senior health insurance_dvu_september 12 2013

September 11, 2013

Senior Health Insurance Resources

1

Senior Health Insurance Workshop Recap Presented by: Dr. Mary Howrey, Library Director

September 11, 2013 2


National Network of Libraries of Medicine

A partner in

this training

series…

Southeastern Atlantic

Region

Baltimore, MD

This project has been funded in whole or in part with Federal funds from the National Library of

Medicine, National Institutes of Health and Human Services, under Contact No. HHS-N-276-

2011-00004-C with the University of Maryland Baltimore.


National Network of Libraries of Medicine /

Southeast Atlantic Region

1,249members

NNLM/Southeastern Atlantic Region http://nnlm.gov/sea/

States Served: AL, FL, GA, MD, MS, NC, SC, TN, VA, WV,

the District of Columbia, Puerto Rico, and the U.S. Virgin Islands

http://nnlm.gov/sea/

http://nnlm.gov/sea/


Healthy Aging Resources on the Web 2013 Friends of the Miramar Library Training Series

Florida Library Association 2013

Friends Award for Best Website:

http://www.friendsofthemiramarlibrary.org

http://www.friendsofthemiramarlibrary.org/


Key points—

Schedule an appointment with a SHINE counselor

Phone: 954-745-9567

SHINE counselors are available at a number of Broward

locations

Know your current costs for your prescription drugs

Is your doctor included in the plan?

Recognize that Medicare doesn’t cover all your costs—a

Medigap policy maybe required with traditional Medicare Parts A

and B / Medicare Advantage plans generally require a co-pay

and deductibles for out-of-pocket expenses

ADRC Website for more info: http://www.adrcbroward.org

Aging and Disability Resource Center of

Broward (ADRC) SHINE Counselors

http://www.adrcbroward.org/


Key points to consider— November 1, 2013 Medicaid Long Term Care Services consolidate into one program in Florida For eligibility, contact— Janice Johnson Florida Department of Children and Families /ACCESS Program Phone: 866-762-2237 For information about the Florida Medicaid program, contact— Vicki Sroka Agency for Healthcare Administration Phone: 954-958-6500 E-mail: [email protected] For information about Medicaid Medical Eligibility, contact— Esther Villalobos Department of Elder Affairs/CARES PSA 10 Phone: 954-597-2240

Medicaid Long Term Care Services

mailto:[email protected]


Key website links— Medicare Starter Kit Online http://www.aarp.org/health/medicare-insurance/info-04-2011/medicare-starter-guide.html

AARPHealth Law Answers http://healthlawanswers.aarp.org/?cmp=RDRCT-HLTHLWGD_JUN20_013

Medicare Supplement Insurance (Medigap) http://www.aarphealthcare.com/medicare/medigap.html

AARP Medicare Advantage http://www.aarphealthcare.com/medicare/medicare-advantage.html?intcmp=MBCH-HEAPRO-MEDADV-041012

AARP Services

http://www.aarp.org/health/medicare-insurance/info-04-2011/medicare-starter-guide.html












http://healthlawanswers.aarp.org/?cmp=RDRCT-HLTHLWGD_JUN20_013




http://www.aarphealthcare.com/medicare/medigap.html

http://www.aarphealthcare.com/medicare/medigap.html

http://www.aarphealthcare.com/medicare/medicare-advantage.html?intcmp=MBCH-HEAPRO-MEDADV-041012











Enrollment begins on October 1, 2013 and ends on March 31, 2014 Of interest to seniors, ages 50-64, with no health insurance

Online enrollment @ Healthcare.gov http://healthcare.gov

Phone: 1-800-318-2596

Personal assistance is available from Navigators-- Enroll America Florida/Broward Advanced Patient Advocacy LLC Broward Community and Health Centers, Inc. (Hollywood) Citrus Health Network, Inc. (Hialeah) North Broward Hospital District (Fort Lauderdale) Community Health of South Florida (Cutler Bay)

Affordable Care Act Enrollment

http://healthcare.gov/


The essential health benefits through the Health Insurance Marketplace include at a minimum: Ambulatory patient services, such as doctor’s visits and outpatient

services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including

behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive services Pediatric services, including oral and vision care

These benefits and services set a standard for a basic health insurance plan…

Affordable Care Act Essential Benefits


The Affordable Care Act (ACA) provides premium tax credits and cost-sharing subsidies to help low- and moderate-income Americans afford coverage. These tax credits reduce the premium of one’s health insurance policy.

