Archive for July, 2015

Back to School Checklist: Get Covered.

July 31, 2015

Sharpening pencils — check. Packing book bags — check. Picking an outfit for the first day — check. What about health insurance for your family, including your kids?

You want your family to be prepared for going back to school. That includes taking care of your health. Luckily, free or low-cost health coverage is available!

Depending on your income and family size, you could qualify for Medicaid/CHIP (your state’s program might have another name, but it’s all the same). If you didn’t qualify before, check again since there are new rules. And even if mom and dad don’t qualify, your kids might!

With free or low-cost coverage, you can make sure your kids are ready for school with:

  • A physical or routine checkup
  • Mental health services
  • Up-to-date vaccines
  • Prescription drugs
  • And more!

And you know what’s the best part? You can enroll any time during the year if you qualify!

If you don’t qualify for free or low-cost coverage, mark your calendar for November 1st — that’s when the health insurance marketplace opens for business!

There’s no reason not to have “get covered” checked off your back to school list.

See what you qualify for

By the Numbers: Celebrating 50 Years of Medicaid in Ohio

July 29, 2015

COLUMBUS, OH – July 30th marks the 50th anniversary of Medicaid being signed into law, bringing health coverage to children, pregnant women, people living with disabilities, and low and moderate income families in Ohio and across the country. Since its inception, Medicaid has allowed for millions of Americans and their families to receive the quality health care and services they deserve. Today, due in large part to the 2010 passing of the Affordable Care Act, Medicaid continues to ensure underserved communities can receive quality health coverage at little or no cost.

“For the last 50 years, Medicaid has made health coverage a reality for millions of Ohioans,” said Trey Daly, Ohio State Director for Get Covered America. “As we continue our work with our partners to make sure that Ohioans enroll in and retain health coverage, we’re thankful that Medicaid has and will continue to provide thousands of working families in Ohio with quality, affordable health care.”

50 Years of Medicaid by the numbers:

  • 71.1 Million: the total number of Americans enrolled in Medicaid or CHIP
  • 12.3 Million: the number of Americans who have enrolled in Medicaid or CHIP coverage since the Health Insurance Marketplace opened in October 2013
  • 2.9 Million: the total number of Medicaid enrollees in Ohio
  • 596,000:  the increase in the number of Medicaid enrollees though Ohio’s expanded Medicaid program which began in January 2014
  • 12: of the number of months in each year that an individual is eligible to sign up for Medicaid
  • 0: the number of dollars a Medicaid enrollee will spend on preventive care

Under the Affordable Care Act, states are given the opportunity to expand Medicaid to cover a greater number of low and moderate income families. To date, 30 states and the District of Columbia have chosen to expand Medicaid. Medicaid enrollees have joined the over 188,000 other Ohioans who have signed up for quality and affordable coverage through the Health Insurance Marketplace. Even in non-expansion sates, there has been a boost in Medicaid enrollment. The uptick is largely attributed to the “Welcome Mat Effect,” an increase in awareness of Medicaid eligibility thanks to the persistent outreach efforts to educate consumers about their health coverage options under the Affordable Care Act.

Enroll America and its partners are working year-round to ensure that Ohioans who qualify have the information and resources to enroll in Medicaid. For those who are eligible, there is no need to wait to sign up. Unlike the Health Insurance Marketplace, which has a time-limited open enrollment period starting November 1, Medicaid enrollment is available year-round.

Unsure if you are eligible for Medicaid? Try the Get Covered Calculator to see if you are eligible or what your estimated monthly costs will be if you qualify to receive financial assistance through the Health Insurance Marketplace. Then use the Get Covered Connector or call 1-800-648-1176 to schedule an appointment with an enrollment assister who can help you through every step of the application process.

Quiz: What Do You Really Know About Medicaid?

July 28, 2015

This week, we’re celebrating the 50th anniversary of Medicaid, a program that provides free or low-cost health insurance to those who qualify. But what do you really know about Medicaid? Test your knowledge with this quiz, and check your answers below!

