Affordable Care Act Outreach University of New Mexico

Transcription

1 Affordable Care Act Outreach University of New Mexico Project Description & Implementation Overview In October, the University Of New Mexico College Of Pharmacy (UNM COP) held its Student Outreach Day. On this day, lectures are cancelled and student pharmacists participate in community service projects throughout the state of New Mexico. The AMCP chapter at UNM organized educational outreach on the Affordable Care Act (ACA). We had locations in four Walgreens pharmacies, a Wal-Mart, and our campus s student union building. We worked with two 4th year student pharmacists to set up ACA training for our volunteers. Two training sessions consisting of a lecture covering the key points of how ACA would affect people and businesses were held. Volunteers were assigned location and shift (9AM- 12PM & 12PM-3PM) and given handouts to guide their discussions. Each group took a different approach. For instance, in the Student Union Building of UNM, we had an interactive poster board to grab student pharmacists attention and quiz them on their knowledge of ACA such as,"is there a penalty for not having insurance?" We also gave away keychain band aids to those who stopped by our tables. Our 36 volunteers reached over 200 people in Albuquerque. We provided information about signing up for insurance and answered a range of questions that the public had about the Affordable Care Act. Purpose of the Project: We wanted to educate undergraduate students and the general public about the changes in healthcare that would come with the Affordable Care Act. We also educated our classmates during the training sessions. When we had the training session, we opened it up for other student pharmacists, and we had a total of 36 volunteers and 56 student pharmacists showed up to the training. Project Budget: Expenses and Revenues Handouts were printed by our College of Pharmacy. One group made a display board, which cost about $5 out of their pocket. Band-Aid key chains were donated by Walgreens to hand out as freebies and to entice people to the booth. No revenues were collected for this project. Who and How Many Chapter Members are involved? All of our chapter members were involved plus other student pharmacists from our College. This was a part of our annual Outreach Day. o During this event, all P1, P2, and P3 student pharmacists were assigned to a community service project. Our ACA Outreach was one of the options.

2 Who Should be Targeted? Audience or Involvement? How Do You Find Them? How Do You Contact? At our Student Union Building, our ACA Outreach targeted student pharmacists while the remaining 5 locations at Walgreens and Wal-Mart targeted the Albuquerque community. Speakers for our project consisted of student pharmacists who had to attend a mandatory training session. At this training session, two fourth year student pharmacists provided a lecture about the ACA and how it will affect everyone. What Materials are needed? Outside Resources, Ordering, etc? Materials needed for this project consisted of highly motivated people with a passion to educate the community regarding upcoming changes with the ACA, 1 poster board, a few tables, handouts with information about health insurance provided by the New Mexico Health Insurance Exchange, Band-Aid key chains provided by Walgreens, paper, printer. Timeline for Implementation and Execution Leader Meet up o August - once o September - once a week (4 times) o October - once Sent out preference sheet - in early September Pick-up packets on October 7th Training on October 7th and 8th Outreach Day - October (day before Fall Break) Follow-up with Faculty Members/Volunteers/Participants Feedback was gathered during a meeting with all the leaders, and and via with the team leaders of the groups. Information gathered from this feedback included a count of people reached, what they liked, disliked, and any suggestions for next year. Thank you letter to the site coordinators/pharmacists/store managers Project Evaluation: What Went Well? What Didn t? How Would You Improve for the Next Year? Went well: There was an interactive display board that allowed student pharmacists to quiz themselves on the law such as: o How long can people stay under their parent s insurance? o Are there exceptions to paying a penalty for not having insurance? At the Student Union Building, undergraduate students and others would actively approach our booth to learn about the ACA. The population at this location was also more willing to participate in the activity as the information provided was more relevant to their personal interests. For example, people who did not have insurance were interested about the penalties faced by those who did not have health insurance and the

3 new eligibility laws that would allow them to obtain health insurance regardless of current health conditions. Didn t go well: At the Wal-Mart and Walgreens locations, it was difficult to get people engaged as people were occupied by their personal tasks. Improve for next year: Some suggestions were to target a population of people who were less likely to have insurance. Project Checklist: General Prep Meetings w/ other groups that were participating in the Outreach Day o Generation Rx o Poison Control Center Presentations (SPIKE) o Diabetes and Heart Health Fairs o Immunizations o HIV testing & education Submit GoogleDoc for all P1, P2, and P3 student pharmacists to choose their preferences for Outreach Day. Set-up locations (ensure tables and handouts are prepared for each location) Assign student pharmacists to ACA outreach project who listed it as their preference plus those that didn t list a preference. Training for ACA o 1 hour training with PowerPoint slide Provide handouts and sign-in sheets to assigned Team Leaders Collect feedback from groups after the event.

