Health Action NM has created a bilingual resource for New Mexicans who find that they owe a penalty for lacking insurance for part or all of 2014.  From March 15th to April 30th, uninsured families and individuals can sign up for health coverage with financial assistance.  The resource provides information about how to connect with in-person assistance to sign up for health coverage and avoid penalties for 2015, which increase to the greater of $325 per person or 2% of household income.   See the bottom of this page to view the resource as a JPG or click here for the PDF version.

 

Who is eligible for the “Tax Season” SEP?

Consumers are eligible for this SEP if they:

• are not currently enrolled in 2015 coverage (whether through New Mexico’s Health Insurance Exchange (NMHIX), an employer, the off-exchange individual marketplace, or other forms of minimum essential coverage),
• attest that they are or will be subject to the fee for not having health coverage for all or part of 2014 when they file their 2014 taxes, and
• attest that they first became aware of, or understood the implications of, the requirement to maintain minimum essential coverage (MEC) after the end of open enrollment (February 15, 2015) in connection with preparing their 2014 taxes.

What does “subject to the fee” mean?

• Eligible consumers must be required to pay the fee for at least part of 2014.
• Consumers do not have to have paid the fee before enrolling through the SEP. In other words, consumers who have not yet filed their 2014 income tax return (including those who have an IRS extension to file their 2014 return) may still be eligible for this SEP so long as they will have to pay the fee when they do actually file their taxes.

Who is not eligible for this SEP?

• Consumers who are exempt from the fee for the entire year in 2014 or who had coverage for the entire year in 2014.
• Consumers who completed their tax filing prior to February 15, 2015 or otherwise became aware that they would be subject to the fee in 2014 before the end of open enrollment.
• Consumers who do not have to pay the penalty but are subject to reconciliation and have to repay Advance Premium Tax Credits received in 2014.

How long does this SEP last?

• This SEP will begin on March 15th and end on April 30th.
• Consumers who qualify must complete the entire enrollment process (that is, including selecting a plan) by 11:59 pm E.S.T. on April 30th.
• Similar to during open enrollment, consumers who enroll in an initial plan during this SEP can switch to a different plan through April 30th. Note, however, that all plan selections and enrollment processes must be completed by 11:59 pm E.S.T. on April 30th.

How will eligible consumers open or unlock this SEP?

• As of March 15th, the online application includes questions about the attestations in the third and fourth eligibility requirements listed above. 
• Consumers can also access this SEP through the Call Center.

When will coverage begin?

• Normal coverage effective dates apply. If a consumer enrolls in coverage on or before the 15th of the month, coverage will be effective on the first day of the following month. In order to have coverage begin April 1st, consumers must enroll on March 15th.
• Note that consumers who enroll through this SEP will be subject to the fee for the months they did not have coverage and were not exempt in 2015 when they file their taxes in 2016. For example, if an eligible consumer enrolls on March 15th his coverage will begin April 1st. When he files his 2015 taxes in 2016, he will be subject to the fee for January through March (3 months) unless he qualifies for an exemption.

Are undocumented immigrants or Native Americans subject to the shared responsibility payment if they don’t have health coverage?

Undocumented immigrants and Native Americans do not have to pay any fees or penalties for lacking health coverage.  The IRS recently clarified this rule, stating “Individuals who are not U.S. citizens or nationals, and are not lawfully present in the United States, are exempt from the individual shared responsibility provision and do not need to make a payment.  For this purpose, an immigrant with Deferred Action for Childhood Arrivals (DACA) status is considered not lawfully present and therefore is exempt.  An individual may qualify for this exemption even if he or she has a social security number (SSN).”

If an improper penalty has been charged, tax filers will need to amend their tax return by filling out Form 8965, which can be found at http://www.irs.gov/pub/irs-pdf/f8965.pdf.

 

 ENGLISH VERSION

Health Action

In collaboration with the National Indian Council on Aging and the Diverse Elders Coalition, Health Action New Mexico has released a resource to help explain how the Affordable Care Act affects Native Americans between the ages 50 and 64.  “There is still a great deal of work to be done to raise awareness among tribal communities and urban Indians about new coverage options available through the new health reform law,” said Barbara Webber, Executive Director of Health Action NM.  “Our hope is that this fact sheet will be helpful for Native Americans who need health services that can’t be provided by the Indian Health Service.”

