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Showing posts from November 10, 2019

How can I find out if my doctor is in an ACA health plan’s network?

How can I find out if my doctor is in a health plan’s network? Each plan sold in the Marketplace must provide a link on the Marketplace web site to its health provider directory so consumers can find out if their health providers are included. The provider network information that insurance companies provide may or may not tell you whether a provider is accepting new patients, or whether a provider speaks your language. It is up to your Marketplace to require insurers to provide you with this information.

Healthy Indiana Plan Seeks Renewal

From CKF: Healthy Indiana Plan Seeks Renewal The Indiana Family and Social Services Administration has begun the process for renewal of the  Healthy Indiana Plan (HIP) 1115 waiver and its substance use disorder (SUD) components, which are set to expire on December 31, 2020 . Additionally, the pending HIP Workforce Bridge program will be a part of the HIP waiver extension request. Similarly, the current SUD 1115 waiver will add proposed Serious Mental Illness (SMI) language to its extension request. The extension requests are for a 10 year HIP waiver approval through December 2030 and approval for the SUD and SMI waivers for 5 years through December 2025. The changes from previously approved or submitted language include: Flexibility to modify the POWER Account contribution tiers below an average limit of three percent of member income with appropriate notice to members, stakeholders and CMS, without requiring the submission of a waiver amendment. Specific modificat

Will covered benefits under all Marketplace plans be the same? How can I compare?

Will covered benefits under all Marketplace plans be the same? How can I compare? Not necessarily. All Marketplace health plans are required to cover the ten categories of essential health benefits. However, insurers in many states will have flexibility to modify coverage for some of the specific services within each category. Any modifications must be approved by the Marketplace before plans can be offered.  All health plans must provide consumers with a Summary of Benefits and Coverage (SBC). This is a brief, understandable description of what a plan covers and how it works. The SBC will also be posted for each plan on the Marketplace web site. The SBC will make it easier for you to compare differences in health plan benefits and cost sharing. Plans might differ in other ways, too. For example, the network of health providers might be different from plan to plan.  

Public Comment: Renewal of the Community Integration and Habilitation Waiver and Family Supports Waiver

DDRS Updates Public Notice Regarding Renewal of the Community Integration and Habilitation Waiver and Family Supports Waiver In accordance with public notice requirements established at 42 CFR 441.301 the Indiana Family and Social Service Administration Division of Disabilities and Rehabilitative Services intends to submit a renewal of the Community Integration and Habilitation waiver and a renewal of the Family Supports waiver to the Centers for Medicare and Medicaid Services for consideration. These waiver renewals will allow DDRS to continue providing home and community-based services to individuals who, but for provisions of such services, would require institutional care. The anticipated effective date is April 17, 2020. The FSW and CIH waivers provide Medicaid HCBS services to participants in a range of community settings as an alternative to care in an intermediate care facility individuals with developmental disabilities or related conditions. These waivers serve p

Public Comment: Employment First plan

ndiana Commission on Rehabilitation Services: In April, 2017, Indiana passed legislation regarding Employment First, meaning that employment is the first and preferred outcome for individuals with disabilities. The Employment First Act pertains to state agencies that provide services and support to help obtain employment for individuals with disabilities, and requires those agencies to effectively implement this employment first policy to advance competitive, integrated employment outcomes, including self-employment, for individuals with disabilities of working age. The Indiana Commission on Rehabilitation Services is responsible for developing a plan for advancing competitive, integrated employment as the first and preferred option, and the plan must include: Identification of barriers to employment for individuals with disabilities; An analysis of federal, state, and local agency policies concerning the provision of services to individuals with disabilities, including the impac

What health benefits are covered under Marketplace plans?

What health benefits are covered under Marketplace plans? All qualified health plans offered in the Marketplace will cover essential health benefits. Categories of essential health benefits include: Ambulatory patient services (outpatient care you get without being admitted to a hospital) Emergency services Hospitalization Maternity and newborn care (care before and after your baby is born) Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices (services and devices to help people with injuries, disabilities, or chronic conditions gain or recover mental and physical skills) Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including dental and vision care The precise details of what is covered within these categories may vary somewhat from plan to plan.