Premium subsidies are available on a sliding scale to individuals and families with incomes between 100-400 percent of the federal poverty level (FPL).

Additional cost-sharing subsidies are deductibles, co-pays and co-insurance.

The ACA provides two forms of subsidies too help pay for health insurance. (1) Premium assistance tax credit and (2) Cost-sharing assistance (limits a person’s maximum out-of-pocket costs or reduces other cost-sharing requirements,such as deductibles, coinsurance, co-payments)

Affordable Care Act Premium Subsidies


Household Size 100% 133% 150% 200% 300% 400%

1 $13,230 $17,596 $19,845 $26,460 $39,690 $52,920

2 17,850 23,741 26,775 35,700 53,550 71,400

3 22,470 29,885 33,705 44,940 67,410 89,880

4 27,090 36,030 40,635 54,180 81,270 108,360

5 31,710 42,174 47,565 63,420 95,130 126,840

6 36,330 48,319 54,495 72,660 108,990 145,320

7 40,950 54,464 61,425 81,900 122,850 163,800

8 45,570 60,608 68,355 91,140 136,710 182,280

For each additional person, add-- $4,620 $6,145 $6,930 $9,240 $13,860 $18,480

Federal Poverty Levels for 2013

Source: Calculations by Families USA based on data from the U.S. Department of Health and

Human Services

http://www.familiesusa.org/resources/tools-for-advocates/guides/federal-poverty-guidelines.html












Income Premium Limit

Up to 133% FPL 2% of Income

133 – 150% FPL 3 – 4 % of income

150 – 200% FPL 4 - 6.3% of income

200 – 250% FPL 6.3% - 8.05% of income

250 – 300% FPL 8.05% - 9.5% of income

350 – 400% 9.5% of income

Premium Limits for Consumers Based on

Income

Source: Community Catalyst & Georgetown University Health Policy

Institute, 2011. Note: Update data and confirm accuracy.


Income Out-of-Pocket Limit (based on 2011

HSA Limit)

100 – 200% FPL 1/3 HSA limit ($1,983/individual;

$3,967/family)


$5,950/family)


$7,933/family)

500% FPL 100% HSA limit ($5,950/individual;

$11,500/family)

Out-of-Pocket Spending Limits for

Consumers Based on Income

Source: Community Catalyst and Georgetown University Health Policy Institute,

2011. (Note: Update data and confirm accuracy.)


Irene Lester, age 32 and currently uninsured, has no children and an annual

income of $22,340 (200% FPL). Irene, a Florida resident, goes on the federal

health insurance exchange to shop for coverage. Below are some medal plan

options for Irene.

Premium Savings Under the ACA Health

Insurance Exchange (Illustrative Example)

Medal Plan

Annual

Premium

Irene Pays

(member

premium)

Premium Tax

Credit

Government

Pays)

Bronze $1,200 $0 $1,200

Silver $2,500 $905 $1,595

Silver Reference $3,000 $1,405 $1,595

Gold $3,595 $2,000 $1,595

Platinum $5,595 $4,000 $1,595


Income as a

% of Poverty

Income –

Single

Individual

OOP Cost

Reduction %

Reduction in

OOP Costs

Members

OOP Limit on

Silver Plans

134% - 150% $16,755 2/3 $4,033 $2,017

200% - 249% $22,340 1/2 $3,025 $3,025

250% - 300% $27,975 1/2 $3,025 $3,025

301% - 350% $39,095 1/3 $2,017 $4,033

351% - 400% $44,680 1/3 $2,017 $4,033

< 400% >44,680 N/A N/A $6,050

Cost Sharing Assistance Under ACA for Out of

Pocket (OOP) Expenses (Illustrative Example)

**People who qualify for the premium assistance tax credit will also be eligible

for cost sharing assistance, but only if they enroll in a silver plan.