Nationally, about one of three Native Americans and Alaskan Indians lack health coverage, according to a 2013 report by the Kaiser Family Foundation.  The only other recourse is to use the Indian Health Service (IHS), which provides primary care for members of Federally Recognized Tribes.  But with severely limited capacity for specialty services and consistent underfunding from the federal government, IHS is often unable to meet the health care needs of the population it serves.  Many tribal members are acutely aware of the link between the lack of access to care and the lower-than-average life expectancy among Native American populations.

New coverage expansions provide benefits for tribal communities and urban Indians that can extend crucial health care services to populations in need.  The Medicaid Expansion provides free health coverage to Americans making under $15,655 per year ($1,305 per month) as an individual.  The New Mexico Health Insurance Exchange is a marketplace where those making above that amount can shop for a private health coverage plan, with financial assistance available to help make coverage affordable.  Native Americans are eligible for premium discounts if they make below about $46,680 per year as individuals ($3,890 per month) and face no out-of-pocket costs if, as an individual, they make below $35,310 per year ($2,943 per month).

Native Americans ages 50-64 stand to gain from these new benefits, especially if they live with chronic conditions that require routine treatment.  Health Action NM’s new resource acknowledges that being able to manage a condition with a doctor is crucial to the health of older adults, which is why IHS and health coverage can lead to a synergy between primary and specialty care providers.  “We made sure to explain how new coverage options can be used in addition to IHS services,” according to Barbara Webber.

With the release of this fact sheet, Health Action NM seeks to make this information available in its most accessible form. “We held an incredible group discussion with members of tribes throughout the state to ensure that this fact sheet is useful for Native Americans in New Mexico,” said Joe Martinez, Outreach Coordinator for Health Action NM. “That discussion will be the basis for future collaborations with Native Americans who want to see their communities thrive.”

Click here to view the fact sheet.

Please contact Health Action NM if you would like copies of the fact sheet for your community:

Health Action New Mexico
3700 Osuna Rd NE, Ste 504, Albuquerque, NM  87109
(505) 322-2152
info@healthactionnm.org
www.HealthActionNM.org

 

Health Action

You may qualify for this years Special Enrollment Period into the NM Health Insurance Exchange if any one of the following occured in your life during 2014 or 2015: 

1) You moved addresses

2) Your income changed or you lost/gained employment

3) You got married 

4) You had a baby 

5) You filed for a divorse

6) You turned 26 and lost your parent's insurance 

RT @YoungInvincible Q2: What types of events qualify you for special enrollment? #MillennialMon pic.twitter.com/EewSckfEhj

— Families USA (@FamiliesUSA) March 16, 2015

@YoungInvincible</a> Q2: What types of events qualify you for special enrollment? <a href="https://twitter.com/hashtag/MillennialMon?src=hash">#MillennialMon</a> <a href="http://t.co/EewSckfEhj">pic.twitter.com/EewSckfEhj</a></p>&mdash; Families USA (@FamiliesUSA) <a href="https://twitter.com/FamiliesUSA/status/577549211778043904">March 16, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script>">

@YoungInvincible</a> Q2: What types of events qualify you for special enrollment? <a href="https://twitter.com/hashtag/MillennialMon?src=hash">#MillennialMon</a> <a href="http://t.co/EewSckfEhj">pic.twitter.com/EewSckfEhj</a></p>&mdash; Families USA (@FamiliesUSA) <a href="https://twitter.com/FamiliesUSA/status/577549211778043904">March 16, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> ">

@YoungInvincible</a> Q2: What types of events qualify you for special enrollment? <a href="https://twitter.com/hashtag/MillennialMon?src=hash">#MillennialMon</a> <a href="http://t.co/EewSckfEhj">pic.twitter.com/EewSckfEhj</a></p>&mdash; Families USA (@FamiliesUSA) <a href="https://twitter.com/FamiliesUSA/status/577549211778043904">March 16, 2015</a></blockquote> <script async src="//platform.twitter.com/widgets.js" charset="utf-8"></script> ">

If you think you qualify for any of these life changing events and would like to still sign up for health coverage, you can either visit www.bewellnm.com (where you can apply online right from the comfort of your home, office, school, etc.) or you can reach Health Action NM at 505-322-2152 and we can get you in touch with your nearest Healthcare Councelor who can set up an appointment to get you covered today! 

