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About Spilyay tymoo. (Warm Springs, Or.) 1976-current | View Entire Issue (Feb. 5, 2014)
Spilyay Tym oo, W arm Springs, Oregon February 5, 2014 Medical insurance coverage available to everyone through Affordable Care Act Elina Langnese Supervisor, W'.S. Managed Care Program W ith the new Medicaid Expansion program increas ing medical coverage, almost everyone in Warm Springs would m ost likely be consid ered eligible for Medicaid. Managed Care is requir ing everyone apply for Med icaid at this time. M anaged Care can re quire our patients to apply, as the Medicaid Plans are a free service with no charge to the patient. The only people not af fected by this requirem ent would be patients with pri vate insurance, other than Shasta, and those patients eligible for Medicare at age 65, a n d /o r patients receiv ing disability through Social Security. I f you apply and you an d /o r any family member are denied, the denial must be brought to Managed Care for processing. temative resource if there is reason to believe th at you may be eligible for alternative resources. In many cases the alternate resource is Medic aid, often known as the O r egon Health Plan. Once on Medicaid, you are required to renew your application at in tervals determined by Med icaid. This will be positive be cause: •Patients can seek outside health care if you have (open card) coverage through D - Map •Patients can seek outside healthcare if they have Pa cific Source Managed Care Plans, where they would need to see a provider in the-Pa cific Source N etw ork (a list would be provided to the pa tient by Pacific Source). • This will extend M an aged Care dollars to m ore patients over a longer period o f time. If people don’t apply, the downside is: for the visit. •If patients are seen in the emergency room and have not signed up for Medicaid, where they would have been eligible, M anaged Care can deny their visits and the pa tients would be responsible for all costs related to that visit. • When, referrals from an IHS provider come through M anaged Care, w e-let the vendor know the insurance status o f our patients. But patients are still required to bring their insurance ID to the vendor for their visit. • I f there is no insurance identified and the patient does not show an insurance card, vendors are beginning to re quire fees prior to seeing bur Warm Springs patients. • It is best to take a copy o f your referral to your ap pointm ent and present it to the vendor. • I f you have n ot followed up to apply fo r M edicaid, even if your IH S provider referred you out, M anaged Care will not cover the cost Who can help you? M anaged Care, the IHS B u sin ess O ffice, an d th e Warm Springs Library have “assisters” who will walk you through the Medicaid appli cation and then they will mail it off. Time frame: T h ere has b een such a large volume o f applications going through that it is taking a very long time to obtain a response from. Medicaid. What will happen if you are receiving medical care beginning in January, 2014 prior to knowing your Med icaid status? We require documentation th a t you have applied for O H P and your application has been sent in, as the ef fective date will retro back to January 1, 2014. You m ay receive State m ents from Vendors, as we will hold claims, just bring the statements in for processing and we will notify the vendors o f their status: Page 5. Health equity meeting Thursday T h e C en tral O regon Health Equity Task Force will host an information- gathering event this Thurs day, Feb. 6, at the Living H ope Church in Madras; The meeting will begin at 5 p.m. . T h e p u rp o s e o f the meeting is to gain informa tion on potential health care inequities in the re gion. Health care workers can then focus on correct- ing any potential inequities. The Let’s Talk Diversity " Coalition encourages tribal - m em bers to attend, said I E m m a Sm ith, C oalition member. “We would like people to share stories o f how medical services could be handled m ore ap p ro p ri ately for patients, and any problem s they may have had at any medical center,” Smith said. Let’s Talk Diversity meting T he L et’s Talk Diversity Coalition is represented by 24 local and regional organiza tions in Jefferson County. Its focus 'is on the aware ness and understanding o f different cultures. By doing so, the C oalition m em bers strive to effectively commu nicate and interact w ith all members o f our community. The Coalition works to en courage racial, cultural and ethnic diversity that values family lifestyles. This includes supporting cultural resources and promoting health and eco nomic equity for everyone. 1 The Coalition mission is to ' develop a sustainable process o f C ultural co m p eten cy th ro u g h inclusive engage ment by creating accountabil ity for. equitable outcomes. . The Let’s Talk Diversity 1 Coalition will hold its regu lar meeting this afternoon, * Wednesday, Feb. 5, front * 12:30 to 3 p.m. at the Health Department in Madras. Federal rule: You .are required by federal regula tions (CFR 42; Ch. 1; Subpt. 36.23,F) to apply for an al- Questions and concerns? If you have a question or a con cern about the new health insurance law, please contact Managed Care di rectly and they will discuss everything with you. You can reach Managed Care by calling 541- 553-4948, or call the clinic at 541- 553-1196. Culture & Heritage offers youth education programs Does, your child need help with math? Math is made fun and easy at the E ducation building. Ittitam asha (counting) is from 4-5 on M onday and Tuesdays, and Thursdays and F ridays. T h e p ro g ra m is brought .to you by the Warm Springs Culture and Heritage D epartm ent. T h e re w ill be N ativ e American games and projects, and tutoring lead by certified teacher E sther Kalama, as s is te d by Jam es Sam. Ittitamasha features beading, weaving, artistry, and assis tance with school work. For in fo rm a tio n call 541-553- 3290. Cover Oregon is a marketplace for Tribal communities to find health insurance and financial help to pay for it. Kiksht There are Kiksht language classes at the Education build ing Tuesday evenings from 5- 6:30, lead by Pam Cardenas, assisted by Valerie Switzler. Ask for free assistance o W arm Springs Vocational Rehabili tation has orientations every M onday at 3 p.m. at their office in th e in d u s tria l park. O rientations are also held on Tuesdays at 3 p.m. at the Community Counseling Center. 541 553 1196 I CERTIFIED COMMUNITY I PARTNER
