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

Transcription

1 Help With Health Care Resources for the uninsured Northern 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... 9 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: Alcona, Alger, Alpena, Antrim, Baraga, Benzie, Charlevoix, Cheboygan, Chippewa, Crawford, Delta, Dickinson, Emmet, Grand Traverse, Gogebic, Houghton, Iosco, Iron, Kalkaska, Keweenaw, Leelanau, Luce, Mackinac, Manistee, Marquette, Missaukee, Menominee, Montmorency, Ogemaw, Ontonagon, Oscoda, Otsego, Presque Isle, Roscommon, Schoolcraft and Wexford. 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. 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 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. 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 of Human Services 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. Alcona Alcona Alpena County Department of Human Services 711 W. Chisholm St. Alpena, MI Alger Alger County Department of Human Services 101 Court St. Munising, MI Antrim Antrim County Department of Human Services 205 E. Cayuga St. Bellaire, MI Arenac Arenac County Department of Human Services 3709 Deep River Rd. Standish, MI /dhs Baraga Baraga County Department of Human Services 108 Main St. Baraga, MI

11 Bay County Bay County Department of Human Services 1399 W. Center Rd. Essexville, MI /dhs Benzie Benzie County Department of Human Services 448 Court Plaza Govt. Ctr. Beulah, MI Charlevoix Charlevoix Emmet County Department of Human Services 2229 Summit Park Dr. Petoskey, MI Cheboygan Cheboygan County Department of Human Services 827 S. Huron St. Cheboygan, MI Chippewa Chippewa County Department of Human Services 463 E. 3 Mile Rd. Sault Ste. Marie, MI Clare Clare County Department of Human Services 725 Richard Dr. Harrison, MI /dhs Clinton Clinton County Department of Human Services 105 W. Tolles Rd. St Johns, MI /dhs Crawford Crawford County Community Mental Health 230 Huron Grayling, MI Delta Delta County Community Mental Health 305 Ludington St. Escanaba, MI Dickinson Dickinson County Community Mental Health 1401 Carpenter Ave., Suite A Iron Mountain, MI

12 Eaton Eaton County Department of Human Services 1050 Independence Charlotte, MI /dhs Gladwin Gladwin County Department of Human Services 675 E. Cedar Ave. Gladwin, MI /dhs Gogebic Gogebic County Community Mental Health 301 E. Lead St. Bessemer, MI Grand Traverse Leelanau Grand Traverse Leelanau County Community Mental Health 701 S. Elmwood, Suite 19 Traverse City, MI Houghton Houghton County Community Mental Health 200 Quincy St. Hancock, MI Iosco Iosco County Department of Human Services 2145 E. Huron Rd. East Tawas, MI Iron Iron County Community Mental Health 337 Brady Ave. Caspian, MI Kalkaska Kalkaska County Community Mental Health 503 N. Birch St. Kalkaska, MI Luce Luce County Community Mental Health 500 W. McMillan Newberry, MI

13 Mackinac Mackinac County Community Mental Health 199 Ferry Ln. Saint Ignace, MI Manistee Manistee County Community Mental Health 1672 US 31 S. Manistee, MI Marquette Marquette County Community Mental Health 234 W. Baraga Ave. Marquette, MI Menominee Menominee County Community Mental Health th St. Menominee, MI Missaukee-Wexford Missaukee-Wexford County Department of Human Services W. Watergate Rd. Cadillac, MI Montmorency Montmorency County Department of Human Services M-32 West Atlanta, MI Ogemaw Ogemaw County Department of Human Services 444 E. Houghton Ave. West Branch, MI Ontonagon Ontonagon County Department of Human Services 730 S. 7th St. Ontonagon, MI Oscoda County Department of Human Services 200 W. Fifth St. Mio, MI Otsego Otsego County Department of Human Services 1999 Walden Dr. Gaylord, MI

14 Presque Isle Presque Isle County Department of Human Services 1242 W. Third St. Rogers City, MI Roscommon Roscommon County Department of Human Services 111 Union St. Roscommon, MI Schoolcraft Schoolcraft County Department of Human Services 300 Walnut St., Courthouse, Rm. 175A Manistique, MI 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 Alger Sterling Area Health Center Dental Clinic 5095 Rifle River Trl. Alger, MI Chippewa Sault Tribal Health Center Dental Program 2864 Ashmun St. Sault Ste Marie, MI Iron Dickinson-Iron Dental Center 211 S. Fourth St., Suite B Crystal Falls, MI upruralhealth.org Mackinac West Mackinac Dental Clinic W Melville St. Engadine, MI upruralhealth.org 12

