Help With Health Care. Resources for the uninsured. Mid Michigan

Transcription

1 Help With Health Care Resources for the uninsured Mid Michigan Revised September 2014

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3 Table of contents Introduction...2 How to get health insurance coverage in Michigan...2 Overview... 2 Healthy Michigan Plan... 4 Health Insurance Marketplace... 6 How to find free and low cost health care services and other health care resources...8 State and federal programs... 8 Dental Vision Mental health and substance abuse services Free and low cost health centers Help lines and special programs Additional resources Understanding health insurance and how to access health care services costs that make up a health plan Finding a doctor Making the most of your appointment Where to go for health care

4 Introduction Your health is important to us. That s why we ve developed this brochure, Help with Health Care, for people who are uninsured and need help with health care in Michigan. It s designed to help you understand how to get health insurance coverage and find free and low cost health care services. It s divided into three sections: 1. How to get health insurance coverage in Michigan 2. How to find free and low cost health care services and other health care resources in Michigan 3. Understanding health insurance and how to access health care services This brochure includes services in the following counties: Arenac, Bay, Clare, Clinton, Eaton, Genesee, Gladwin, Gratiot, Hillsdale, Huron, Ingham, Isabella, Jackson, Lapeer Lenawee, Livingston, Midland, Saginaw, Sanilac, Shiawassee and Tuscola. 1 How to get health insurance coverage in Michigan The Affordable Care Act gave more people the chance to get health coverage. In Michigan, you have many health plan choices. Although health reform is complex, many resources are available to help you understand it and find a plan that meets your needs and budget. If you have limited income, you may qualify for a tax credit or reduced cost-sharing through the Health Insurance Marketplace. Or, you may qualify for the Healthy Michigan Plan. Did you know? Reduced cost-sharing, also called a subsidy, lowers the amount you pay out of pocket for deductibles, coinsurance and copayments. This helps cover costs such as doctor visits. 2

5 Number of people in your family/ household If your household income is in this range, you may be eligible for a premium tax credit through the Health Insurance Marketplace If your household income is in this range, you may be eligible for reduced cost-sharing through the Health Insurance Marketplace 1 $16,106 $46,680 $16,106 $29,175 2 $21,708 $62,920 $21,708 $39,325 3 $27,311 $79,160 $27,311 $49,475 4 $32,914 $95,400 $32,914 $59,625 5 $38,517 $111,640 $38,517 $69,775 6 $44,120 $127,880 $44,120 $79,925 7 $49,722 $144,120 $49,722 $90,075 8 $55,325 $160,360 $55,325 $100,225 Income levels are based on the 2014 federal poverty guidelines. These guidelines are updated each year. Did you know? Premium tax credits help lower the cost of a monthly premium 3

6 1. The Healthy Michigan Plan The Healthy Michigan Plan is the state s new Medicaid option. This plan was created to expand Medicaid to more people. It provides health care benefits to Michigan residents at a low cost. To be eligible for the Healthy Michigan Plan you must be: Ages Not currently eligible for Medicaid Not eligible for or enrolled in Medicare Not pregnant when applying for the Healthy Michigan Plan Have income at or below 133% of the federal poverty level ($16,000 for a single person or $33,000 for a family of four) A resident of Michigan The Healthy Michigan Plan includes many health care benefits and services covered under the federal health care law. This means it s easier to get the health care you need at a cost you can afford. The Healthy Michigan Plan includes the following services: Doctors visits Emergency visits Lab services and fees Mental health and substance abuse treatment Preventative and wellness treatment and chronic disease management Rehabilitation service and equipment Dental care Hospitalization Maternity care Prescription drugs Pediatric services for 19 to 20 year olds including dental and vision care There are three easy ways to enroll in the Healthy Michigan Plan: Visit /mibridges* Call the Michigan Health Care Hotline at Visit your local Department office 4