4 Affordable Care Act: How You Can Help Your Patients Find the Best Insurance for Them Monique Dodd, MLS(ASCP) CM, PharmD Candidate 2014 Christine Oshida, PharmD Candidate 2014 Michel Disco, RPh, MBA

5 Why Health Care Reform?

6 Why Health Care Reform? 1 The U.S. has the highest health care cost per person than any other industrialized country in the world. ACA moves toward reducing health care cost: Universal coverage. Value of health care, not volume. Focusing on evidence-based care. Preventive care. 1. Health Action New Mexico

7

8 Affordable Care Act, Affordable Insurance Exchanges: If employer does not offer insurance or too expensive. Insurance marketplace for individuals and small businesses. Individual Responsibility: Required to purchase insurance or pay a fee. Expanding Access to Medicaid: Low-income individuals and families are eligible. NM expands coverage to 138% of FPL ($15,856/yr for 1 person or $32,499 for a family of 4). Making Coverage Affordable: Tax credits for middle class if not eligible for other coverage. May qualify for reduced cost-sharing. 2. HHS.gov/HealthCare

9 Affordable Care Act, Ending Annual Coverage Limits: Law prohibits new and existing plans from imposing annual dollar limits on coverage. Ending Discrimination: Law prohibits companies from refusing to sell or renew coverage due to pre-existing conditions. Prohibits charging more because of gender or health status. Increasing Small Business Tax Credit: Small business tax credit raised. % credit for small nonprofit organizations. 2. HHS.gov/HealthCare

10 October 1 st, 2013 Health insurance exchanges launch across the U.S. Shop/compare/buy individual health insurance. 40% of the population do not know that the ACA is a valid law. 3 40% of the population are not familiar with the term health insurance exchange. 3 Enroll before December 1 st to guarantee coverage on January 1, Kaiser Family Foundation

11 Health Insurance Exchange (Marketplace) 4 Presents benefit options in a standard format so consumers can compare plans. Toll-free hotlines where consumers can ask questions. Trained navigator assisted programs. Certified health plans that sell policies which comply with regulatory standards and requirements. Determines eligibility for tax credits, subsidies, Medicaid or the Children s Health Insurance Program (CHIP). Certifies exemption from individual mandate. 4. healthinsurance.org

12 New Mexico Health Care Exchange (NMHIX) ual/#state=new-mexico Who is the exchange for? 5 No health insurance. Cannot afford employer health insurance. Small businesses with 50 employees. Currently buying own insurance but interested in more affordable options. 5. New Mexico Health Insurance Exchange (NMHIX)

13 Pay a Fee if No Health Coverage by No health coverage in 2014: Pay a penalty ( individual shared responsibility payment ) $95 per adult. $47.50 per child. Or 1% of income. Fees increase annually. Whichever is higher. Fees paid when taxes are filed for HealthCare.gov

14 Exemptions from Payment 6 Uninsured < 3 months of the year. Lowest-priced coverage would cost > 8% of household income. Don t file tax return d/t too low of income. Member of federally recognized tribe or eligible for services through Indian Health Services provider. Member of a recognized health care sharing ministry. Member of a recognized religious sect with religious obligations to insurance, including Social Security and Medicare. Incarcerated. Not lawfully present in the U.S. 6. HealthCare.gov

15 Hardship Exemptions 6 Homeless. Evicted in past 6 months or facing eviction/foreclosure. Received a shut-off notice from utility company. Recently experienced domestic violence. Recently experienced death of a close family member. Experienced fire, flood, or other natural or human-caused disaster. Filed bankruptcy in last 6 months. Medical expenses that could not be paid in last 24 months. Experienced unexpected increases in necessary expenses d/t caring for ill, disabled, or aging family member. Expect to claim child as tax dependent who has been denied Medicaid and CHIP. Determined ineligible for Medicaid because state did not expand eligibility for Medicaid under the ACA. 6. HealthCare.gov

