MomsFirst&

Affordable Health Care

GOALS: MomsFirst

To lower the number of

babies that die before they are

a year old. MomsFirst

wants to help YOU have a

healthy pregnancy.

GOALS: Affordable Care Act (ACA)

Expand access to affordable health insurance coverageOffer coverage to those with pre-existing health conditions.Lengthen coverage to young adults on parents insuranceIncrease patient protection against insurance companiesStress importance of prevention & wellness

Focus on better health care quality & results

Lower health care costs.

WHAT is the ACA?

11/09/13

Also known as “ACA” or

“Obamacare”

Signed into LAW in 2010

Introduced changes to

improve patient protection, health care access, and affordability in

the United States

It’s the Law!Beginning in January 2014, most people will need to

purchase or obtain health insurance coverage – this is the

mandate.*(subject to fine)

Open enrollment begins

November 15, 2014*Some people will be exempt from this rule.

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WHY do I need the ACA?

11/09/13

Millions of Americans living without health insurance• 50 million Americans, 1.5

million Ohioans, 150,000 Cuyahoga County residents

• Millions with pre-existing conditions were denied coverage

Insurance premiums more than doubled over

the last decade

Health care costs skyrocketing in the U.S.

Health care system relies on treatment

instead of prevention

WHO is Exempt?

If you have financial hardship

If you have religious objections

If you are a member of a federally recognized tribe

If you are an undocumented immigrant

If you are incarcerated If your income falls below the threshold required to file a tax returnIf the lowest cost health plan available exceeds 8% of your income

11/09/13

WHO is Eligible?

If you live in the service area, and

You are a U.S. citizen or national, or

You are a non-citizen who is lawfully present in the U.S. for the entire period for which enrollment is sought, and

You are NOT incarcerated

11/09/13

WHAT are 10 Essential Health Benefits of ACA?

Ambulatory patient services Prescription drugsEmergency services Rehabilitative services and

devicesHospitalization Laboratory servicesMaternity and newborn care Preventative and wellness

services and chronic disease management

Mental health and substance use disorder services, including behavioral health treatment

Pediatric services, including oral and vision care (pediatric oral services may be provided by stand-alone plan)

WHAT Coverage is Available in Ohio?

HOW Can I Get Coverage?

Beginning in 2014, most individuals will need to purchase or obtain health insurance coverage.

Employer-sponsored insurance Individual private insurance Young adults under age 26 on parent’s

insurance TRICARE/Veterans Affairs Medicare Medicaid/CHIP Health Insurance Marketplace*

*financial help will be available

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HOW TO APPLY

The Health Insurance Marketplace

www.healthcare.govThe Health Insurance

Marketplace

… to access the Marketplace and stay informed with up-to-date consumer information.

11/09/13

The Health Insurance Marketplace

The ACA requires every state to set-up and operate a Health Insurance MarketplaceA place for qualified individuals and employers to directly compare private health insurance optionsCan directly compare plans on the basis of price, benefits, quality, and other factors

Financial assistance is available for most applicants

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Advantages of the ACA

Easier way to shop for health coverage• Simplifies search• All options in one place• A streamlined application and an individual or family can

explore every qualified insurance plan in the areaMost people will get a break on costs• 90% of people who are currently uninsured will qualify

for discounted or free health insurance

Clear options presented in common language• All health insurance plans in the Marketplace present

their price and benefit information in plain language

WHO WILL QUALIFY?

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Medicaid Expansion

Ohio Medicaid Expansion in 2014

11/09/13

Beginning January 1, 2014, more low-income Ohioans will be eligible for Medicaid coverage.

Additionally, shifts to a simplified way of calculating income to determine eligibility and streamlines the application process

HOW Can I Apply for Medicaid?

11/09/13

1. In-person:

Job and Family Services

2. By phone:

Ohio Medicaid Consumer Hotline

(800-324-8680)

3. Online:benefits.ohio.gov

Marketplace Takeaways

It’s an easier way to shop for health insurance• Simplifies the search for health insurance• One application, one time, and an individual or

family can explore every qualified insurance plan in the areaMost people will be able to get a break on

costs• 90% of people who are currently uninsured will

qualify for discounted or free health insuranceClear options with apples-to-apples comparisons• All health insurance plans in the Marketplace

present their price and benefit information in plain language

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HOW Can I Stay Informed!

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Health Insurance Marketplace

Healthcare.govlocalhelp.healthcare.gov1-800-318-2596

Medicaid

Benefits.ohio.gov1-800-324-8680

www.ohioforhealth.org

WHERE Can I Get Help?Healthcare.govThe Marketplace 24/7 Toll-Free Call Center• 1-800-318-2596 (TTY 1-855-889-4325)

Certified In-Person Assisters• Navigators• Certified Application Counselors• Agents and brokers

Federally-Qualified Health Centers

11/09/13

NEON Outreach & Enrollment Specialists Team

Alicia Weatherspoon-White, ext 1581

NEON Southeast Health Center

Lisa Harris, ext 1222

NEON Hough Health Center

Khalil Ismail, ext 1181

NEON Superior/Norwood

216-231-7700

Tell Everyone You Know!!

Questions?