From pahealthaccess.org:
Lost adultBasic?
If you were one of the thousands of folks who lost their coverage last month, we want to connect you with resources to help get you the care you need. Contact the Consumer Health Coalition in Pittsburgh at 412-456-1877 if you live in Altoona or parts West, and contact the Pennsylvania Health Law Project toll-free at: 1-800-274-3258 if you live in the East. We fought so hard for adultBasic because we know that right now, there really are no good options. But, these health care navigators will help you look for stopgap measures such as community health clinics, discount prescription drug programs, and help you determine whether or not you may qualify for another state program like Medical Assistance for Workers with Disabilities, Medicaid, or programs specifically for women.
We are keeping up the fight to bring adultBasic (or a program with similar benefits, by another name) back, but we need your help! If we want our legislators, the Governor, and the Blues to do the right thing, they need to hear from the real people whose lives and livelihoods are jeopardized by their inaction. Please, if you were on adultBasic and want to help us bring it back, email Athena (aford@pahealthaccess.org) or Erin (egill@pahealthaccess.org) to share your story. Be sure to include a little bit about yourself, how long you were on adultBasic and how it helped you get the care you need, and what you’re going to have to do now that it’s gone. Also include your address, email, and phone number so we can follow up.
From the PA Insurance Department:
adultBasic Phase-Out Health Options
Details about other health options and how to apply:
There are a number of health care options that adultBasic enrollees should explore immediately. If employer-based group coverage is available to you, and you have a pre-existing condition, we urge you to explore that option now, so that you get coverage before May 2, 2011.
HIPAA CERTIFICATE OF CREDITABLE COVERAGE
What will I get in the mail from my adultBasic insurance company?
Please look for this important documents from your adultBasic insurance company in the mail: HIPAA Certificate of Creditable Coverage notice (second week in March 2011)
If you do not receive these documents by the dates listed above, please call your adultBasic insurance company (using the toll-free phone number listed on your ID card).
What is a HIPAA Certificate of Creditable Coverage?
A HIPAA Certificate of Creditable Coverage is an important document that shows your prior health care coverage. This certificate usually reduces how long your new group health care plan may exclude you from coverage for a pre-existing health condition. The insurance company providing your adultBasic coverage will be mailing this very important Cerificate to you. Please keep it for your records. If you do not receive a Certificate in the mail by the end of March, contact your adultBasic insurance company and verify your mailing address.
Why is this HIPAA Certificate of Creditable Coverage so important?
You will need this “HIPAA Certificate of Creditable Coverage” if you want to apply for group health insurance coverage, such as coverage provided by your employer. If you have a pre-existing condition and want to have coverage for that condition included in your new group coverage, you need to use this Certificate by the end of April, as it is only useful within 63 days (May 2, 2011) of your adultBasic insurance ending on February 28, 2011. You may, of course, get individual coverage, or get group coverage after May 2, but if you do, this Certificate will not help you and any pre-existing conditions you may have may not be covered.
What should I do with the HIPAA Certificate of Creditable Coverage?
When you receive a HIPAA Certificate of Creditable Coverage from your adultBasic insurance company, check it for accuracy. It must include the name of each person covered under the former policy, along with the starting date and ending date of coverage. Simply forward a copy to your new health insurance company, but remember to keep a copy for your own records. You might want to store the certificate inside the cover of the new health insurance policy itself for easy reference later.
Medical Assistance:
You may apply for health care coverage at www.compass.state.pa.us to see if you qualify for Medical Assistance (MA). If your circumstances have changed since enrolling in adultBasic – for example, if you’ve become disabled, turned 65, or your income has decreased – you may qualify for MA. To learn more, go to www.compass.state.pa.us and click on “Do I Qualify?” to find out if you may be eligible or call the PA DPW Helpline at 1-800-692-7462.
Medicare:
If you have turned 65, are disabled or meet other eligibility requirements, you may qualify for Medicare. For more information, go to: http://www.ssa.gov/medicareonly/ If you do not wish to apply online you may make an appointment by calling 1-800-772-1213. People who are deaf or hard of hearing may call the “TTY” number, 1-800-325-0778, between 7 a.m. and 7 p.m. on business days.
SpecialCare℠ Health Insurance:
Pennsylvania’s Blue Cross and Blue Shield plans offer SpecialCare, a subsidized health insurance plan for individuals and families. Eligibility for SpecialCare is similar to that for adultBasic. SpecialCare differs from adultBasic both in the level of benefits and the cost. To simplify the transition from adultBasic to SpecialCare, the Blue plans have agreed to waive pre-existing condition exclusions for adultBasic members who enroll directly into SpecialCare by May 2, 2011.
For more information or to enroll in SpecialCare, contact the plan that provides services in your county. Note: Special Care is not offered by the Pennsylvania Insurance Department, nor does identifying it here serve as an endorsement or sponsorship or other affiliation by or with the Pennsylvania Insurance Department. The Special Care products are offered by the Blue Cross and Blue Shield Plans, and these products and the website links are identified here as a resource to assist adultBasic enrollees in finding alternative coverage.
Highmark Blue Cross Blue Shield, 1-800-544-6679, TTY 1-800-452-8086
www.highmarkbcbs.com/SpecialCare
SpecialCare offers hospitalization and health care benefits that are more limited than the adultBasic benefit package. If you would like more details on what is covered by SpecialCare, please contact the Blue Cross and Blue Shield plan that provides services in your county.