7 After you enroll in a Healthy Michigan Plan, you will be asked to fill out a Health Risk Assessment Form. You may receive the form in the mail, or at your doctor s office. The form is also online at /healthymiplan.* You should also make an appointment with your doctor. Together, you will go over the Health Risk Assessment Form. After the appointment, your doctor will sign the form and mail it back to your health plan. The form should be completed each year. The Healthy Michigan Plan has copays. After you are enrolled in a health plan, most copays will be paid through a special health care account called the MI Health Account. The monthly amount you pay will be based on the services you receive in the first six months. If you have an income between % of the federal poverty level, you will also be required to contribute a small amount of your yearly wages for cost sharing purposes. You will get more information about your MI Health Account, copays and contributions from your health plan. You can also see the chart of copayments below. Covered services Copay Physician office visits (including free-standing urgent care centers) $ 2 Outpatient hospital clinic visit $ 1 Emergency room visit for non-emergency services Copayment ONLY applies to non-emergency services There is no co-payment for true emergency services Inpatient hospital stay (with the exception of emergent admissions) Pharmacy $ 3 $ 50 $ 1 generic $ 3 brand Chiropractic visits $ 1 Dental visits $ 3 Hearing aids $ 3 per aid Podiatric visits $ 2 Vision visits $ 2 5

8 You can reduce your copays by working to improve your health. Copays are not required for certain services that help you get or stay healthy. These include preventive services and services that help you manage a chronic condition. 2. The Health Insurance Marketplace The Health Insurance Marketplace is a government website. You can visit the Marketplace at healthcare.gov.* This is where you can shop for and compare health plans. You can apply for health coverage and tax credits. If your income is between 100 percent and 400 percent of the federal poverty level, you may be eligible for tax credits or a subsidy. This will help lower the cost of your health coverage. To get an estimate of the subsidy for which you might be eligible, go to bcbsm.com/subsidy. There are four types of plans available in the Marketplace: Bronze plans cover 60% of health care costs Silver plans cover 70% of health care costs Gold plans cover 80% of health care costs Platinum plans cover 90% of health care costs To enroll in a plan on the Marketplace, you will need: q Number of dependents. This is the number of people you claimed on your last tax return. q Social Security number(s) or immigration document number(s). Did you know? Reduced cost sharing is only available if people chose a silver plan. In some cases, it will be less expensive to choose a silver plan than a bronze plan. q Estimated household income. This is the yearly income for you and each of your dependents. This can be found on last year s W-2 tax forms. q Policy numbers for current insurance. Questions about health insurance or how to get coverage? 6

9 If you have questions about health care reform, health plans and enrolling in coverage: Visit HealthCareReformBasics.com/Now for information on health care reform Visit Healthcare.gov for information on the health insurance marketplace Visit bcbsm.com/getinsurance for information on Blue Cross health plans and costs Visit insurance.bcbsmseminars.com for information on educational sessions near you Call Blue Cross Blue Shield of Michigan at with any other questions If you would like to speak with us in person, you can visit one of our 11 statewide walk-in centers. Visit bcbsm.com/index/healthinsurance-help/locations.html and type in your ZIP code to find your nearest walk-in center. 7

10 2 How to find free and low cost health care services and other health care resources If you have health insurance, please check with your health plan to see what providers are in your network. If you do not have insurance, below is a list of free or low-cost health care clinics by county. This may help you find local and low-cost health care near you. Please call ahead for hours, services offered or to make an appointment. State and federal programs The Michigan Department of Community Health has an online directory of free or low-cost health care services and resources at /healthcarehelp.* Below you can find a list of health departments by county. Arenac Arenac County Department 3709 Deep River Rd. Standish, MI Bay Bay County Department of Human Services 1399 W. Center Rd. Essexville, MI Clare Clare County Department of Human Services 725 Richard Dr. Harrison, MI Clinton Clinton County Department 105 Tolles Rd. St. Johns, MI Eaton Eaton County Department of Human Services 1050 Independence Blvd. Charlotte, MI