Health Action

Some consumers in New Mexico have been purposely misdirected to private insurance brokers when they thought they were visiting the official Health Insurance Exchange website, healthcare.gov, or calling a qualified broker or enrollment counselor.  This is a serious issue because the official exchange is the only place to get financial assistance for premiums and out-of-pocket costs.  In addition, brokers continue to offer plans that do not meet the standards for a qualified health plan, leaving consumers with weak insurance that doesn’t shield them from tax penalties.

An enrollment counselor at the Southwest Women’s Law Center reports that she has seen an influx of consumers that have been victims of this scam.  The center’s Staff Attorney, Paige Duhamel, talked to a number of consumers who said that the brokers “talked at a rapid pace to pressure the consumer, refused to answer questions and caused a great deal of confusion and stress about the enrollment process.”  

It is important that consumers know what to do to avoid these types of issues.  Below are signs of fraudulent activity to keep an eye on when seeking enrollment assistance:

1) You are being charged an enrollment or sign-up fee

2) Your plan’s deductible is more than $6,350

3) The assister has you pay for the first few months’ premiums in advance

4) The assister does not speak to you about financial assistance or Medicaid eligibility

5) The assister asks you if you have a pre-existing condition

6) If you do enroll, the assister does not send you any documentation about your enrollment

7) The assister a) is unwilling to give you their name and direct contact number, b) has an out-of-state contact number, c) has a non-1800 number, or d) has a direct contact number that is anything other than the number for healthcare.gov (1-800-318-2596).  Always take down the name and phone number of the person with whom you are speaking

8) The assister only talks to you about one health insurance carrier’s plan

 

Health Action

Health Action NM teamed up with local Albuquerque Theatre company, Blackout Theatre, to produce a Young Adult enrollment video! Check it out, share it with your friends, and tell us what you think!

 

Health Action

Health Action NM's team member, Joseph Martinez, graciously accepted Families USA's Health Equity Advocate of the Year Award for 2015! Joe was joined by other advocates from all over the United States to brainstorm and share strategies at the annual Families USA conference held in Washington D.C. on Jan 22-24.

Joseph Martinez works tirelessly to ensure that all people living in the state of New Mexico have access to affordable, accessible, and accountable health coverage, no matter what. He truly is an advocate in every sense of the word and here at Health Action NM we are proud to say that Joseph Martinez is a part of our advocacy team.

Congratulations Joe!

Health Action

#fbfaf6">

Happy Holidays and best wishes for the upcoming New Year! May our year bring good health, prosperity and contentment.  Thank you for the partnership we share with you!    This year, Health Action NM partnered with many local organizations throughout New Mexico to achieve the following:  Established presence in 36 communities in 12 counties of New Mexico. Our focus was and remains hard-to-reach uninsured families. Convened 278 outreach and enrollment events attended by 9621 persons. 1643 families and individuals were enrolled at these events and another 1080 were connected to enrollment assisters and provided with follow-up. 75% of the events were bilingual and all material provided by HANM was bilingual. We are thankful for the many persons of action from many communities across New Mexico who continue to step forward, neighbors helping neighbors, to assist one another to get enrolled and learn how to use their healthcare coverage. Our vision is to use enrollment as a springboard for developing grassroots health advocacy leadership across the state.   Additionally, Health Action New Mexico is persistent in monitoring that the State of New Mexico works on all cylinders to get all who are eligible enrolled, oriented on how to use and keep their healthcare coverage.   At the Legislative Session in January, we will be asking for greater access to quality, affordable dental care for all by permitting dental therapists to practice in New Mexico under the general supervision of dentists and trained in our community colleges.   This year, our 20th anniversary, we want to do even more. We want expanded dental access to become a reality as we introduce legislation for the fourth time to make this happen. We want to set up local community associations to create a pipeline of vetting and supporting persons from their rural, tribal and underserved communities to become homegrown dental therapists. We want newly insured families to better understand how to use their new coverage and how to use their appeal rights when benefits are denied. We want rural, homeless, veterans and Hispanic families to get access to the health care that they need. We have expanded our field team to include a member in the border communities. We want communities to learn how to be their own champions for change and to recognize that health is much more than the health care system.   Never before has our mission of affordable, accessible, accountable health care for all made such transformative steps towards this goal. But much could be taken away and much more needs to be done. We can only do this with your help and support.   Please go to https://donatenow.networkforgood.org/donatehealthactionnm and make a generous tax deductible donation today. You can also mail a check to 3700 Osuna Rd, NE, Suite 504, Albuquerque, NM 87109.     With your financial support, Health Action New Mexico can keep passionately working to make greater access for health and dental care an authentic human right for all in New Mexico.   Cordially,   Barbara K Webber​ Executive Director​                                                                            “I’m looking forward to… (being able to) take care of my teeth, get new eyeglasses, and I might be able to get some help for an issue I’ve been struggling with for years… The stress of not being able to see a doctor …was difficult. Not having health coverage is bizarre at this age.” - Iris 63, whom HANM helped with resources for an appeal to get Expanded Medicaid.   Health Action NM http://healthactionnm.nationbuilder.com/

