Veterans’ agents like our guest speaker, Leo Parent, help their clients navigate systems the same way outreach and enrollment workers do – so Leo encouraged us to get to know our local veterans’ agents. The national Department of Veterans’ Services (VA) system has its own twists and turns, and having a veterans’ agents help could make a real difference for any client who’s been in one of the seven uniformed services. Veterans' agents can help clients show they meet minimum requirements for free health care through the VA health system.
VA health care is different from other subsidized coverage in Massachusetts – though it does meet the individual mandate. If admitted to a local emergency room, for example, a patient must be transferred to one of five VA Medical Centers in Massachusetts as soon as possible to avoid paying for their inpatient care out of pocket. Outreach & enrollment workers at hospitals may be in the position of calling the VA on behalf of veteran patients, or encouraging them to apply for the Health Safety Net in addition to VA care. We’ll follow up with more detailed Questions and Answers about Veterans’ Health Care on this blog soon.
A coverage gap came up regarding a Medicare Advantage dental benefit that is offered through Fallon Senior. In some regions, it can be very difficult to find a dental provider who takes Fallon Senior. These patients are unable to use their Fallon dental benefit -- but because Fallon is supposed to be billed first, they can’t use the Health Safety Net, either.
While the one-day Permission to Share Information (PSI) process for My Account Page (MAP) is working very well, HAN members report problems with longer-term PSI's. Many outreach workers reported trying to follow up on a client’s case and finding that their PSI was not on file.
HAN members also discussed an issue involving clients who do not speak fluent English and use MassHealth's interpreter services over the phone. If the client does not understand the content of the conversation, even when it is interpreted, outreach workers can't take the phone to help with clarification. One person at the HAN meeting discussed a workaround she uses: She asks her client if it’s okay to listen in on the line during their conversation with the interpreter (she gives the client the handset while using the headset). That way, she is able to explain the process to her client during the phone call.
HAN members also discussed difficulty getting MassHealth or Commonwealth Care coverage for emergency ambulance transportation. There appears to be some miscommunication between the local ambulance service and the Medicaid Managed Care Organization (MMCO - meaning, one of the four nonprofit health plans that offer CommCare and MassHealth coverage). It’s a little unclear whether this is a broad problem or an isolated mistake – is this something anyone else reading this blog has seen?
We heard some good news from Health Care For All: the Children's Mental Health bill ("Yolanda's Law") was signed, and a report of Health Care Reform's key indicators from the Division of Health Care Finance and Policy shows health insurance access is improving. Since June 30, 2006, 439,000 Massachusetts residents have gained health insurance, and we have the lowest percentage of uninsured in the nation. Many thanks are owed to outreach and enrollment workers, who continue to help Massachusetts residents navigate new and complex systems to get - and keep - their health care.
Free health clinic in North Amherst - The Amherst Survival Center has opened a free health clinic with two volunteer physicians; more information about the hours and location is on their website (current clinic hours at the Center are: Monday 11:30-1:30 with Dr. Lowery, and Thursday 5-6 with Dr. Clapp). They are still in need of volunteers who can help with transportation, interpretation, and serving as a patient liaison to other medical services.
Health Safety Net pharmacy in Holyoke - Patients who are eligible for the Health Safety Net (HSN) can get prescriptions filled at the Holyoke Health Center pharmacy, even if they aren't currently patients at the health center. They will be put on a waiting list to see a provider at the health center; if they become health center patients, they will be able to continue filling their prescriptions at the health center. To help expedite the process, patients should bring their old prescription bottles with them.
Whether or not you were at this meeting, please add your comments to what we discussed on this blog!
veterans
tee hee i love learning about this stuff according to my mind.......we know what a veteran and how they set off in many directions but what we dont know is that they use their intelligence to determine weather we have freedom or not and we dont worship them enough in order for them to think they are doing something great. So the path we take is a 20%, the road the veterans take is like an amount we cant be told to....cherish the loved one in your family that sets your mind on how you get dresed that one morning or who you decide to marry, or even how you worship god... thank that person who decides for you.
sincerely , laykin pass
only 12 yrs of age knows more than a 40 yr old man
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