11 Gladwin Gladwin County Department 675 E. Cedar Ave. Gladwin, MI Gratiot Gratiot County Department 201 Commerce Dr. Ithaca, MI Hillsdale Hillsdale County Department 40 Care Dr. Hillsdale, MI Huron Huron County Department 1911 Sand Beach Rd. Bad Axe, MI Ingham Ingham Community Health Center 5303 S. Cedar St. Lansing, MI ingham.org Isabella Isabella County Department 1919 Parkland Dr. Mt Pleasant, MI Jackson Jackson County Department 301 E. Louis Glick Hwy. Jackson, MI Lapeer Lapeer County Department 1505 Suncrest Dr. Lapeer, MI

12 Lenawee Lenawee County Department 1040 S. Winter St., Suite 3013 Adrian, MI Livingston Livingston County Department 2300 E. Grand River Howell, MI Midland Midland County Department 1509 Washington St. Midland, MI Saginaw Saginaw County Department 411 E. Genesee Saginaw, MI Sanilac Sanilac County Department 515 S. Sandusky Rd. Sandusky, MI Shiawassee Shiawassee County Department 1720 E. Main St., Suite 1 Owosso, MI St Clair St Clair County Department 220 Fort St. Port Huron, MI Tuscola Tuscola County Department 1365 Cleaver Rd. Caro, MI

13 Washtenaw Washtenaw County Department of Human Services 22 Center St. Ypsilanti, MI ewashtenaw.org Children s Special Health Care Services Women, Infant and Children Programs /wic Dental and vision The following organizations provide dental or vision services only. Dental services Arenac Sterling Dental Clinic 5095 Rifle River Trail Alger, MI sterlinghealth.net Genesee Dental North Side 5399 N. Saginaw St. Flint, MI hamiltonchn.org Ingham Healthy Smiles Dental Center 2815 S. Pennsylvania, Suite 203 Lansing, MI ingham.org Michigan Dental Program 109 N. Michigan Ave., 8th Floor Lansing, MI Lenawee Family Medical Center Lenawee Dental 128 S. Broad St. Adrian, MI familymedicalmi.org Livingston VINA Community Dental Center 400 E. Grand River Brighton, MI vinadental.org Shiawassee Wadsworth Dental Center 2308 Wadsworth Rd. Saginaw, MI healthdelivery.org 11

14 St Clair Baker College of Port Huron Dental Hygiene Program 3403 Lapeer Rd. Port Huron, MI dentalhealthcouncil.org Community Dental Clinic of St Clair County 3037 Electric Ave. Port Huron, MI stclaircounty.org Washtenaw Community Dental Center 406 N. Ashley Ann Arbor, MI umich.edu University of Michigan School of Dentistry 1011 North University Ann Arbor, MI dent.umich.edu Discount Dental Plans dentalplan.com Mid Michigan District Health St John Community Dental Clinic 1307 E. Townsend Rd. St John, MI mmdhd.org Vision services Eye Care America eyecareamerica.org Lions Club International lionsclubs.org Saginaw Saginaw Area Foundation for Eye Care 5161 Cardinal Park Dr. Saginaw, MI safeeyecare.org Vision USA aoa.org 12

15 Mental health and substance abuse services Every county in Michigan has a community mental health agency. The agency provides mental health and substance abuse services for residents in that county. For more information, see the list of agencies below by county or visit mhweb.org/directory.htm.* Clare Clare County Community Mental Health 789 N. Clare Ave. Harrison, MI cmhcm.org Genesee Hamilton Community Mental Health 420 W. 5th Ave. Flint, MI hamiltonchn.org Gladwin Gladwin County Community Mental Health 655 E. Cedar Ave. Gladwin, MI cmhcm.org Gratiot Gratiot County Community Mental Health 608 Wright Ave. Alma, MI cmhcm.org Huron Huron County Community Mental Health 1108 S. Van Dyke Rd. Bad Axe, MI cmhcm.org Isabella Isabella County Community Mental Health 301 S. Crapo St. Mt Pleasant, MI cmhcm.org Lapeer Lapeer County Community Mental Health 1570 Suncrest Dr. Bad Axe, MI cmhcm.org 13

