and Open Enrollment. The third type of health insurance we will look at is Medicaid.  The good news about Medicaid is there is NO OPEN ENROLLMENT! You can apply for Medicaid programs any day of the year.

Medicaid is a social health care program for families and individuals with low incomes and certain disabilities.

The Affordable Care Act (ACA) expanded eligibility and federal dollars for Medicaid.  However, each state was given the choice of how it would expand Medicaid. As a result, each state has different rules for Medicaid. It does not transfer from state to state.

Indiana has three main programs with different names and rules.

Hoosier Healthwise (HHW) 

HHW is for children up to age 19 and pregnant women.

Package A (Standard Plan) includes the following:

  • Full service
  • No premiums
  • May have small copay of $.50-$3 for pharmacy, transportation, or emergency services.

Package C (Children's Health Insurance Program or "CHIP") includes the following:

  • Small monthly premium and copayment based on family income.

Package P (Presumptive Eligibility for Pregnant Women or "PEPW") includes the following:

  • Limited service for prenatal care while full application is being processed. 

Hoosier Care Connect (HCC) 

HCC is a coordinated care program for people who have a disability and are not eligible for Medicare.  They may be aged, blind, or disabled.  Members receive all Medicaid-covered benefits plus care coordination services.  Members on Medicaid for Employees with Disabilities (M.E.D. Works) are also on HCC.

Healthy Indiana Plan (HIP)

HIP covers adults 19-64 years of age whose incomes are less than 138% of the federal poverty level. There are two types of HIP:

  • HIP Basic is a fee for service plan.  This means that you  pay an amount every time you use it. This includes doctor visits, medicines, hospitals, labs, and X-rays. This is usually $4.

  • HIP Plus is a program where you make a contribution every month to a Power Account but don't have copays when you use it.  The contribution is 2% of your income.  This program also covers dental and vision. 

This is a simplified explanation of Medicaid. If you would like more information, visit . You can also visit to speak to one of our Eligibility Navigators.

Tuesday, September 20, 2016

Understanding Health Insurance (3-Part Series): Part 2-Medicare

By Beth Sullivan, CIN, CAC, SHIP Counsellor

In Part 1 of this series, we learned that Open Enrollment could be called "sign up time." In Part 2, we will talk about Open Enrollment for Medicare. Unlike Open Enrollment for the Marketplace, which changes every year, Medicare happens on the same dates every year.  Open Enrollment is only one of three different enrollment periods that Medicare has.

October 15 to December 7 are the dates chosen for Open Enrollment.  As this time of year approaches, you see an increase in advertising on TV and in your mailbox for Medicare Plans.  This is also a great time of year to speak to an Eligibility Navigator about your options for the coming year and to check that your plan covers your current needs.

During this time you can:

  • Change from original Medicate to a Medicare Advantage Plan. 
  • Change from a Medicare Advantage Plan back to original Medicare.
  • Switch from an Advantage Plan to another Advantage Plan. 
  • Switch from an Advantage Plan that doesn't offer drug coverage to an Advantage Plan that does. 
  • Join a Medicare Prescription Drug Plan. 
  • Switch from one drug coverage plan to another. 
  • Drop your Medicare drug coverage completely. 

Confused? Let's look at what this means. You can:

  • Change from your Red, White, and Blue card for an Advantage Plan (also called a Replacement Plan) card.
  • Change from an Advantage Plan back to your Red, White, and Blue card. 
  • Change from one Advantage Plan to Another Advantage Plan. 
  • Switch from an Advantage Plan that doesn't cover your medicines to one that does. 
  • Switch from and Advantage Plan that does cover your medicines to one that doesn't. 
  • Join a Medicare Drug Coverage Plan. 
  • Switch from one Drug Coverage Plan to another. 
  • Drop your medicine coverage completely. This is not a good idea unless you have another medicine plan in place because it is required by the law. 

The next enrollment for Medicare is actually a Disenrollment Period, or a time to get rid of an Advantage Plan and go back to the Red, White, and Blue card.

This enrollment period is from January 1 to February 14.

During this time, you can leave your Advantage Plan and switch back to Original Medicare. This coverage would begin the first day of the following month. If you switch to Original Medicare, you will have to wait until February 14 to also join a Medicare Prescription Plan to add coverage. This coverage would begin the first day of the month after enrolling.

The third enrollment is called the Initial Enrollment Period and it's the time you get a 65th birthday present from the Federal Government called Medicare! Initial Enrollment begins three months after your birthday for a window of seven months. If you are already collecting Social Security Retirement Benefits, you will be automatically enrolled in Original Medicare. If you are not receiving Social Security Benefits yet, you will need to enroll.

There is one more situation that triggers Medicare enrollment and that is when you are on Social Security Disability. In the 25th month of disability, you can enroll in Medicare.

There are many different times and different plans to consider, but you can contact an Eligibility Navigator at Windrose Health Network or call SHIP at 1-800-452-4800 to speak to someone about Medicare.