15 Marquette Sawyer Dental Center 301 Explorer, Suite B Gwinn, MI upruralhealth.org Discount Dental Plans dentalplan.com Vision services Eye Care America eyecareamerica.org Lions Club International lionsclubs.org Vision USA aoa.org 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.* Alcona Northeast Michigan Community Mental Health Montmorency 311 Lake St. Harrisville, MI nemcmh.org Alger Pathways Alger Office 601 W. Superior St. Munising, MI pathwaysup.org Alpena Northeast Michigan Community Mental Health Alpena 400 Johnson St. Alpena, MI nemcmh.org Antrim North Country Community Mental Health Antrim County 203 E. Cayuga Bellaire, MI norcocmh.org Baraga Baraga County Center Skanee Rd. L Anse, MI cccmh.org 13

16 Charlevoix North Country Community Mental Health - Charlevoix County 6250 M-66 North Charlotte, MI norcocmh.org Cheboygan North Country Community Mental Health Cheboygan County 825 S. Huron, Suite 4 Cheboygan, MI norcocmh.org Chippewa Hiawatha Behavioral Health Chippewa Office 3865 S. Mackinac Trl. Sault Ste Marie, MI hbhcmh.org Crawford Northern Lakes Mental Health - Crawford 204 Meadows Dr. Grayling, MI northernlakescmh.org Delta Pathways - Delta Office 2820 College Ave. Escanaba, MI pathwaysup.org Dickinson NorthPoint Behavioral Healthcare Kingsford Office 715 Pyle Dr. Kingsford, MI nbhs.org Emmet North Country Community Mental Health Emmet County 1420 Plaza Dr. Petoskey, MI norcocmh.org Gogebic Gogebic Community Mental Health 130 U.S. 2 Wakefield, MI gccmh.org Grand Traverse Leelanau Northern Lakes Mental Health Grand Traverse/Leelanau 105 Hall St. Traverse City, MI northernlakescmh.org 14

17 Houghton Rice Memorial Center 901 W. Memorial Dr. Houghton, MI cccmh.org Rice Memorial Center CLK Branch Calumet Ave. Calumet, MI cccmh.org Iron NorthPoint Behavioral Healthcare Iron River Office 703 Second Ave. Iron River, MI nbhs.org Kalkaska North Country Community Mental Health Kalkaska County 625 Courthouse Dr. Kalkaska, MI norcocmh.org Luce Pathways Luce Office County Rd. Newberry, MI pathwaysup.org Mackinac Hiawatha Behavioral Health Mackinac Office 114 Elliot St. St. Ignace, MI hbhcmh.org Manistee Centra Wellness Network 2198 US -31 S Manistee, MI centrawellness.org Marquette Pathways Marquette Office 200 W. Spring St. Marquette, MI pathwaysup.org Menominee NorthPoint Behavioral Healthcare Menominee Office 401 Tenth Ave. Menominee, MI nbhs.org Montmorency Northeast Michigan Community Mental Health Montmorency 630 Caring St. Hillman, MI nemcmh.org 15

18 Ontonagon Ontonagon County Center 515 Quartz St. Ontonagon, MI cccmh.org Otsego North Country Community Mental Health Otsego County 800 Livingston Blvd. Gaylord, MI norcocmh.org Northern Michigan Substance Abuse Services, Inc W. M-32 Gaylord, MI nmsas.net Presque Isle Northeast Michigan Community Mental Health Presque Isle 156 N. 4th St. Rogers City, MI nemcmh.org Roscommon Northern Lakes Mental Health Roscommon 2715 S. Townline Rd. Houghton Lake, MI northernlakescmh.org Schoolcraft Hiawatha Behavioral Health Schoolcraft Office 125 N. Lake St. Manistique, MI hbhcmh.org Wexford/Missaukee Northern Lakes Mental Health Wexford/Missaukee 527 Cobbs St. Cadillac, MI northernlakescmh.org 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. Alcona Alcona Health Center Harrisville 205 N. State St., Suite A Harrisville, MI alconahealthcenters.org 16

19 Alcona Health Center Lincoln 177 N. Barlow Rd. Lincoln, MI alconahealthcenters.org Alpena Alcona Health Center Alpena 1185 US-23 North Alpena, MI alconahealthcenters.org Alcona Health Center Ossineke US-23, South Ossineke, MI alconahealthcenters.org Free Clinic of Alpena 1600 W. Chisholm Alpena, MI Antrim Bellaire Family Health Center 307 E. Cayuga St. Bellaire, MI ejfhc.org Central Lake Family Health Center 7960 W. Old State St. Central Lake, MI ejfhc.org Charlevoix East Jordan Family Health Center 601 Bridge St. East Jordan, MI ejfhc.org Boyne Area Free Clinic, INC 624 State St. Boyne City, MI boyneareafreeclinic.com Cheboygan Northern Care Center 117 W. State St. Cheboygan, MI Chippewa Community Health Access Coalition Sault Ste. Marie 143 Arlington St. Sault Ste. Marie, MI upchac.org Bay Mills Health Center W. Lakeshore Dr. Brimley, MI baymillshealthcenter.com Community Care Clinic 509 Osborn Blvd. Sault Ste. Marie, MI warmemorialhospital.org 17