16 Livingston Livingston County Community Mental Health 2280 E. Grand River Ave. Howell, MI cmhcm.org Midland Midland County Community Mental Health 218 Fast Ice Dr. Midland, MI cmhcm.org Saginaw Saginaw County Community Mental Health 500 Hancock St. Saginaw, MI cmhcm.org Sanilac Sanilac County Community Mental Health 227 E. Sanilac Rd. Sandusky, MI cmhcm.org Shiawassee Shiawassee County Community Mental Health 1555 Industrial Dr. Owosso, MI cmhcm.org St Clair St. Clair County Community Mental Health 3111 Electric Ave. Port Huron, MI scccmh.org Tuscola Tuscola County Community Mental Health 125 W. Lincoln St. Caro, MI cmhcm.org Washtenaw Washtenaw County Support and Treatment Services Ann Arbor 2140 E. Ellsworth Ann Arbor, MI Washtenaw County Support and Treatment Services Ypsilanti 555 Towner Blvd. Ypsilanti, MI

17 Free and low-cost health centers Below is a list by county of places you can go for free or low-cost medical care. Many of these clinics may provide additional services, such as dental services, vision services and mental health treatment. Always call before you go to make sure the hours and services meet your needs. Arenac Sterling Medical 725 E. State St. Sterling, MI sterlinghealth.net Bay Bay-Arenac Behavioral Health 201 Mulholland Bay City, MI babha.org Bayside Health Center 3884 Monitor Rd. Bay City, MI healthdelivery.org Helen M. Nickless Volunteer Clinic 1460 W. Center Rd. Essexville, MI mclaren.org Genesee CBM Health Care Inc. Genesee Torrey Rd. Fenton, MI cbmhealthcare.org Clio Health Center 4154 W. Vienna Rd. Clio, MI hamiltonchn.org Genesee Community Health Center 422 W. 4th St. Flint, MI genchc.org Genesee County Free Medical Clinic 2437 Welch Blvd. Flint, MI gchd.us Hamilton Community Health Main 2900 N. Saginaw Flint, MI hamiltonchn.org Hamilton Community Health of Burton G-3375 S. Saginaw Burton, MI hamiltonchn.org 15

18 Hamilton Health North Point Site 5710 Clio Rd. Flint, MI hamiltonchn.org Gladwin MidMichigan Medical Offices Beaverton 439 S. Ross St. Beaverton, MI midmichigan.org/chs Hillsdale St. Peter s Free Clinic of Hillsdale County, Inc. 3 N. Broad St. Hillsdale, MI stpetershillsdale.org Ingham Birch Community Health Center 812 E. Jolly Rd. Lansing, MI ingham.org Care Free Medical and Dental Lansing 5135 S. Pennsylvania Ave. Lansing, MI carefreemedical.com Care Free Medical and Dental Mason 790 E. Columbia Mason, MI carefreemedical.com Cristo Rey Community Center 1717 N. High St. Lansing, MI cristo-rey.org Eastern Health Center 220 N. Pennsylvania Lansing, MI ingham.org His Healing Hands 2025 W. Holmes Rd. Lansing, MI hhhministry.org Lansing Community College Dental Hygiene Clinic 515 N. Washington Sq., Room 107 Lansing, MI lcc.edu Otto Community Health Center 500 E. Thomas St. Lansing, MI ingham.org 16