Health Action

By: Colin Baillo (Central NM Apprentice- Health Action NM)

The open enrollment period for purchasing individual or family coverage through the NM Health Insurance Exchange has arrived!  Beginning November 15, 2014 the exchange, www.bewellnm.com, will once again be available for those seeking coverage, this time without the technical difficulties that plagued the website during the last enrollment season.  The enrollment period is only three months long, ending February 15, 2015.  Here are some important things to keep in mind if you intend to purchase or renew coverage on the exchange:

Before shopping on the exchange, see if you are eligible for Medicaid

You can visit https://www.yes.state.nm.us to sign up for Medicaid.

Medicaid is a public health coverage program that provides cost-free insurance to low income Americans.  Individuals making less than $16,105 a year and families of four making less than $32,913 a year are eligible for Medicaid.  Medicaid is available throughout the year, unlike plans acquired on the exchange, which can only be purchased during the open enrollment period.  If you are 1) between the ages 19-64 and 2) are a U.S. citizen or lawfully present immigrant and meet household income requirements, you may be eligible for free health insurance.

Visit http://kff.org/interactive/subsidy-calculator/ to see if you qualify for Medicaid.  You will need to provide your zip code, annual income, and the number of people in your family. 

You can also use the chart below to determine whether you and your family qualify for Medicaid:

 

Household Size	Income per Month/Year
1 person	Less than $1,342/$16,105
2 people	Less than $1,809/$21,707
3 people	Less than $2,276/$27,310
4 people	Less than $2,743/$32,913
5 people	Less than $3,210/$38,516
6 people	Less than $3,677/$44,119

 

Is this your first time buying health insurance? 

If you don’t qualify for Medicaid, the next step is to visit http://www.bewellnm.com, where you can shop for health coverage.  It is important to keep in mind that the window for obtaining coverage through the exchange is limited, lasting from November 15, 2014 to February 15, 2015.  Shopping for insurance can be a daunting task.  Luckily there are experts available to help you find the plan that is right for you. 

The New Mexico Health Insurance Exchange Enrollment Assistance Center is offering free assistance and advice on finding appropriate coverage, tax credits, and more.  You can even purchase coverage on site.  The enrollment center is in Albuquerque, located at 2301 San Pedro NE near Indian School.

Visit http://bewellnm.com/find-an-hcg/ to find a Health Care Guide near you.

You can also contact New Mexico’s consumer hotline by calling 1-855-99-NMHIX.

You may be eligible for a tax credit that acts as a discount on your insurance premiums and out-of-pocket costs.  You will need to know your household income to determine your eligibility.  Check out the Kaiser Family Foundation’s subsidy calculator to see how much you can save on your health plan. Right now, you can view price estimates for plans that you can purchase that factor in tax credits at https://www.healthcare.gov/see-plans/.  Insurance lingo can often be confusing.  If you run in to any terminology that you are unfamiliar with, check out BeWell NM’s healthcare glossary.