Florida has 3,750,200 non-elderly uninsured (Source: Enroll

America, 2012) / Approximately 25% or 1 of 4 Floridians have no

health insurance

Florida ranks third among the states with the largest number of

uninsured in the nation. Only California and Texas have larger

numbers of uninsured.

Miami-Dade County, FL Broward County, FL

Uninsured residents (#4 rank in US) Uninsured Residents (#12 in US)

Florida’s Uninsured Numbers

762,000 408,000


38%

13%

23%

14% 12%

0%

5%

10%

15%

20%

25%

30%

35%

40%

Under100%

100-138% 139-250% 251-399% 400%+

Federal Poverty Level Among Florida’s Uninsured

Percent

Federal Poverty Level (FPL) of

Florida’s Uninsured

Source: Kaiser Commission on Medicaid and the Uninsured, October 2012


Visit the Internal Revenue Service website http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home U.S. Treasury Department http://www.treasury.gov/press-center/Documents/36BFactSheet.PDF Kaiser Family Foundation Subsidy Calculator

http://kff.org/interactive/subsidy-calculator/

Families USA http://www.familiesusa.org The Bottom Line: How the Affordable Care Act Helps Florida Families (October 2011) http://familiesusa2.org/assets/pdfs/health-reform/helping-families/Florida.pdf

Information about the Premium Tax Credits

in 2014

http://www.irs.gov/uac/Affordable-Care-Act-Tax-Provisions-Home













http://www.treasury.gov/press-center/Documents/36BFactSheet.PDF








http://www.familiesusa.org/

http://familiesusa2.org/assets/pdfs/health-reform/helping-families/Florida.pdf








Miramar Branch Library/Broward County Library System Adult Services Department 954-357-8090 Option 3

Friends of the Miramar Library http://www.friendsofthemiramarlibrary.org

DeVry University Library/Member of the National Network of Libraries of Medicine, Southeastern Atlantic Region http://www.mir.devry.edu/academics_library.html Phone: 954-499-9851 E-mail: [email protected]

Member Libraries of these Southeast Florida consortia--

Southeast Florida Library Information Network (SEFLIN) http://www.seflin.org

Southeast Florida Health Science Libraries Consortium (SFHSLC) http://www.sfhslc.org/

Library Assistance is Available for Your

Health Insurance Questions

http://www.friendsofthemiramarlibrary.org/

http://www.mir.devry.edu/academics_library.html

mailto:[email protected]

http://www.seflin.org/

http://www.sfhslc.org/

http://www.sfhslc.org/


Here’s your opportunity to ask questions and talk with our experts from— Service Providers— 2-1-1 Broward ADRC Broward / SHINE Medicare Insurance Counseling Medicaid / Agency for Health Care Administration Department of Children and Families / ACCESS Program Department of Elder Affairs/CARES AARP Miramar Branch Library Adult Services Department DeVry University South Florida/National Network of Libraries of Medicine Friends of the Miramar Library ACA Health Insurance Expo Participants— Broward Community & Family Health Centers, Inc (Navigators) CarePlus (United Healthcare) Congresswoman Debbie Wasserman Schultz Office Enroll America Florida (Navigators) Florida CHAIN (Affordable Care Advocacy) Florida Blue Humana MarketPOINT KidCare Medicaid/AHCA Molina Healthcare of Florida, Inc. Sunsure Insurance/Florida Blue

Questions??


Please complete the Workshop Feedback Survey

You can register for one of the PC Workshops offered on Saturday, October 5 and Saturday, October 12 from 10:30am – 12pm in the Technology Center

These workshops will introduce online tools to help you with selecting your Medicare health insurance or Affordable Care Act insurance

SHINE Counselors will be on hand answer any of your questions on October 5 and October 12 at the Miramar Branch Library’s Technology Center

THANKS for attending today’s Workshop and Expo

Workshop Feedback and Registration for the

October 5 and October 12 PC Workshops