19 Sexton Health Center 102 S. McPherson Lansing, MI ingham.org Sparrow Community Health Center 1322 E. Michigan Ave, Suite 308 Lansing, MI ingham.org St. Lawrence Community Health Center 1100 W. Saginaw, Suite 500 Lansing, MI ingham.org Willow Health Center 306 W. Willow Lansing, MI ingham.org Iosco St. Mary s of Michigan Center of HOPE North A German St. Tawas City, MI stmarysofmichigan.org Isabella Isabella Citizens for Health 2940 Health Parkway Mount Pleasant, MI Jackson Center for Family Health 505 N. Jackson St. Jackson, MI centerforfamilyhealth.org Center for Family Health at LifeWays 1200 N. West Ave. Jackson, MI centerforfamilyhealth.org Dove Health Alliance and Counseling 602 W. Michigan Ave. Jackson, MI Jackson High Health Center 544 Wildwood Jackson, MI centerforfamilyhealth.org St. Luke s Clinic 132 Seymour Ave. Jackson, MI stlukescliniconline.org Lapeer Imlay City Health Center 100 E. 3rd St. Imlay City, MI healthdelivery.org 17

20 Loving Hands Clinic 148 Maple Grove Rd. Lapeer, MI lovinghandsclinic.org Lenawee Family Medical Center of Adrian 690 Riverside Dr. Adrian, MI familymedicalmi.org Livingston Faith Medical Clinic 350 Mower Pinckney, MI faithmedicalclinic.net St. Luke s Hometown Healthcare Clinic 9912 E. Grand River, Suite 1000 Brighton, MI stlukehome.com Saginaw Bridgeport Community Health Center 6297 Dixie Hwy. Bridgeport, MI healthdelivery.org David R. Gamez Community Health Center 501 Lapeer Saginaw, MI healthdelivery.org Healthy Futures 2215 N. Center Rd. Saginaw, MI healthyfutures.com Jane s Street Academic Health Center 1522 Janes Ave. Saginaw, MI healthdelivery.org Roosevelt Ruffin Community Health Center 229 Gallagher Rd. Saginaw, MI healthdelivery.org St. Mary s of Michigan Center of HOPE 723 Emerson St. Saginaw, MI stmarysofmichigan.org Laingsburg First Baptist Church 901 E. Grand River Rd. Laingsburg, MI fbcl.net 18

21 Shiawassee Shiawassee Community Health Center 1975 West M-21 Owosso, MI healthdelivery.org Shiawassee Free Medical Clinic 818 W. King St., Suite 101 Owosso, MI redeemerowosso.com St Clair Algonac Medical Center 555 St. Clair River Dr. Algonac, MI downrivercs.org Down River Medical Center Algonac 555 St Clair River Dr. Algonac, MI downrivercs.org People s Clinic For Better Health 3110 Goulden St. Port Huron, MI mymercy.us/peoplesclinic Port Huron Medical Center 1011 Military St. Port Huron, MI downrivercs.org Washtenaw Chelsea Grace Clinic 603 S. Main St. Chelsea, MI faithinaction1.org Corner Health Center 47 N. Huron Ypsilanti, MI cornerhealth.org Hope Medical Clinic, Inc. Ypsilanti Clinic 518 Harriet St. Ypsilanti, MI thehopeclinic.org Manchester Health Center 4800 Esch Rd. Manchester, MI healthdelivery.org Packard Health 3174 Packard Rd. Ann Arbor, MI packardhealth.org 19

22 Shelter Association of Washtenaw County 312 W. Huron St. Ann Arbor, MI annarborshelter.org Neighborhood Family Health Center 111 N. Huron, Suite 200 Ypsilanti, MI stjoesannarbor.org Ypsilanti Family Health Center 200 Arnet St., Suite 200 Ypsilanti, MI uofmhealth.org Bay Helplines and Special Programs HDI Obstetrics/Gynecology and Midwife Services 3175 W. Professional Dr. Bay City, MI healthdelivery.org Saginaw Hearth Home HIV/AIDS Awareness Counseling 732 Hoyt St. Saginaw, MI healthdelivery.org Mammogram and Pap Smear Referral Program Nursing Home Helpline

