ON TARGETHealthcare Insurance101

“Everything You Should Know About Medicare”

By CIOS2011.org

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Community Insurance Outreach Services

C.I.O.S. is an non-for profit organization providing

insurance related services and support to the metro

Youngstown area. Our mission is to bridge the gap

between insurance companies, consumers, and local

government by providing education and resources.

C.I.O.S. address the need for educating consumers and

employers to better understand their insurance

needs, assist the insurance industry with risk

management, and provide employment

opportunities within the insurance markets.

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C.I.O.S.

Community Insurance Outreach Services

Non-profit organization Services

Education

Employment

Support

Community based programs

designed & operated by the

community it serves

Insurance industry sponsored

initiative

Outreach partnerships with other

non-profits

Services based on community

needs which provide superior

satisfaction

Ohio...Let’s Start Here

!!!

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Parent Plan Dependent 26 Year Old

Healthcare

Access to Preventative Services and NO Lifetime Limits

Pre-existing Condition Insurance Plans

Coordination of Care

Secure Medicare Trust Fund

Partnership for Patients

The Affordable Care Act ACA (Healthcare Reform)

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Medicare

Everything You Need to Know…….

Getting Ready for Open Enrollment

October 15th 2012-December 7th 2012

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QUICK FACTS

AEP- Annual Enrollment Periods

October 15th 2011- December 7th 2011

• You can change your Medicare health or

prescription drug coverage for 2012.

Disenrollment Period

January 1st 2012- February 14th 2012

• January 1st 2012 new coverage begins if you

switched or joined a plan. New costs and

coverage changes also begin if you kept

your existing coverage.

QUICK FACTS

• NEW—Making changes to your coverage

after December 31 Between January 1–

February 14, 2011, if you’re in a Medicare

Advantage Plan, you can leave your plan

and switch to Original Medicare.

• If your Medicare Advantage Plan

includes prescription drug coverage and

you join a Medicare Prescription Drug

Plan, you will be disenrolled from your

Medicare Advantage Plan and returned

to Original Medicare.

Enrollment Periods Medicare 2012 Saturday October 15th 2011

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1-800-686-1578 MEDICARE EXPERTS

OSHIIP

Ohio Senior Health Insurance Information Program

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Medicaid

Medicaid pays for covered medical bills, dental bills, eyeglasses, and homemakers services. Certain people covered by Medicare may qualify for full Medicaid benefits. Other will qualify for partial Medicaid, also known as “spend down”.

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Medicare-Medicaid Coordination

Medicare Premium Assistance Program (MPAP

This program helps people eligible

for Medicare who have limited

income and assets get help in

paying the cost of one or more

of the following:

Medicare premium(s)

Medicare deductibles

Medicare coinsurance

Eligibility Criteria: To qualify for MPAP, applicants must be eligible for Medicare and meet basic requirements.

When applying for MPAP, proof of income, resources, age or disability, citizenship (if not a U.S. citizen) and other health insurance is required.

No face-to-face interview with the local county department of job and family services is necessary.

Medicaid for Older Adults and People with Disabilities

Medicaid for the Aged, Blind & People with Disabilities (ABD) Ohio Medicaid offers a span of programs for older adults and people with disabilities to assist with medical expenses. These programs provide health care coverage consisting of primary and acute-care benefit packages along with long-term care.

To qualify for ABD Medicaid, applicants must be:

age 65 or older, or

considered legally blind, or

an individual with a disability (as classified by the Social Security Administration), and

must meet basic requirements.

When applying for this type of Medicaid, proof of income, resources, age or disability, citizenship (if not a U.S. citizen) and other health insurance is required.

A face-to-face interview with the local county department of job and family services is also necessary.

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Medicaid Income Eligibility 2012

2011 HHS Poverty Guidelines

Persons

in Family

48 Contiguous

States and D.C. Alaska Hawaii

1 $10,890 $13,600 $12,540

2 14,710 18,380 16,930

3 18,530 23,160 21,320

4 22,350 27,940 25,710

5 26,170 32,720 30,100

6 29,990 37,500 34,490

7 33,810 42,280 38,880

8 37,630 47,060 43,270

For each

additional

person, add

3,820 4,780 4,390

Who Qualify in

Ohio?

FPL Single Marrie

d

Resources

Single/Marrie

d

Older Adults (age

65 or older) &

Disabled People (of

any age)

64% $589 $1,011 $1,500/$2,250

Qualified Medicare

Beneficiary (QMB)

100% $867 $1,176 $4,000/$6,000

Specified Low-

Income

Medicare

Beneficiary (SLMB)

120% $1,040 $1,400 $4,000/$6,000

Qualified Individual

(QI-1)

135% $1,170 $1,575 $4,000/$6,000

Qualified Working

Disabled Individual

(QWDI)

200% $1,734 $2,334 $4,000/$6,000

SOURCE: Federal Register, Vol. 76, No. 13, January 20, 2011,

pp. 3637-3638

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“Insurance Literacy” “Claims Assistance” “Career Pathway”

Insurance Literacy Program

provides free educational

seminars on :

• Basic Insurance

• Health Insurance

• Property & Auto Insurance

• Life & Accident Insurance

• We also provide free

insurance seminars

for business

Our “Restoring the Community” program offers catastrophic claims assistance and support to local residents and business.

We provide advice and guidance during insurance claim process.

We act as an authorized agent and advocate, respond to denial letters, assist with documentation, and refer to local state insurance agencies for complaints.

The “Career Pathway” program

offers career placement and

credentials in the insurance

industry.

We provide recession –proof

employment opportunities by

securing our clients with an

state insurance license with in

90 days.

Our clients are vested after 5

years of commitment and

provide

training, credentialing, support

, and marketing.

Our Common Pledge… “Providing progress, stability, & dedication to

disadvantage communities across America.”

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WWW.CIOS2011.ORG

For more information and event dates visit