Tag Archives: EmblemHealth

Harlem, wondering what are most common Health Care Reform Q and A’s? Learn more here

Harlem, the Affordable Care Act, also known as Obamacare, has been in the news for quite some time. Whatever your position is about this subject matter, learning more about it empowers us all. EmblemHealth provided an article to HarlemGal Inc that covers some of the most common questions and answers about Obamacare. Given the significance around the subject matter, this blog is sharing the article in its entirety. Hope you find it helpful -HG.

Answers to the Most Common Health Care Reform Questions

By Sana Hashmi, Director of Health Care Reform and Product Design at EmblemHealth.

Through the open enrollment period, more than 1 million New Yorker’s are expected to sign up for health insurance online through NY State of Health, part of the national health care reform law known as the Affordable Care Act or Obamacare. But what do you need to do and how do you do it?

Experts from EmblemHealth have been answering a lot of questions. To help New Yorker’s choose an insurance plan, below are some of the most common questions and the answers.

Q. What is the Affordable Care Act or Obamacare?
In 2010, President Obama signed this law to make quality, affordable health care available to more Americans and offer financial assistance to those who need it most. It also requires most Americans to have health insurance starting in 2014 or pay a penalty.

Q. What happened October 1?
NY State of Health, the state’s health insurance marketplace, opened. You can learn all about it at http://www.nystateofhealth.ny.gov. Anyone who enrolls in a health plan between October 1 and December 15 will be eligible for health insurance starting January 1, 2014. The deadline for enrolling on the health plan marketplace in the first enrollment period is March 31, 2014.

Q. Do I need to sign up for health insurance?
Unless you already have health insurance, the answer may be yes. The federal law says that most people in the US (legal residents and “lawfully present” immigrants) must have health insurance starting in 2014 or pay a penalty. If you don’t have health insurance right now, the law is designed to help you get an affordable plan.

Q. How can I afford health insurance?
People who qualify will be eligible for tax credits and subsidies to help lower the cost of coverage. Household income and family size are used to decide who gets help with costs and how much help they can get. You may be eligible for this help if your income is between 100% and 400% of the Federal Poverty Level. The only way to know the exact dollar amount is to apply through the marketplace.

Q. Am I eligible for subsidies or tax credits?
Many people will be. Under the new law, you may get financial assistance when you apply for a plan on NY State of Health. You may get tax credits to lower monthly payments, subsidies to lower out-of-pocket costs when you go to the doctor, Medicaid (no-cost health coverage) or Child Health Plus (a low-cost health plan for young people up to age 19).

Q. I already have insurance but my spouse needs it. Will my salary affect her ability to receive a subsidy or a tax credit?
Yes. Eligibility for tax credits and subsidies is based on total household income.

Q. How do I sign up and what information do I need?
You can sign up for a health care plan online, in person, over the phone or by mail. You will need social security numbers for all family members you plan on enrolling, or document numbers for legal immigrants. Also, have employer information and income information at hand, and policy numbers for any health plans covering members of the household.

Q. Can I enroll my entire family?
Yes. The law requires most citizens and legal residents to have health insurance.

131021-obama-healthcare-hmed-240p.380;380;7;70;0Q. I have health insurance through my company. Will I need to sign up on NY State of Health?
If you have health insurance through your employer, you may not need to sign up. To be sure, ask your employer’s health benefits administrator (the person who assists with health benefits) or someone in the human resources department.

Q. I heard the new employer mandate was delayed. How does this affect me?
The employer mandate was delayed until January 2015. Once it takes effect, employers with 50 or more full-time workers must provide adequate, affordable health care coverage to their full-time employees or pay a penalty. (Adequate, affordable coverage means the plan covers 60% of total health care expenses and costs employees no more than 9.5% of their household income.)

If you have health insurance through your employer, you may not need to sign up. If you don’t have health insurance through your job, you can visit NY State of Health to look at your options. For more information, ask your employer’s health benefits administrator (the person who assists with health benefits) or someone in the human resources department.

Q. Can I still buy insurance directly from a health insurance company?
Yes, you can buy health insurance directly from a health insurer. But financial assistance is available only through NY State of Health.