16

17 CURRENTLY HAVE HEALTH INSURANCE

18 Patient s Rights

19 Patient s Rights 7 No lifetime limits on benefits. Annual limits are being phased out. Insurers cannot cancel coverage d/t illness. Can obtain preventive care (e.g., annual exams and cancer screenings, vaccines) w/ no out-ofpocket expense. Children < 19 yoa cannot be denied coverage d/t health status. Insurers cannot exclude coverage for treatment related to child s preexisting conditions. 7. Consumersunion.org

20 UNINSURED

21 How Long Can Children Stay on Parent s Plan?

22 How Long Can Children Stay on Parent s Plan? 6 Can be added or kept on parent s insurance policy until age 26. Can remain on plan if: Married. Not living with parents. Attending school. Not financially dependent on parents. Eligible to enroll in their employer s plan. 6. HealthCare.gov

23 Why Should I Have Health Coverage? 6 Most people need medical care at some point. No one says, I m not going to get hurt or sick today. Protects from very high medical expenses. Insurance will pay a good portion of medical expenses. 3-day hospital stay averages $30,000. Broken leg costs up to $7, HealthCare.gov

24 SMALL BUSINESSES

25 Changes for Small Employers

26 Changes for Small Employers 7 Employers can receive tax credit up to 50% of what is spent on employee coverage. 35% for nonprofit companies. Businesses must have: Fewer than 25 FT employees, Pay average salaries <$50,000, Cover at least 50% of employees premiums. 7. Consumersunion.org

27 MEDICAID

28 Medicaid 8 Managed Care Companies providing Medicaid services: Molina. Blue Cross Blue Shield. Presbyterian. United. Current Medicaid members can make their selection on October 15, CentennialCare.net

29 Medicaid Eligibility 8 Individuals yoa with income up to 138% of FPL. $15,856 a year for 1 person. $32,499 for a family of 4. Adults with low income w/o children will be granted coverage w/o a waiver. Online applications available or apply in person at local ISD (income support division) office. Call for general questions ( ) ( )

30 MEDICARE

31 Medicare Current Medicare covered benefits will not be reduced or removed. The new law provides continued coverage in the prescription donut hole coverage gap and the donut hole will be completely closed by Medicare will completely cover initial Welcome to Medicare Exam and will also pay for an annual wellness visit with a healthcare professional. The new law will eliminate co-insurance and part B deductibles for many preventive services, including: immunizations, colonoscopies, many cancer screenings, and other benefits. Automatic refills will no longer be available for mail order prescriptions. Starting January 2014, prescription drug plans will require your approval to deliver a prescription (new or refill). 9. Medicare.gov

32 Medicare Resources, To receive more information on Medicare plans and Medicare prescription drug plans available to you in your area, visit: or call MEDICARE ( ). Allows you to enter you information to determine what plan is best for you. Can determine if plans will cover specific medications and lab tests. Open Enrollment Period: 10/01/13 10/15/13 Choose Plan 10/15/13 12/07/13 Can change your Medicare or Prescription drug coverage for /01/14 New Coverage Begins 9. Medicare.gov

33 Common Health Insurance Terms 4 Premium: fixed amount consumer pays to insurance plan (usually every month) regardless if medical care is needed that month. Deductible: the amount paid for care before insurance company begins to cover the cost. Copayment: fixed amount paid for a medical service after deductible has been met.

34 Healthcare Explained

35 References 1. Healthactionnm.org [internet]. Health Action New Mexico. c HHS.gov [internet]. HHS.gov/HealthCare U.S. Department of Health & Human Services. c Kaiser Health Tracking Poll: April The Henry J. Kaiser Family Foundation. 4. Anderson C. What is a health insurance exchange? Healthinsurance.org BeWellNM.com [internet]. New Mexico Health Insurance Exchange. c HealthCare.gov [internet]. Health Insurance Marketplace. c Consumersunion.org [internet]. The Affordable Care Act: The First Year. ConsumersUnion Policy & Action from Consumer Reprots CentennialCare.net [internet]. New Mexico Human Services Department. 9. Medicare.gov [internet]. The Official U.S. Government Site for Medicare.

36

37

38

39

40

41

42