23 Tuscola Community Health Center Wolverine Human Services 150 Enterprise Dr. Vassar, MI healthdelivery.org Central Michigan Free Clinic 2012 E. Preston Mt. Pleasant, MI mclaren.org 21

24 Additional Resources United Way Collaborative can help with food, housing, employment, health care, counseling and more. Dial or visit mi211.org* for quick and easy access to information about services in your community. Findcare.org* lists over 500 health care clinics in Michigan. This makes it easy to find the clinics, the services they offer and how to contact them. 3 Understanding health insurance and how to access health care services Once you ve enrolled in a health plan, you can use it to cover medical care costs, fill prescriptions at the pharmacy or get emergency care. There are five costs that make up a health plan. They are: 1. Premiums. A fixed monthly amount paid to the insurance company for health coverage. This cost varies based on what s covered in your plan and the doctors you see. 2. Copayments. Fixed dollar amounts you pay at the time of your services, such as a doctor visit. 3. Deductible. A fixed dollar amount paid by you for medical services before the insurance company starts to pay. You pay 100 percent of covered medical costs until the deductible amount is reached. Preventative services are covered 100 percent and don t count toward the deductible. 4. Coinsurance. A fixed percentage of cost of covered services that is shared with the insurance company after the deductible is met. For example, an 80/20 coinsurance means the insurance company pays 80 percent and you pay 20 percent. 5. Out of pocket maximum. This is the maximum amount you pay in deductibles, copayments and coinsurance in one plan year. Once you meet the out of pocket maximum, the health insurance company will typically cover 100 percent of covered services for the rest of the plan year. 22

25 To get the best care possible, it s important for you to play an active role in your own health care. Work closely with your doctor to get the best possible care. Ask questions about prevention, diagnosis, treatment and recovery. This will help ensure your safety, prevent errors and improve your overall health. Below are some tips on how to find a doctor, make an appointment and talk with your doctor. Find a doctor For Blues members visit: bcbsm.com/find-a-doctor. If you have a different health plan, go to healthgrades.com* to find a list of doctors along with their ratings. Make the most of your appointment Locate your health plan ID card, photo ID or Social Security number. Gather a list of current medical records including medications, immunizations, allergies and family medical history. Write down questions and concerns you want to cover with your doctor. Understand your costs. Follow your doctor s advice and schedule follow-up appointments. Where to go for health care Your primary care physician, or PCP, is the best place to start when an illness or injury occurs. When your PCP isn t available, it s okay use a local urgent care center. Urgent care centers treat illnesses that are not life-threatening. They also treat medical issues that may grow worse if you leave them untreated. The hospital or emergency room should be used only in the case of serious, potentially life-threatening medical emergencies. *Blue Cross Blue Shield of Michigan does not control this website or endorse its general content. 23

26 I m sick or hurt... Where do I go? (Or, where do I take my child or parent?) CALL OR SEE MY DOCTOR Need medical care and feel safe to wait a day. Examples are: Runny nose Simple backache Sore throat Earache GO TO URGENT CARE Need medical care today and feel safe to wait a few hours. Examples are: Tried but could not reach my doctor Reached the doctor and told to go to an Urgent Care Center GO TO EMERGENCY ROOM OR CALL 911 Need medical care now and do not feel safe to wait. Examples are: Trouble breathing or chest pain Fainting Sudden numbness or weakness Uncontrolled bleeding Severe pain or serious injury 24

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28 You may download copies of this brochure from our website in PDF format. Go to bcbsm.com and type Help with Health Care Brochures in the search box. You may also call our toll-free hotline at to order extra copies free of charge. When you leave your message, be sure to include your name, address, phone number, number of brochures you d like and which version you need (Southeast Michigan, Mid-Michigan, West Michigan or Northern Michigan and the Upper Peninsula). CB 9138 SEP 14 R032735