Q. What are “metal” plans?
All health insurers participating on NY State of Health will offer four types of metal plans — Bronze, Silver, Gold and Platinum plans. They cover the same benefits but, between health insurers, differ in monthly costs and in the choice of doctors, hospitals and other health care providers. “Catastrophic” plans will be available for people under age 30 and others who qualify. This plan covers essential health benefits, routine preventive-care services and three annual visits to a primary care doctor at no out-of-pocket cost to you. It has similar benefits as the metal plans, but different costs.

Q. What will be covered?
All health insurance plans will be required to provide coverage for these essential benefits:
1. Routine doctor visits
2. Visits to the emergency room
3. Hospital care
4. Maternity and newborn care
5. Mental health and substance-abuse treatment
6. Prescription drugs
7. Habilitative and rehabilitative services
8. Laboratory tests
9. Preventive and wellness services and chronic-disease management
10. Pediatric services, including vision care
Certain preventive care services, like cholesterol tests, will be covered at 100% so that it’s easier to stay healthy.

Q. I don’t want health insurance. Will I be penalized?
If you don’t have health insurance in 2014, you may have to pay a penalty when you file your taxes. For 2014, the penalty is $95 per adult and $47.50 per child or 1% of taxable household income — whichever is higher. For example, if you are a single adult with $50,000 of taxable income, the penalty would be $500.

The penalty will go up each year until 2016, when it will be $695 per adult and $347.50 per child or 2.5% of taxable household income — whichever is higher. After 2016, the penalty will continue to go up with the cost of living.

It’s important to think about more than just cost when considering your options. Health insurance is essential to protecting both your physical and financial health, in case something happens.

Q. Where do we go for more information?
The NY State of Health website, nystateofhealth.ny.gov, is a good place to start. Customer service information is available at 1-855-355-5777. EmblemHealth also has extensive information at emblemhealthreform.com.

The Easter Bunny is coming to Harlem, EmblemHealth offering photos

EmblemHealth invites the Harlem community to join a spring celebration and receive a FREE photo taken with the Easter Bunny. Families can also enjoy balloon sculpting and receive fun giveaways. This is all happening this Saturday, March 30 from 11 am to 2 pm at 215 West 125th Street.

WHO: EmblemHealth Neighborhood Care Harlem
WHAT: Picture with the Easter Bunny
WHEN: Saturday, March 30, from 11 am to 2 pm
WHERE: 215 West 125th Street, New York, NY 10027

For more information, visit www.emblemhealth.com or call (866) 469-0999.

EmblemHealth to offer Harlem residents free flu shots October 16th and 20th

Flu season is upon us and its time to think about how to manage that. EmblemHealth will be offering Harlem residents complimentary flu shots, blood pressure screenings and “brown bag” prescription medication reviews on October 16 at the West Harlem Farmers Market and on October 20 at Mount Morris Park.

Also, while there take advantage of receiving free health and wellness screenings. EmblemHealth and Harvest Home Farmer’s Markets are offering these services at each location through the end of November.

EmblemHealth and Harvest Home Farmer’s Markets Kick-Off ‘Eating for Good Health,’ cooking demonstrations available in Harlem

EmblemHealth and Harvest Home Farmer’s Markets are offering locally grown fruits and vegetables, cooking demonstrations and health and wellness screenings to the people of NYC this summer, with two locations in Harlem, through the “Eating for Good Health” program.

A kick-off celebration for the start of the cooking demonstrations is scheduled for the week of July 10 – 14, 2012 with special activities, giveaways and health screenings. Below are the schedules of the two Harlem locations that are participating in the “Eating for Good Health” program:

Mt. Morris Park Historic District Market-Saturdays through November 17
Cooking Demonstrations begin July 14, 2012 through Oct. 27, 2012
120th Street and Lenox Avenue

West Harlem Farmer’s MarketTuesdays beginning July 10 Nov. 20, 2012
Cooking Demonstrations begin July 10-Nov. 20, 2012
137th Street and Broadway

For more information, please visit www.harvesthomefm.org.