This document provides information about Medicare, Medicaid, and the Community Insurance Outreach Services (CIOS) organization. CIOS is a nonprofit that provides insurance education and assistance to residents in the Youngstown, Ohio area. The document outlines Medicare enrollment periods, eligibility for Medicaid programs, and CIOS's services, which include insurance literacy programs, claims assistance, and a career pathway program in the insurance industry.
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Healthcare 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
Community based programs
designed & operated by the
community it serves
Insurance industry sponsored
initiative
Outreach partnerships with other
non-profits
Services based on community Support Education
needs which provide superior
satisfaction
Ohio...Let’s Start Here
Employment
!!!
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Healthcare
The Affordable Care Act ACA (Healthcare Reform)
Access to Preventative Services and NO Lifetime Limits
Pre-existing Condition Insurance Plans
Parent Plan Dependent 26 Year Old
Coordination of Care
Secure Medicare Trust Fund
Partnership for Patients
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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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Enrollment Periods Medicare 2012
Saturday October 15th 2011
QUICK FACTS QUICK FACTS
AEP- Annual Enrollment Periods
• NEW—Making changes to your coverage
October 15th 2011- December 7th 2011 after December 31 Between January 1–
February 14, 2011, if you’re in a Medicare
Advantage Plan, you can leave your plan
• You can change your Medicare health or and switch to Original Medicare.
prescription drug coverage for 2012.
• If your Medicare Advantage Plan
Disenrollment Period includes prescription drug coverage and
you join a Medicare Prescription Drug
January 1st 2012- February 14th 2012 Plan, you will be disenrolled from your
Medicare Advantage Plan and returned
• January 1st 2012 new coverage begins if you to Original Medicare.
switched or joined a plan. New costs and
coverage changes also begin if you kept
your existing coverage.
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OSHIIP
Ohio Senior Health Insurance Information Program
1-800-686-1578 MEDICARE EXPERTS
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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”.
9. Medicare-Medicaid Coordination
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Medicare Premium Assistance Program Medicaid for Older Adults and People
(MPAP with Disabilities
This program helps people eligible Medicaid for the Aged, Blind & People with
for Medicare who have limited Disabilities (ABD) Ohio Medicaid offers a span of
programs for older adults and people with
income and assets get help in
disabilities to assist with medical expenses. These
paying the cost of one or more programs provide health care coverage consisting of
of the following: primary and acute-care benefit packages along with
Medicare premium(s) long-term care.
Medicare deductibles
Medicare coinsurance To qualify for ABD Medicaid, applicants must be:
age 65 or older, or
Eligibility Criteria: considered legally blind, or
To qualify for MPAP, applicants must be eligible for an individual with a disability (as classified by the
Medicare and meet basic requirements. Social Security Administration), and
must meet basic requirements.
When applying for MPAP, proof of
income, resources, age or disability, citizenship (if When applying for this type of Medicaid, proof of
not a U.S. citizen) and other health insurance is income, resources, age or disability, citizenship (if
required. not a U.S. citizen) and other health insurance is
required.
No face-to-face interview
with the local county A face-to-face interview with the local county
department of job and department of job and family services is also
family services is necessary.
necessary.
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Medicaid Income Eligibility 2012
2011 HHS Poverty Guidelines
Who Qualify in FPL Single Marrie Resources
Persons 48 Contiguous Ohio? d Single/Marrie
in Family States and D.C. Alaska Hawaii d
1 $10,890 $13,600 $12,540
Older Adults (age 64% $589 $1,011 $1,500/$2,250
2 14,710 18,380 16,930
65 or older) &
3 18,530 23,160 21,320 Disabled People (of
any age)
4 22,350 27,940 25,710
5 26,170 32,720 30,100 Qualified Medicare 100% $867 $1,176 $4,000/$6,000
6 29,990 37,500 34,490 Beneficiary (QMB)
7 33,810 42,280 38,880
Specified Low- 120% $1,040 $1,400 $4,000/$6,000
8 37,630 47,060 43,270 Income
Medicare
For each Beneficiary (SLMB)
additional 3,820 4,780 4,390
person, add
Qualified Individual 135% $1,170 $1,575 $4,000/$6,000
(QI-1)
Qualified Working 200% $1,734 $2,334 $4,000/$6,000
Disabled Individual
(QWDI)
SOURCE: Federal Register, Vol. 76, No. 13, January 20, 2011,
pp. 3637-3638
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Our Common Pledge… “Providing progress, stability, & dedication to
disadvantage communities across America.”
“Insurance Literacy” “Claims Assistance” “Career Pathway”
Insurance Literacy Program Our “Restoring the The “Career Pathway” program
provides free educational Community” program offers offers career placement and
seminars on : catastrophic claims credentials in the insurance
assistance and support to industry.
• Basic Insurance local residents and business.
• Health Insurance We provide recession –proof
• Property & Auto Insurance employment opportunities by
We provide advice and
guidance during insurance securing our clients with an
• Life & Accident Insurance state insurance license with in
claim process.
90 days.
We act as an authorized Our clients are vested after 5
agent and advocate, respond years of commitment and
• We also provide free to denial letters, assist with provide
documentation, and refer to training, credentialing, support
insurance seminars local state insurance , and marketing.
for business agencies for complaints.
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For more information and event dates visit
WWW.CIOS2011.ORG