You’re a CAC! Now What?How to Have a Happy OE3

Who am I? Who are you?

• CAC since 2013• RiverStone Health

– Community Health Center in Billings

• Team of 6 “Care Coordinators” – Reducing Social Determinants

• 900+ enrollments since OE1• Outreach and In-reach

strategies for HIM

Upcoming Slides

• Application Process– Website Walkthrough

• Health Insurance Literacy 101– How to sound like you know what you’re talking

about• FAQ’s• Tips and Tricks – Keep Calm, Assist On

THE APPLICATION PROCESS

Setting the Stage

• Your enrollment starts with the very first conversation– Plant the seed of necessary info• Income information• Social Security Numbers• Date of Birth

• Always ask:– Do you have an email address?– Does your employer offer you insurance?

• Use a checklist to help you stay consistent

Pre-Visit Planning

• Team Based strategy• Helps with continuity if you aren’t the one

meeting with the patient• Prepare yourself and the client for the end

result of the appointment– Will they fall in the “gap?”– Will they be eligible for tax credits?– Do they meet SEP eligibility?

Website Time Planning

• How long are your appointments? Set reasonable expectations– 1hr (account creation, eligibility determination, and

enrollment)• How do we do GSD?– Use every minute– Be prepared to stay on task– Sprinkle in education between the clicking, scrolling, and

dead screen time

Educate Yourself

• Education is the movement from darkness to light – Allan Bloom

• To the uneducated, an A is just three sticks – A. A. Milne

• “It’s all Greek to me!”

HEALTH INSURANCE LITERACY 101

Normal People Hate Insurance

• It’s not fun, glamourous, interesting, or seemingly necessary

• Taboo Topic and “Don’t want to think about it” mentality

• That’s okay – reassure them– Opportunity to build report and trust– let them know your role in the process– You are here to HELP

What Does My Plan Cover?

• I want the best plan!• 10 EHB and describe

what that means for consumers

• Metal Tiers– Give an example of

Bronze vs Silver utilization

BIG Buzz Words

• Premium• Deductible• Co-Pay• Co-Insurance• Network• Prescription Formulary• Tell a story, paint a picture

Instead of That…Try This!• A premium is the amount to be paid for an insurance policy

– A premium is a bill that you pay each month in order to keep your policy current. It’s like a cable bill you need to keep current so they don’t shut off service.

• A health insurance provider network is a group of health care providers that have contracted with a HMO, PPO, or POS to provide care at a discount.– A network is a group of doctors or medical facility where you

will see the best rates for healthcare services. If you want to pay the best prices, you will need to make sure you are using someone who is listed by your insurance company

COMMON QUESTIONS AND WHERE TO FOCUS YOUR EFFORTS

You will be asked…

• What plan do you think is best?– REFRAME: Kick in your EHB knowledge, metal plan

descriptions, and health insurance terminology• What do you think about this whole mess?– REFRAME: We aren’t political figures, but it sure feels

good when…• I think I’d rather just take the fine!– REFRAME: That is completely up to you, but let me remind

you of what that means…

Focus and Frame

• Did you know you could get help paying for your insurance plan?

• It only takes a few minutes to discover your options!• I am here to help you walkthrough the process and

make an educated decision.• Open enrollment ends January 31st. • Insurance can give you peace of mind throughout the

year and offers many benefits!

TIPS & TRICKS

Parting Thoughts

• Learn how to quickly make an email account• Create a cheat-sheet for patients to take home• Make materials that work for you!• Develop your elevator speech to answer the

question of “What do these plans cover?”• If you don’t know…find out• Keep Calm and Enroll On

Have a Great Summit!