The Blue Cross and Blue Shield plans have agreed to make SpecialCare available to all adultBasic enrollees who are losing adultBasic coverage and who meet the SpecialCare criteria. SpecialCare health insurance is available to uninsured lower-income individuals and families who fall into the same income guidelines as the adultBasic program. You must apply for SpecialCare with the Blue Cross and Blue Shield plan that provides services in your county, and should do so before May 2, 2011. Please see the list above for phone numbers and websites where you can receive more information and apply.
The Blue plans have agreed to waive pre-existing condition exclusions for adultBasic members who enroll directly into SpecialCare by May 2, 2011. For more information or to enroll in SpecialCare, contact the plan that provides services in your county. Rates for SpecialCare vary among Blue plans, but are generally higher than adultBasic rates. Please see the list above for phone numbers and websites where you can receive more information and apply. Many of the same doctor’s that participated with adultBasic also participate with SpecialCare. To find out if your doctor participates, please contact the Blue Cross and Blue Shield plan that provides services in your county.
Employer-based Coverage:
You may have the option to select coverage provided through your employer, or another family member’s employer if applicable. In many cases, an employer subsidizes the cost of such coverage. If employer-based group coverage is available to you, and you have a pre-existing condition, we urge you to explore that option now, so that you get coverage before May 2, 2011. See above for how your “HIPAA Certificate of Creditable Coverage” works.
PA Fair Care:
PA Fair Care is Pennsylvania’s health insurance program for uninsured people with pre-existing medical conditions. To be eligible, the federal Affordable Care Act says you must be uninsured for six months and have a pre-existing condition. This means you would be eligible for PA Fair Care in September if you are not covered by health insurance for the six months between February 28 (when adultBasic ends) and September 1, 2011. For information of PA Fair Care visit www.PAFairCare.com or call 1-888-767-7015.
Community Health Centers:
There are approximately 200 community health centers across the state that provide free or low-cost comprehensive, high quality medical health care for all ages on an ability-to-pay basis. In some locations, a full range of services such as dental care and prescription drugs may be available. Services may be free or low-cost, based on your household income. To find the health centers nearest you, call the PA Association of Community Health Centers, Monday through Friday, 8:30 a.m. to 5 p.m., at 1-866-944-CARE (2273), or go to http://www.pachc.com/health_find.html for a list of Pennsylvania health centers.
Financial Assistance with Hospital Bills:
Most hospitals offer financial assistance for uninsured patients who need treatment but cannot afford to pay their bills. Patients who qualify will have their bills reduced or eliminated. If you have hospital bills that you cannot afford to pay, call the hospital’s billing department and ask how you may apply for financial assistance.
Other Specialized Programs:
Prescription Drug Financial Assistance – Pennsylvanians who do not participate in any other state or federally funded prescription program may be able to receive free or low-cost prescriptions. Call 1-800-955-0989 for The Pennsylvania Patient Assistance Program Clearinghouse or go to www.aging.state.pa.us, “Prescription Assistance” and “Other Pharmaceutical Programs.” The Clearinghouse will help you apply for free or low-cost prescription medicines available from drug manufacturing companies and other sources.
Medical Assistance for Workers with Disabilities (MAWD) – MAWD is a health insurance program for working individuals with a disability. There is no set requirement for how many hours you must work or how much you must earn, but you must work and receive wages to qualify. For more information, call 1-800-692-7462 or go to www.dpw.state.pa.us , type in “MAWD” in the Site Search box in the top right corner, then click on the first link to “Medical Assistance Benefits for Workers with Disabilities”.
SelectPlan for Women – Pennsylvania’s SelectPlan for Women is a free, confidential health care program for women between the ages of 18 and 44 that pays for family planning services and related preventive health screens provided by participating health care professionals. Family planning-related prescriptions are free at any participating pharmacy. For more information and to see if you are eligible, call 1-800-842-2020 or go to www.selectplanforwomen.com.
HealthyWoman Breast and Cervical Screening Program (HWP) - HWP offers breast and cervical exams at no cost for eligible women. These exams include mammograms, clinical breast exams, pelvic exams and Pap tests. You qualify if you are 40 to 64 years old; have no or limited insurance; and have low to moderate household income. For more information and to find the HWP check-up site near you, call 1-800-215-7494 or go to www.pahealthywoman.org.
Breast and Cervical Cancer Prevention and Treatment Program (BCCPT) – If you have been diagnosed with breast or cervical cancer or a pre-cancerous condition of the breast or cervix, you may be eligible for free care through BCCPT. The care covers your breast or cervical cancer treatment, as well as any other unrelated conditions while receiving your cancer treatment. You qualify if you are female; under age 65; meet the income requirements; and have no or limited insurance. For more information, call 1‑800-842-2020 or click here for more information.
Pregnancy/High-Risk Pregnancy (Healthy Beginnings/Healthy Beginnings Plus) — If you are pregnant, you may be eligible for Healthy Beginnings or Healthy Beginnings Plus – free programs that provide comprehensive health care coverage to pregnant women and their babies for a full year. Call 1-800-842-2020 for more information on how to apply and for locations near you or click here for more information.
