SHOW AUDIO: kpft_2015-02-11_2200, ACA-OBAMACARE SIGNUP, LAST CHANCE FOR 2015, GUEST MICHAEL COULTER

Link is usually posted within about 72 hours of show broadcast.

Welcome to Thinkwing Radio with Mike Honig (@ThinkwingRadio), a listener call-in show (every Wednesday night from 10-11PM CT) on KPFT-FM 90.1 (Houston). My engineer and discussion partner is Egberto Willies (@EgbertoWillies). Listen live on the radio or on the internet from anywhere in the world! When the show is live, we take calls at 713-526-5738. (Long distance charges may apply.)  For the purposes of this show, I operate on two mottoes:

• You’re entitled to your own opinion, but not your own facts;
• An educated electorate is a prerequisite for a democracy.

POSSIBLE TOPICS:

• Affordable Care Act and the Marketplace Health Insurance Options: Sign up before the final 2015 deadline on February 15th in order to get coverage beginning March 1st, 2015.

GUESTS: (More complete biographical info on my guests are below Source links.)

• Michael F. Coulter, LMSW-IPR, MACSS | Outreach Health Insurance Specialist, Medicare Advantage and Health Plans Branch | Division of Medicare Health Plan Operations | Dallas Regional Office, Centers for Medicare and Medicaid Services

NOTE: This post is subject to update before and after the show. ______________________________________________________________________
Some of the links used for this show are BELOW the break: SOURCES (Below the break) Not all topics discussed on tonight’s show:

• Find Local Enrollment assistance near anyplace you live (Courtesy of GET COVERED AMERICA)
• HEALTHCARE.GOV: Affordable Care Act and the Marketplace Health Insurance Options 1-800-318-2596 (Available 24/7)
  • “FROM COVERAGE TO CARE: A Roadmap to Better Care and a Healthier You” [PDF]
  • Get access to the Coverage to Care booklet.
• TEXAS MEDICAID: 877-541-7905
  
• HARRIS COUNTY HEALTH SYSTEM (Available to all eligible residents of Harris County, TX),
  • Patient Appointment Center: Harris Health System’s Patient Appointment Center helps you schedule, reschedule or cancel most appointments. Call 713-526-4243 to speak with one of our trained schedulers. The Patient Appointment Center is open Monday through Friday, 7 a.m. to 5 p.m. and Saturday, 7 a.m. to 3 p.m.

SOURCES WHICH MAY BE RELEVANT TO OTHER DISCUSSION:

• #ThinkwingRadio: NOV. 5, 2014, 10PM, @KPFT-FM 90.1 (Houston). GUESTS: CALLERS! YOU! TOPIC(s): The ACA/Obamacare sign-up period is coming Nov. 15
• ThinkwingRadio: March 12, 2014, 10-11PM, KPFT-FM 90.1 (Houston). TOPIC: ACA/Obamacare Last Chance Enrollment
• ThinkwingRadio: Feb. 19, 2014, 10-11PM, KPFT-FM 90.1 (Houston). TOPIC: How and why you should sign up for the ACA (‘Obamacare’)

TOPICS & QUESTIONS WE WILL TRY TO COVER:

• Local enrollment events
• Who qualifies for healthcare through the federal marketplaces?
• State-based marketplaces vs. Federal-based marketplaces
  • Income gap.
• Money freed up for other programs due to the advent of ACA.
• What is involved in applying?
  • What information will applicants need to have handy?
  • Does setting up an account in the system obligate you to apply?
  • Can you explore the options without giving the site any personal information?
  • What are the income constraints for application, if any?
    • Where are the approximate income ranges where you can get some subsidy assistance?
    • One would expect that you can make too much for subsidy assistance, but can you make too little?
    • For someone who makes too little to get a subsidy, what other options might they have to obtain some kind of health coverage?
      • (Automatic Medicaid application, when applicable)
  • Goes into effect with FIRST PREMIUM PAYMENT!
    • Changes can be made in selection anytime thru the end of the Open Enrollment period.
  • Subsidy Assistance: “Advance Premium Tax Credit” vs. “Premium Tax Credit”
  • IRS penalty recourse comes ONLY out of tax refunds or “Earned Income Tax Credit”. NO GARNISHMENT!
• Are there penalties for not having health insurance for 2015.
  • What are the penalties?
  • Are there exceptions that can enable people to avoid being penalized?
  • What are the options for someone who wants health insurance, makes too little to be subsidized or qualify for Texas Medicare, and can’t afford the premiums?
    • Will they be penalized?

     

  • How can penalties be waived?
  • Waiver application: Available in the application process
  • PENALTIES GO UP EACH YEAR, based on Bronze-level premium.
• Special enrollment periods: “Life-changing Events”
• Change or loss of jobs?
• Change of income? Up OR down!
• Marriage, divorce, childbirth, relocation, etc.
• Is there any overlap between the Healthcare Marketplace policy, VA care. Medicare and Medicaid?
• What are the differences between Bronze, Silver, Gold, and Platinum plans?
  • Is it true that a ‘better’ plan can sometimes cost less after calculating subsidies?
  • Insurance Terminology: (“The Coverage to Care Booklet”)
    • What is the difference between a co-pay and a deductible?
    • What is the difference between an HMO and a PPO?
  • How do prescription co-pays and deductibles usually work?
  • How important is it to choose your plan based not only on co-pays and deductibles, but also based on anticipated medical costs and needs?
• When evaluating a policy, what should you look at First? Second? Third?
• Should a person in the marketplace be re-selecting among the plans every year, or just ‘ride’ with that they have?
• Once you have a plan, who do you call for information about your coverage?
• Aside from Harris County Health System are there equivalents in the surrounding counties or cities?

MORE ABOUT MY GUEST:

Michael F. Coulter, LMSW-IPR, MACSS. Outreach Health Insurance Specialist, Division of Medicare Health Plans Operations, Customer Service Branch, CMS Dallas Regional Office

Michael Coulter is The Region VI Team Lead for the Marketplace Cities of Houston and Corpus Christi for 2014.  Michael is also the Region VI Lead for the 2014 Medicare Open Enrollment Period. He is a member of the Dallas Regional Office for the Centers for Medicare and Medicaid Services the Division of Plans Operations, the Customer Service Branch.

Michael  has been with the Department since 2009 and has served as an auditor for Part C&D Medicare Plans as well as PACE Plans in the Five State Region served by the Dallas Regional Office.  Michael joined the Outreach Team during the Pre-Existing Condition Insurance Plan Campaign in 2012. He has been instrumental in reaching some of our non-traditional partners in the new and emerging Health Insurance Marketplace because of the unique background he brings to CMS.  Michael has been the Regional Lead for the Medicare Open Enrollment Period for the past two years.

Michael is a Veteran of the United States Air Force. He served in Operation Desert Storm and is a trained and licensed Social Worker with Independent Practice Recognition.  Michael has extensive experience in Community Mental Health Service Delivery thru the Mental Health Mental Retardation System in North Texas. Michael has vast experience that he has brought from positions he has held with the State of Texas at the Veterans Land Board and the US Department of Veterans Affairs before joining the US Department of Health and Human Services in the Centers for Medicare and Medicaid – Dallas Regional Office.

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