Friday, September 16, 2016

Understanding Health Insurance (3-Part Series): Part 1-Federal Marketplace ACA

By Beth Sullivan, CIN, CAC, SHIP Counselor

As more people have access to medical care through the Affordable Care Act (ACA), many for the first time, there are new terms to learn and understand.  Let's look at one those terms and put it plainly! The term for today is Open Enrollment, which, basically, means "sign up time."

What is Open Enrollment?

Open Enrollment is the time when a health insurance company has to accept new patients without regard to health history.  This is required by law.

Many companies have Open Enrollment when employees who have insurance through their jobs may change their plans or sign up for health coverage.  Ask your employer when Open Enrollment is for your company.

Why is Open Enrollment important?

Open Enrollment is when we all need to look at our health coverage and make decisions for the coming year.  Since there is no such things as a "crystal ball," at least not that I have found, we need to make sure our families are protected from unexpected illness and injury.

The Federal Marketplace is for people who do not have health insurance through a job and do not meet the rules for HIP or Medicare.  People meeting the rules for the Marketplace may receive tax credits to help offset the cost of the insurance.

When is Open Enrollment for the Marketplace?

The Open Enrollment dates for the Federal Marketplace are listed below.  It is important to remember that, if you have coverage through the Marketplace, the plans change every year and it is in your best interest to do a new application to see if your plan has changed and if there is a plan that better fits your needs.  Eligibility Navigators are available to help you with this.

November 1, 2016: Open Enrollment.  It is the first day you can enroll, re-enroll, or change a 2017 insurance plan through the Health Insurance Marketplace.  Coverage can start as soon as January 1, 2017.

December 15, 2016: Last day to enroll in or change plans for coverage to start January 1, 2017.

January 1, 2017: 2017 coverage starts for those who enroll or change plans by December 15.

January 31, 2017: Last day to enroll in or change a 2017 health plan. After this date, you can enroll or change plans only if you qualify for a Special Enrollment Period.

HIP, Hoosier Healthwise, and Medicaid do not ave Open Enrollment times. You may apply at any time for these plans.

Tuesday, September 13, 2016

Eat Fresh With SNAP and EBT

By Beth Sullivan, CIN, CAC, SHIP Counselor

Did you know...

Over 50 Indiana farmers markets are authorized to accept SNAP (Supplemental Nutritional Assistance Program) & EBT transactions via Hoosier Works cards? An additional 25 farm stands throughout the state are authorized to accept SNAP/EBT, as well. 

At the 2016 Indiana Farmers Market Forum and Indiana's first SNAP Sign-Up Day, an additional 16 farmers markets and farm stand became SNAP authorized expanding local and fresh food access at key locations around Indiana!

Every individual and family ought to have decision-making options as to where and how they make food purchases, especially in regards to fresh, local food and agricultural products.

Eat fresh! Eat Local!

Friday, September 2, 2016

Understanding And Moving Forward With Post-Traumatic Stress Disorder (PTSD)

By Jessica Bosecker, LMHC

One minute you’re fine, walking along, doing your thing, and then something changes, and your whole world shifts.  We’ve all experienced life changes, but what happens when our brains don’t move forward, but continue reliving the experience, the trauma? Those who live with the experience of Post-Traumatic Stress Disorder understand this phenomenon all too well. 

Post-Traumatic Stress Disorder is characterized by a host of symptoms, including intrusive thoughts about the trauma, distressing dreams related to the event, flashbacks, overall distress, physiological reactions to “triggers” that remind us of the trauma, avoidance behaviors around trauma reminders, negative emotions and cognitions, and behavior alterations, which include irritability, reckless behavior, hypervigilance, becoming easily startled, difficulty with sleep, and concentration.

While these symptoms of PTSD sound severe, they can be hard to recognize or notice in those around us.  Part of recovery is recognizing the struggle within ourselves and reaching out for help, whether through self-help groups, acknowledging difficulties to those we trust, or seeking professional help in the form of medication and/or therapy services.

For those with PTSD, neural pathways in the brain are changed, encouraging symptoms such as reliving the experience.  Part of healing our mental struggle, is focusing on the physical.  One technique frequently used for anxiety associated with PTSD, is called “ground techniques.”  This focuses on the five senses, and asks you to focus your thoughts on what you can hear, see, smell, touch, and taste. Other techniques that also focus on the physical include deep breathing and progressive muscle relaxation.  Exercise can also be a helpful tool in retraining your brain and coping with symptoms of PTSD.

For many, feeling connected to others is an anchor to tie them to recovery, whether it be family, friends, others that experienced the trauma, or a professional.  Connecting emotionally to another person alleviates the sense of isolation that can accompany PTSD and can give us the strength to move forward when we’re struggling to do so on our own.

Whether you are struggling with PTSD, or have a loved one who is struggling from a trauma, know that there are many ways to begin moving forward and shifting your world back to one that you understand.