Restoring Peace of Mind for Client with Hospital Bills
No one goes through life without needing urgent medical treatment. For an uninsured person who needs immediate diagnosis and treatment, the financial consequence is devastating. Last month, “Alice” called our Helpline about her adult son, “Max,” who had lost his job. Max, who suffers from diabetes, was recently hospitalized for complications. While in the hospital, he applied for and was denied Medicaid (known in Pennsylvania as Medical Assistance). Concerned about the looming medical and ambulance bills and Max’s lack of insurance, Alice reached out to PHLP.
We advised Max to appeal the denial because his resources and income were below the limits for Pennsylvania’s Healthy Horizons program
, and PHLP contacted Max’s County Assistance Office (CAO) to explain the situation.
A day later the County Assistance Office placed Max in Healthy Horizons, and approved that coverage retroactively to cover his hospital stay. Alice and Max were grateful for PHLP’s work in securing a quick resolution to Max’s appeal.
PHLP Facilitates Conversations About Effective Outreach Strategies
Last month, PHLP and the Pennsylvania Health Access Network (PHAN)
co-facilitated a day-long conversation
about effective outreach strategies to enroll consumers in health insurance coverage. The invite-only gathering of 30 attendees included community health centers and hospitals, health insurers, navigators and certified application counselors. Space and lunch were generously donated by the Hospital & Healthsystem Association of Pennsylvania (HAP)
Attendees shared lessons learned, new research, and best practices that were successful in the first open enrollment period. Attendees also discussed what’s next in continued outreach and enrollment activities, including marketplace sustainability, helping consumers keep their coverage and renew, as well as the importance of reaching consumers during a very different second open enrollment (November 15, 2014–February 15, 2015)
. Participants will meet again in the fall to continue the discussion and explore ways to partner and maximize resources.
PHLP Releases Recommendations for Transition in Children's Health Insurance
Under the Affordable Care Act, eligibility for children’s health care coverage changed for households with income between 100 and 138 percent of the Federal Poverty Guidelines: effective January 1, 2014, these children became eligible for Medicaid. However, an agreement between state and federal government officials allows these children the choice of staying in the Children’s Health Insurance Program (CHIP) or moving to Medicaid until December 31, 2014. After December 31, 2014, they must move to Medicaid.
To smooth the transition for an estimated 30,000+ children and assure retention of the child’s medical home, a group of children’s advocates, including PHLP, released a set of recommendations that can be found here