  1. True or False: You can only enroll in Medicaid during open enrollment.
  2. True or False: Some states have their own name for their Medicaid and CHIP programs.
  3. True or False: If you didn’t qualify for Medicaid in the past, you could qualify now.
  4. True or False: You qualify for Medicaid based on your income.
  5. True or False: Some states don’t have Medicaid.


  1. False. If you qualify, you can sign up for Medicaid at any time during the year.
  2. True. Some states’ Medicaid programs have their own names, such as California’s Medi-Cal or Oklahoma’s SoonerCare.
  3. True. There are new rules in place, so even if you didn’t qualify for Medicaid in the past, you or someone in your family could qualify now.
  4. False. Whether you qualify for Medicaid depends on your income, your family size, and where you live.
  5. False. Every state has some form of Medicaid. Some states’ programs cover more people than others.

Well, how did you do?

Help us spread the word — if you know someone who can’t afford health insurance, encourage them to see if they qualify for free or low-cost coverage today!

See what you might qualify for

Where Should You Go When You’re Sick or Hurt?

July 23, 2015

There are different types of care for different situations.

Your main doctor (sometimes called a primary care doctor or general practitioner) is usually your first stop if you have a minor illness or minor injury. Minor illnesses or injuries could include a cold or a minor sprain. In most cases, you need to make an appointment with your primary care doctor in advance. Most primary care doctors are available during the day on weekdays, and might not be available at night or on weekends. Seeing your primary care doctor usually costs less than going to an urgent care center or an emergency room.

Urgent care centers are usually open after normal business hours. If the following are true, and urgent care center might be the right place to go:

  • Your illness or injury isn’t life threatening
  • You need to get care soon
  • You can’t see your primary care doctor (maybe you can’t get an appointment soon enough or it’s the weekend)

Often, your share of the costs for going to an urgent care center will be lower than going to an emergency room.

An emergency room (also called the ER) is part of a hospital that is usually open 24 hours a day. They’re the best place to go when you have a serious situation, like a broken bone. Remember: Visits to the emergency room can have higher out-of-pocket costs than visits to your primary care doctor or an urgent care center.

Make sure to review your summary of benefits and coverage so you know what your share of the cost of health care is. For many plans, the costs are different for different types of care.

If you have questions about your out-of-pocket costs, you can read more here. If you have questions about your plan, you can contact your insurance company directly.

What’s a Specialist? When Should I See One?

July 14, 2015

A specialist is a doctor who has more education and training in a certain area. For example, a cardiologist is a doctor who specializes in hearts. A gynecologist is a doctor who specializes in women’s health. There are many different kinds of specialists.

For most situations, your primary care doctor is your first stop when you need care. They will tell you if you need to see a specialist. This is called a referral.

For example, if you have a skin rash, your primary care doctor might refer you to a dermatologist, which is a doctor who specializes in skin health.

With some health insurance plans, you need a referral from your primary care doctor before seeing a specialist. However, you do not need a referral to see a gynecologist.

Some insurance plans have different co-pays and co-insurance for visits to specialists. To learn more about out-of-pocket costs for specialists, you can review the summary of benefits and coverage for your plan. And if you have more questions, you can always call your insurance plan directly!

LGBT Newlyweds: Say “I Do” to Getting Covered

July 8, 2015

Is getting health coverage part of your wedding plan?

LGBT couples in all 50 states now have the right to get married. So if you plan on tying the knot soon, know this: You could also get covered!

As a newly-married couple, you:

  • Do not have to wait for the next enrollment period to start (that’s November 1st, by the way). You’ll have a special 60-day window to sign up and pick a plan.
  • Can avoid the fine. You could face a fine of $325 per adult or 2% of your income (whichever is greater) if you are not covered.

Getting married is a life-changing event and so is getting health coverage. So in sickness and in health, say, “I do” to getting covered.

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