The Affordable Care Act. Access to Health Care for Immigrants and Refugees

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1 The Affordable Care Act Access to Health Care for Immigrants and Refugees

2 We will try to answer the following questions in this presentation: Why is health insurance important? What does this new law change? Who is eligible for health insurance? How can you sign up for health insurance? Who should you call for more information?

3 Why Health Insurance is Important Medicine, visits to the doctor, and medical treatments are often very expensive. Health insurance helps people afford health care. You pay a premium to buy health insurance, which is like investing money in a bank. When you need to use health services, the health insurance pays for some of your medical costs. Your medical costs are lower when you have health insurance.

4 Why did the government decide to make a new law about health insurance? There are 50 million people in the United States who have no health insurance. The government believed that if more people had insurance they could go to the doctor when they need to and get the medicine they need.

5 NEW Health Insurance Marketplace where you can shop for health insurance If you cannot get health insurance through your job you can go to where you can apply for: MaineCare or Medicare OR Private Health Insurance (with subsidies)

6 Your Income = How Much Help You Can Get You can get help paying for your health insurance premiums: Family Size Yearly Income (100% FPL - 400% FPL) 1 $ 11,670-46,680 2 $ 15,730-62,920 3 $ 19,790-79,160 4 $ 23,850-95,400 5 $ 27, ,640 6 $ 31, ,880 To can get help paying for your out-of-pocket medical costs: Family Size Yearly Income (100% FPL - 250% FPL) 1 $ 11,670-29,175 2 $ 15,730-39,325 3 $ 19,790-49,475 4 $ 23,850-59,625 5 $ 27,910-69,775 6 $ 31,970-79,925 If you are ineligible for MaineCare because of your immigration status, you can get help paying for your health insurance premiums and your out-of-pocket medical costs: Family Size Yearly Income (no income 400% FPL) 1 $ 0-46,680 2 $ 0-62,920 3 $ 0-79,160 4 $ 0-95,400 5 $ 0-111,640 6 $ 0-127,880 Income guidelines above are based on the 2014 federal poverty levels What You Will Need to Enroll Social Security Numbers (or document numbers for lawfully present immigrants); Employer and income information for every member of your household who needs coverage (for example, pay stubs, a copy of your income tax forms, or W-2 forms); Dates of birth for each person in the household; If anyone in your household has health insurance, you will need the policy numbers for the plans; If you are eligible for insurance through your job, you will need information about that insurance plan (even if you are not enrolled). About verifying immigration status: If you are a lawfully present immigrant, your status will be verified by the U.S. Citizenship and Immigration Services (USCIS) with the Systematic Alien Verification for Entitlements (SAVE) database. If you can t verify status electronically, you can provide other documents to fix the records. You only have to prove immigration status for people in your family who are applying for insurance. Information about immigration status may be used only to determine your eligibility.

7 I am lawfully present in the United States I am an ADULT: age 21 or older I am not lawfully in the United States (undocumented) OR I have DACA status I am a Refugee or Asylee I may get: MaineCare Medicare Medicare Savings Program (MSP) DEL Program Maine Rx Plus Help to buy insurance (QHP) from the Marketplace CarePartners MedAccess Free Care I was born here in the United States I am waiting for an Asylum decision I may get: Emergency MaineCare DEL Program Maine Rx Plus Help to buy insurance (QHP) from the Marketplace (with work authorization) CarePartners MedAccess Free Care I have Temporary Protected Status (TPS) or an H2A/H2B visa I may get: Emergency MaineCare DEL Program Maine Rx Plus Help to buy insurance (QHP) from the Marketplace CarePartners MedAccess Free Care I am a CHILD: under 21 years old I am lawfully present in the United States I am a Lawful Permanent Resident (Sponsored with green card) For less than 5 years I may get: Emergency MaineCare DEL Program Maine Rx Plus Help to buy insurance (QHP) from the Marketplace CarePartners MedAccess Free Care For 5 years or more I am not lawfully in the United States (undocumented) OR I have DACA status I may get: Emergency MaineCare DEL Program Maine Rx Plus CarePartners MedAccess Free Care I may be able to get: MaineCare Medicare Medicare Savings Program (MSP) DEL Program Maine Rx Plus Help to buy insurance (QHP) from the Marketplace CarePartners MedAccess Free Care I may get: MaineCare Help to buy insurance (QHP) from the Marketplace I may get: MaineCare Help to buy insurance (QHP) from the Marketplace I may get: Emergency MaineCare Maine Rx Plus DEL if age 19 or 20 AND disabled CarePartners/MedAccess Free Care

8 Eligibility based on Immigrant Status U.S. born Citizens and naturalized citizens Refugees and Asylees Lawfully Permanent Residents (sponsored with that status for more than 5 years) If you are low income and fit into a coverage category, you may qualify for MaineCare If you are 65 or older or have a disability, you may qualify for Medicare If you make between 100%-400% FPL, you will be eligible for subsidies to help you buy insurance in the marketplace

9 Eligibility based on Immigrant Status People waiting for an Asylum decision Lawfully Permanent Residents with sponsors with their green card for less than 5 years People with Temporary Protective Status Guest workers with an H2A or H2B visa You will NOT be eligible for MaineCare (unless you are under age 21 or pregnant) or Medicare You will be eligible for subsidies in the marketplace if you have income below 400% FPL. Asylum applicants are eligible for subsidies once they get their work authorization.

10 Eligibility based on Immigrant Status People without documentation People with Deferred Action for Childhood Arrivals or DACA You are not eligible for MaineCare, Medicare or for health insurance through the marketplace. The new law does NOT require you to have health insurance. You are allowed to buy a private plan purchased outside of the Marketplace or your employer could offer you health insurance. You do qualify for Emergency MaineCare but that only pays for health care needed to stabilize an emergency medical condition.

11 It is important to think of each family member separately when determining eligibility. Some people in a family may be eligible for MaineCare or subsidies in the marketplace while others will not. It s safe for an ineligible family member to apply for those who are eligible. Information provided will not be used to enforce immigration laws or for deportation.

12 Health Insurance Requirement The law includes the "individual mandate." A mandate is an order or an obligation. The law says if you qualify for insurance, you have to enroll. If you do not, you will have to pay a tax penalty when you file your taxes.

13 Douglas Cavendish, from the Noun Project

14

15 Review Health care insurance is important because health care is so expensive without it. If you have a job, ask your employer if there is coverage from your job. If not, you can use the Health Insurance Marketplace to get insurance. The Marketplace gives people options to choose which insurance plan works best for them, just like when you re shopping in a real market.

16 OPEN ENROLLMENT: Starts November 15, 2014 Ends February 15, 2015

17 For more information: Health Insurance Marketplace Call Center The Call Center can connect you to language lines for immediate interpretation into 150 languages Apply online at Visit enroll207.com to find out who can help you in your local area

18 Pchc logo

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