Advocating the right to quality, affordable health care for every person in Maine.
Consumer Assistance HelpLine

1-800-965-7476

Winter 2011 Newsletter

New Year Brings New Medicare Benefits!

Several important benefits of the Affordable Care Act took effect on January 1st:

  • Seniors with Medicare get free preventive care, like cancer screenings and blood pressure checks
  • Seniors also get a free annual wellness visit with their doctor
  • Lower prescription drug costs for seniors with Medicare
  • Creation of the Center for Medicare and Medicaid Innovation to improve quality and reduce costs

For more information about the new benefits in Medicare, call Legal Services for the Elderly at 1-877-353-3771.

In other ACA-related news, Maine was recently selected as one of eight states to expand its Patient-Centered Medical Home Pilot to include Medicare. Funded by the ACA, the medical home pilots are aimed at enhancing primary care and care coordination. Interested in learning more about this and other quality-related efforts? Contact Mitchell Stein.

For more information about ACA benefits, click here.

Legislative and Policy Update

Click on the links below for more information about these topics:

CAHC Intervenes in Anthem Rate Hearing

Anthem requested a rate hike of approximately 9.7% for its individual health insurance products to go into effect July 1, 2011. The Maine Bureau of Insurance Superintendent Mila Kofman will hold a public hearing before she approves the request. CAHC has intervened as a party to the case to represent consumers’ interests and enhance consumer participation in the rate review process.

For complete and up-to-date information about the proposed rate increase visit the Bureau’s website.

The Bureau is holding three more public comment sessions:

Tuesday, March 22nd, 5-7pm, Portland
*Note: Bureau staff will be available beginning at 4:30 pm to provide training and answer questions.

NEW!! Early April, date/time/location TBD, Orono

Monday, April 11, 4-6pm, Gardiner

You may also submit written comments by sending them to the Superintendent:

By E-mail: Sarah.Hewett@maine.gov

By Mail: Superintendent of Insurance
ATTN: Sarah Hewett (INS-11-1000)
34 State House Station
Augusta, ME 04333

There are also web-based trainings (webinars) available before the hearings to explain the rate review process and how to testify:

Sunday, March 20, 6pm
Monday, March 21, 6pm

If you or someone you know has an Anthem individual policy and is interested in getting involved, please contact us!

Giving People Hope

From the HelpLine:

HelpLine staff recently assisted a woman who has Multiple Sclerosis and Medicare coverage as a disabled person. She used to have MaineCare as a secondary insurance because of her very low income but after getting married she realized their combined income is over the guideline for MaineCare. The medications she takes costs thousands of dollars a month, more than their income, in fact. So the deductible and co-pay costs for her, even with her Medicare Part D plan, were going to make them go broke. She was very distraught and thought maybe she shouldn’t have gotten married.

Happily there is a program to help them. By utilizing a procedure called the Ineligible Spouse Allocation, we are able to deduct $337 from the couple’s monthly income which brought the combined income down just enough for the woman to be eligible for the Maine Medicare Savings Program. When using the Ineligible Spouse Allocation, only one person of the couple gains eligibility. This works fine for this couple. The Medicare Savings Program that the woman is eligible for using this procedure will take care of her Part D premium, deductible, co-insurance and “donut hole,” making it possible for the couple to remain married and not go bankrupt.

Have a question of your own? Call the free and confidential CAHC HelpLine: 1-800-838-7476

CAHC Welcomes Emily Blanck to the Consumer Assistance Program!

Emily Blanck joined CAHC in early February as the Consumer Assistance Program Associate. Emily will provide support to the HelpLine, outreach and education and electronic communications programs and staff. A 2009 graduate of American University with a BA in Public Communication and a minor in Health Promotion,

Emily previously was the media advocacy intern for the American Cancer Society Cancer Action Network in Washington, DC. At ACS CAN she gained experience and interest in health-related nonprofit organizations, as well as the importance of accessible and affordable health care, while working to promote the organization’s position on pending legislation and other relevant issues. She resides in her hometown of Winthrop and is looking to buy a house in the area. Welcome Emily!

