A Place to Start Regarding Insurance Information

Contributed by Chaunta Tsegaye, MSA, Insurance Specialist, AAoM

The landscape of healthcare has changed leaving families with more questions and concerns than ever before.  In past issues we have always tried to help inform families of changes in this landscape and how services are affected.  This issue will be no different, but because of the pandemic some service options have been extended and new options added.

Due to under and unemployment families not only face financial difficulties, but are also questioning, where can they go for insurance?  The easiest place to go is to the Healthcare Marketplace.  On this website you can create an account and search for affordable, yet thorough coverage. Things to remember when creating an account: 

  • Give accurate information regarding household income and zip code
  • Monthly premium is calculated based on service options
  • Premium credits are reflected in quote
  • Check with your providers and see if they accept the Marketplace plan
  • If you are eligible for other insurances; you will be prompted (i.e. Medicaid)
  • The service will not begin until you pay the premium payment
  • You can cancel at any time
  • You can not be dually enrolled in a Marketplace and Medicaid plan

Families can also apply to the Social Security Administration for Social Security Disability Insurance. If you are unsure of your eligibility you can go to the website or contact your local Social Security office. 

** All government funded programs have asset tests and income limits. **

Open Enrollment Dates:

Medicare open enrollment is not only for people 65 and up, but could also help with medical expenses for people who receive State Medicare.  Open enrollment for these changes begin  October 15, 2021 thru December 7, 2021 for services beginning January 1, 2022.

Marketplace “Child Only” open enrollment begins November 1, 2021 thru December 15, 2021; coverage begins January 1, 2022.  

Medicaid does not have an enrollment period.  To set up an account and apply for benefits go to MiBridges and fill out the appropriate information. Be sure to check only the boxes for the household member that you are requesting benefits for.  If you are enrolled in a HMO (i.e. Molina) be sure to recertify during recertification period.

Employer Sponsored Plan Open enrollment varies based on your employer.  Most plans have a January start date.  If you are unsure of when your company has open enrollment, contact your HR department.

No matter which plan you choose or which options are available you should always do the following before making a final decision:

  • Make sure your providers are in-network
  • Understand your deductible, co-insurance, co-pays, and out of pocket (oop) max 
  • Verify coverage for mental and behavioral health services

With so many options families may feel overwhelmed.  If you have questions, please do not hesitate to contact the Autism Alliance of Michigan 877-463-2266 or navigator@aaomi.org