The Metro Detroit Health Insurance Program (MDHIP) provides financial assistance to low income tax paying working people and pensioners (age 55 to 64) who do not have health insurance, who do not have health insurance offered through their job, and who do not earn enough money or have the savings to buy and use the "Silver" health insurance plans offered on the healthcare exchange. All households and individuals who participate in MDHIP must earn less than 200 percent of the Federal Poverty Level (FPL) yet earn too much (or don't meet the requirements) to qualify for Medicaid coverage. The assistance that MDHIP participants receive allows them to buy "Silver" health insurance plans from the healthcare exchange at a greatly reduced or at no cost, and to avoid the very costly tax penalties that now exist for those who do not purchase health insurance. We also consider giving some assistance with health insurance deductibles for those with a serious medical issue who can't afford the full deductible.
The impetus for the MDHIP program concept is the fact that people earning below 200 percent of the FPL have offered to them very high quality (low deductible) health insurance policies worth thousands of dollars at a fraction of their retail price. This is due to the subsidies provided under the Affordable Care Act (ACA). But these greatly reduced prices are still too high for most people earning below 200 percent of the FPL. But with some assistance, these low income workers and pensioners can purchase these excellent health insurance policies and finally get access to quality healthcare. By piggybacking off the government subsidies, we can provide our participants access to excellent health insurance coverage while only spending a fraction of what the policies are worth, allowing us to provide healthcare access to a large number of uninsured people with a relatively small amount of dollars. See Why MDHIP is an Excellent Choice For Your Charitable Giving on the right side of the MDHIP home page to understand the power of this charitable concept and the matching program that is in place for donations from the general public.
The MDHIP program is run completely by volunteers. The MDHIP program concept was pilot tested with over 50 individuals and families during the first 8 months of 2015 under a nonprofit named MichUHCAN. The pilot proved to be very successful, with enrollees both very happy with the program and very appreciative of the program's existence. This has given us the confidence to create our own nonprofit where we plan to make MDHIP an ongoing program with a desire to significantly expand the program in 2016. The expansion will greatly depend on how much money we can raise.
Persons who wish to participate in the MDHIP must have a total estimated gross (pre-tax) 2016 family income that falls below our qualifying income limits and they must also file income taxes and be eligible to purchase a subsidized insurance plan from the health insurance marketplace. The income limits are as follows:
|* Family Size||**Estimated 2016 Gross Family Income Limits For MDHIP|
|1||less than $24,000|
|2||less than $29,200|
|3||less than $33,600|
|4||less than $38,000|
|5||less than $42,500|
|* Family Size||** Estimated 2016 Gross Family Income Limits For MDHIP|
|2||less than $33,000|
|3||less than $38,000|
|4||less than $43,000|
|5||less than $46,800|
* Family Size is the number of dependents you claim on your IRS Form 1040 including yourself.
** Combined gross estimated 2016 income of all family members included in Family Size.
MDHIP participants who are only insuring themselves will receive financial assistance of up to $100 per month and participants who are insuring themselves and at least 1 other member of their family will receive up to $150 per month to be used toward their health insurance costs when they enroll in a Silver health insurance plan through the U.S. government's healthcare exchange. Most require significantly less than these amounts to fully pay for their health insurance. If a participant earns too much to purchase a health insurance plan that costs less than our maximum monthly assistance, or chooses to go with a more expensive plan, that participant will be responsible for paying for the portion of their health insurance bill that is above their maximum monthly MDHIP assistance amount. Most enrollees in MDHIP are getting their insurance at zero cost to them.
MDHIP has created partnerships with many clinics/social service organizations that are primarily located in low income areas. These organizations understand that the MDHIP program can be of great benefit to those in their communities who qualify, and so the MDHIP program works to incentivize these organizations to reach out to their communities and find the uninsured who are often unaware of the subsidies that are available to them under the Affordable Care Act and also unaware that they will be hit with significant tax penalties if they remain uninsured. The process of becoming an MDHIP participant begins when one of these MDHIP referring organizations identifies a person or family (client) who meets MDHIP's enrollment eligibility requirements. They then send MDHIP a "referral form" and if we have a slot available for this client in our program, the referring organization can assist their client with enrolling in a "Silver" health insurance plan and with enrolling in the MDHIP program. At this point, all of our partnering organizations have people on staff trained in healthcare exchange (marketplace) enrollment so they can assist our participants in shopping for and purchasing their health insurance plans.
The MDHIP administrator provides guidance and education to our participants where he can. 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. Our Participant's Guide also educates our enrollees about the need to inform the healthcare exchange about any income changes (or changes in family size) as they will affect their subsidy and thus the cost of their insurance. Our participants are given our administrator's phone number and can call him whenever they have questions or issues. 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. 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.
In the future, we at MDHIP would like to see our program copied by other organizations in other communities around the country. To this end, we are offering any interested person or group our website program, our advice, and the forms and guides we have developed for our partners and our enrollees. We are also developing a "how to" manual which provides a step by step guide for creating a program that is similar to MDHIP. We would be glad to offer it to any interested persons.