CAHC in the News

December 15, 2010 Portland Press Herald The Health Care Debate
December 21, 2010 Portland Press Herald Health Chief to take on Medicaid
February 1, 2011 Portland Press Herald Judge Rules Full Health Care Law is Void
February 7, 2011 Action Alert/Blog Post Modernize Rate Review J. Ditré and L. Kirsh
February 8, 2011 Bangor Daily News Interactive Consumer Assistance Program Map of the U.S.
February 28, 2011 MPBN Obama’s Flexibility Pledge on Health Care Gets Mixed Reaction in Maine
February 28, 2011 Capitol Weekly To Bend the Cost Curve, Modernize Health Insurance Rate Review. J. Ditré and L. Kirsch
March 3 Portland Press Herald Dirigo Health gets support, faces cuts
March 3 MPBN Proposed Dirigo Funding Cuts Leave Policyholders in Limbo
March 3 WCSH-6 Dirigo is still ‘open for business’
March 4 The Daily Sun, PortlandHealth care group says Dirigo still ‘open for business’

March 15 Bangor Daily News Anthem customers protest proposed rate increases

March 16 Portland Phoenix Progressive Nightmare by Deirdre Fulton

Dirigo Health Agency Enjoys One of Its Busiest Months

The Dirigo Health Agency (DHA) is open for business, and enjoyed one if its busiest months in January in terms of enrollment in its programs. Among the more appealing benefits to individuals and businesses are:

  • Competitive rates for its DirigoChoice product (a Harvard Pilgrim plan). Businesses will face no increase in their premiums at renewal this year, while individual premiums will increase only 2%. Please note that these increases apply to each unadjusted community rate class. If a business or an individual moves into a different rating category, they may see a change in their premiums.
  • The Part-Time Worker Voucher Program is funded by a federal grant provided by the Human Resources and Service Administration. It allows employers to offer the same health insurance coverage to part-time and seasonal workers as they do to full-time employees, but at only 5% of the monthly premium.
  • DHA plans pay private rates to hospitals and providers.
  • Small business tax credits offered by the Affordable Care Act can be combined with a DHA product to create a viable option for businesses that could not afford coverage in the past.

Although Governor LePage has proposed cuts over the next three years to DHA, there are still over 580 businesses and nearly 15,000 Mainers enrolled in its programs. Maine Voices for Coverage, a group that CAHC is a member of, requested the list of businesses enrolled in either DirigoChoice or the Voucher Program through a Freedom of Access request. The list can be found here.

In addition, CAHC hosted a press conference on March 3 highlighting the DirigoChoice, Part-Time Employee Voucher Program, and Pre-Existing Condition Insurance Program products offered by DHA. (See CAHC in the News for coverage!)

CAHC Celebrates Go Red for Women “National Wear Red Day”

CAHC staff wore red on Friday, February 4th to celebrate Go Red for Women, the American Heart Association’s campaign to educate women about heart disease and ways to cut their risk. In addition to wearing red, the staff celebrated with a “heart-healthy” potluck lunch.

CAHC Staff Attends Families USA Health Action Conference in DC

Despite inclement weather conditions, CAHC Executive Director Joe Ditre and Public Relations Coordinator Greg White traveled to our nation’s capitol in January to participate in the annual Families USA Health Action Conference. Together with state advocates from across the country, Greg and Joe honed their health policy expertise and gained new insights into the upcoming challenges our state is facing.

The workshops focused on a variety of topics including health care quality, rate review, and implementation of the Affordable Care Act. President Obama, the keynote speaker, House Minority Leader Nancy Pelosi, and other lawmakers also shared their vision of health care for 2011 and beyond.

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Open Enrollment is the time of year you can sign up for health insurance.

Open Enrollment to get insurance for 2018 will start November 1, 2017. It will end December 15, 2017.

If you don't sign up for a health plan by December 15, 2017, you may not be able to get health insurance in 2018. If you don't have insurance, you might have to pay a fine when you file your taxes.

Visit HealthCare.gov or call our HelpLine at 1-800-965-7476 to learn more and find out how to apply!

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