Shop around before renewing your health plan

If you purchased a plan on the exchange last year then you will be re-enrolled in to the same plan for 2015 unless your insurance company stops offering your plan or you choose to purchase a new plan.  If you like the coverage you received you should still be sure to review your plan before renewing it, as the premiums, co-pays, and other aspects of your plan’s cost may have changed.  In other words, you may pay more than you did last year for the same plan, so be sure to review your plan and shop around.  There may also be new plans offered on the exchange that are more affordable or better suit you and your family’s needs.

Sign up by December 15th if you want your coverage to start January 1st

While the enrollment period lasts through February 15th, you can start using your coverage at the beginning of 2015 if you sign up by December 15th.  If you wait until the end of the enrollment period to sign up for coverage, your insurance will kick in on March 1st, 2015.

Premiums in New Mexico are lower than they were last year

New Mexico has announced that premiums on the exchange will be lower than last year’s, which is great news for state residents shopping on the exchange.  According to the Albuquerque Journal, “premiums will drop on average by 7 percent at Molina Healthcare, 1.5 percent at New Mexico Health Connections and 1 percent at Blue Cross and Blue Shield of New Mexico.  Premiums will be unchanged at Presbyterian Health Plan.”  A new insurance company, Christus Health Plan, has entered the marketplace this year.

The penalty for lacking insurance is higher than it was last year

If you don’t obtain some form of health coverage, you may have to pay a shared responsibility fee.  The penalty was the greater of $95 per adult or 1% of income in 2014.  This year the penalty has increased to the greater of $325 per adult or 2% of income.  You can avoid the penalty by finding health coverage.

A hardship exemption exists for those who truly cannot afford insurance.  To see if you qualify for a hardship exemption, visit https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/.

89% of uninsured Americans don’t know about the upcoming open enrollment period… so spread the word!

It is crucial that the uninsured know about the limited window of opportunity to obtain health insurance through the exchange.  According to a survey conducted by the Kaiser Family Foundation, 89% of the uninsured population doesn’t know about the upcoming enrollment period.  Be sure to do your part by telling everyone you know and care about that coverage is available to them and that they may be eligible to receive discounted insurance premiums.  It is estimated that, so far, 28 million Americans gained health insurance as a result of the ACA.  Tens of millions stand to gain from the law this year as well.  We are approaching another historic moment in which Americans are finally able to obtain the security of meaningful, affordable, and non-discriminatory health insurance.  Let’s do all we can to make sure that moment is realized.

Health Action

By Barbara K. Webber / Executive Director, Health Action New Mexico
PUBLISHED in the Albuquerque Jourmal: Wednesday, June 4, 2014 at 12:05 am

For Levi Casas, sometimes just getting out of bed was exhausting.

Although he’s decades younger, there were some days when he felt like he was 80 years old. Born and raised in Las Cruces, Levi worked a steady job until he was diagnosed with pancreatic cancer.

After chemotherapy ravaged his system, Levi was no longer able to work. Without a job, he lost his health insurance. Soon he went from fighting cancer to fighting for access and affordable treatments that could save his life.

Fortunately, Levi was able to get the care he needed through new health care options. Today, with his cancer treatments covered by Medicaid, Levi’s tumor has shrunk considerably and he is nearing the end of his chemo sessions.

Health care reform has given thousands of New Mexicans a new chance at a healthier life like Levi’s. More than 422,000 previously-uninsured people in New Mexico have new options for accessing high quality, affordable health care – either through Medicaid or the New Mexico Health Insurance Exchange.

But the story doesn’t end there. Although the first round of open enrollment through NMHIX ended on March 31, thousands of New Mexicans are still eligible to sign up for low- or no-cost insurance options all year round.

If you are a family of four earning less than about $32,000, or an individual earning less than about $16,000, you could be eligible for no-cost insurance through our state’s expanded Medicaid program. You can enroll at any time and begin coverage immediately. In addition, Native Americans are also eligible to sign up for insurance at any point during the year, regardless of income.

Thanks to these new health care options, it is easier than ever to apply and enroll in Medicaid. Eligibility is now simply based on income.