20 Crawford Ausable Free Clinic 1200 N. Down River Rd. Grayling, MI ausablefreeclinic.org Delta Escanaba Medical Clinic 710 S Lincoln Escanaba, MI Dickinson Kingsford Medical Clinic 800 East Blvd. Iron Mountain, MI Care Free Dental of Dickinson & Florence 500 S. Stevenson Ave. Iron Mountain, MI carefreedental.org Emmet Community Health Center of Northern Michigan 3434 M-119, Suite C Harbor Springs, MI alconahealthcenters.org Grand Traverse Grand Traverse County Youth Health and Wellness Center 880 Parsons Rd. Traverse City, MI Traverse City Clinic Traverse Hwy. Traverse City, MI nmhsi.org Traverse Health Clinic 3147 Logan Valley Rd. Traverse City, MI traversehealthclinic.org Houghton Quincy Hill Health Center U.S. Highway 41 Hancock, MI upruralhealth.org Iosco Alcona Health Center Oscoda 5671 N. Skeel Dr., Suite 8 Oscoda, MI alconahealthcenters.org Iron Iron River Medical Clinic 1500 W. Ice Lake Rd. Iron River, MI

21 Luce Community Health Access Coalition Newberry 500 W. McMillan Newberry, MI upchac.org Mackinac Community Health Access Coalition St. Ignace 594 N. State St. St. Ignace, MI upchac.org Mackinac Straits Rural Health Center 1140 N. State St. St. Ignace, MI Manistee Bear Lake / Onekama Clinic 6433 Eight Mile Rd. Bear Lake, MI nmhsi.org Marquette Marquette General Family Medicine Marquette 5087 U.S. 41 S. Marquette, MI mgh.org Upper Peninsula Medical Center 1414 W. Fair Ave., Suite 36 Marquette, MI penmed.com Upper Great Lakes Family Health Center Gwinn 135 E. M-35 Gwinn, MI uglhealth.org Upper Great Lakes Family Health Center Sawyer 301 Explorer St. Gwinn, MI uglhealth.org Marquette Alger Health Center 700 W. Washington St. Marquette, MI upruralhealth.org Menominee Northern Menominee Health Center N16088 Balsam Ln. Spalding, MI upruralhealth.org Northern Menominee Health Center South Harbors 1110 Tenth Ave. Menominee, MI upruralhealth.org 19

22 Missaukee Great Lakes Family Care McBain 117 N. Roland St. McBain, MI alconahealthcenters.org Montmorency Thunder Bay Health Services Atlanta M-32 Atlanta, MI tbchs.org Thunder Bay Health Services Hillman State St. Hillman, MI tbchs.org Ogemaw Ogemaw Clinic 1827 E. Greenwood Rd. Prescott, MI sterlinghealth.net Ontonagon Ewen Medical & Dental Center 200 S. Elm St. Ewen, MI upruralhealth.org Presque Isle Thunder Bay Health Services Onaway W. M-68 Onaway, MI tbchs.org Onaway School Based Health Center 4549 M-33 Hwy. Onaway, MI tbchs.org Thunder Bay Health Center Rogers City 205 S. Bradley Hwy. Rogers City, MI tbchs.org Roscommon MidMichigan Health Park Houghton Lake 9249 W. Lake City Rd. Houghton Lake, MI midmichigan.org/chs Mid Michigan Medical Offices Roscommon 135 Lake St. Roscommon, MI midmichigan.org/chs 20

23 Houghton Lake School Based Health Clinic 4433 W. Houghton Lake Dr. Houghton Lake, MI midmichigan.org/chs Roscommon School Based Health Clinic 299 E. Sunset Dr. Roscommon, MI midmichigan.org/chs Wexford Great Lakes Family Care 520 Cobb St. Cadillac, MI alconahealthcenters.org Stehouwer Free Clinic 201 N. Mitchell St., Suite L-1 Cadillac, MI Helplines and Special Programs Mammogram and Pap Smear Referral Program Nursing Home Helpline

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 9139 SEP 14 R032735