How We Guide and Educate Our Participants

MDHIP provides guidance and education to our enrollees through mailings, email and a direct phone line that enrollees can call anytime to get their questions answered. Many enrollees are new to health insurance and don't understand what copays, deductibles and coinsurance are. They also may not understand how an HMO operates; the necessity to choose a primary care physician whom they must first see before seeing a specialist. Additionally, they are likely to be unaware of the free screenings and vaccines that come with their insurance policy. Our administrator sends out information to our enrollees regarding the free tests/screenings and vaccines that are available to them and how an HMO works. MDHIP also educates its enrollees in the pitfalls of the Affordable Care Act (ACA) and in owning health insurance such as 1) being sure to stay in network or you will be personally liable for paying the full medical bills you incur, 2) being sure to respond to any government requests for income documentation or lose your tax credits and ultimately your health insurance, and 3) being sure to update the health insurance marketplace with any changes to your income during the year so that your tax credits can be adjusted. Failure to do this can result in a surprisingly large and unpayable tax bill at the end of the year. The ACA and health insurance are complicated subjects, even for those with some experience with health insurance, but for those new to insurance or unfamiliar with the ACA, insurance ownership can be treacherous without guidance. We have seen that first hand. There is a fair amount of turnover in MDHIP participants due to income changes, job changes and more, but those that come through the program leave with a much better understanding of the requirements of health insurance and the ACA than when they entered.

Our administrator sometimes receives calls from people who have heard about MDHIP but earn too little to qualify for our program. In this case, we inform them of the Medicaid expansion and connect them with someone at one of our partnering organizations who can assist them with Medicaid enrollment. We can also advise those that don't qualify for our program for other reasons as to their options and where to go and get assistance with shopping for and purchasing an insurance policy. So we do our best to educate and assist, not just our enrollees who may have issues, but all the low income individuals with whom we have contact.