This means that thousands more New Mexicans who previously did not qualify for Medicaid can get the care they need. This is also great news for those that were previously turned down when they applied – including childless adults who, for the first time in New Mexico, may qualify for Medicaid.

For many, financial assistance means that their health insurance costs are less per month than a cell phone bill. But the benefits – like doctors’ visits, prescription drugs, and screenings for diseases like cancer and diabetes – can be truly priceless.

Native Americans in New Mexico also stand to benefit from better access to health care plans – particularly important for our state, where they make up more than 10 percent of the population. Improving access and quality of care is something our tribal communities desperately need.

Native Americans in New Mexico experience large health disparities compared to the rest of the state and are more likely to be sicker and die younger. They also are face unique obstacles in access and affordability of care.

For those living on a reservation, health care facilities and services are limited and typically do not offer in-patient services, specialty or major emergency care. Those living off the reservation must find health care that meets regulations from Indian Health Services, whittling down their choices.

Now if you are Native American you can purchase private insurance through NMHIX at any time, and, if your household income is below $34,470 for an individual or $70,650 for a family of four, you won’t have to pay for out-of-pocket costs like deductibles, co-payments and co-insurance.

This makes providing care to one out of 10 New Mexicans even more affordable.

During open enrollment, more than 95,000 new people signed up for insurance through NMHIX or Medicaid. This is a great success, and it will continue to grow as more Native Americans and people eligible for Medicaid enroll in coverage.

That’s thousands more people like Levi that will have access to quality, affordable life-saving care.

New Mexicans who want to enroll can contact Medicaid at yes.state.nm.us, or by calling 855-637-6574. Native Americans who wish to enroll can contact the Native American Professional Parent Resources, at 855-241-8137.

Original Link: http://www.abqjournal.com/410356

Health Action

GUEST POST: Julie Bataille, Director, Office of Communications, Centers for Medicare and Medicaid Services

Today’s release of the final Enrollment Report for the first open enrollment period shows that over 8 million consumers enrolled in quality health coverage through the Health Insurance Marketplace.  These results clearly demonstrate that the affordable coverage offered through the Marketplace is what Americans need and want. 

These numbers were also achieved thanks, in part, to an unprecedented public outreach and education campaign to increase awareness among the uninsured about the new Marketplace, Medicaid, and the Children’s Health Insurance Program, in communities across the country.

Over the course of the initial open enrollment period, HHS officials, Federal agencies across the government, members of the Administration, and our partners outside of government, engaged in a combination of outreach strategies—including traditional media, social media, community-based outreach, and in-person assistance—to help uninsured Americans get the information they needed to find health coverage that meets their needs and budget.  The campaign also focused on those populations that would most benefit from access to affordable coverage, including ethnic and racial minorities.

Let me share some of our key efforts with you:

• Our efforts included over 7,700 outreach and enrollment activities across the country—including over 2,100 activities in Latino communities, and over 1,700 activities in African-American communities.
• Over the course of Open Enrollment, more than 28,000 in-person assisters were trained, and they reached more than 2.4 million consumers through events, outreach activities, and storefront locations.  Over 4.7 million consumers were helped by more than 14,000 assistors at Community Health Centers nationwide.
• Our Call Center supported more than 20.6 million calls from FFM states, including 1.2 million in Spanish, and more than 114,000 calls in other languages. Additionally, millions of people visited HealthCare.gov.
• We launched Marketplace Facebook pages and Twitter accounts in both English and Spanish, and netted over 327,000 Facebook Fans in English and an additional 55,000 Fans in Spanish.
• In our partnership work, more than 1,900 national, state, and local organizations in every state signed on to become “Champions for Coverage,” and worked to increase awareness and understanding of the Marketplace, as well as Medicaid and CHIP.  

Taken together, our outreach and education efforts during this first open enrollment period significantly raised awareness about the Marketplace and its benefits; ensured that consumers had the information and assistance they needed to apply for and enroll in quality coverage; and contributed to over 8 million enrollees. As we begin to work on year two, we plan to build on this success and the lessons learned over the past months to reach even more Americans who stand to benefit from the security of quality, affordable coverage.

Health Action