Mid Illinois, Springfield / Decatur

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Navigating the Health Care Maze

 Health Alliance July 08, 2014
By Lorelei Lawson

Signing up for Medicare can be daunting for many older adults. With the advent of the Affordable Care Act, also known as “Obamacare,” the requirements and options for those not quite ready for Medicare have expanded to help everyone get the health insurance they need.

New phases of the Affordable Care Act keep coming, along with new confusion for those trying to give their families the peace of mind that health insurance brings. Where do they turn for help navigating their health care options?

One company in Central Illinois is going above and beyond to provide the information and assistance people need. Health Alliance brings community liaisons to the people who need them most when enrolling in a mandated health care plan, choosing a private health care plan, or finding a Medicare plan.

Two of these community liaisons, Jamie Meagher of the Champaign Health Alliance office, and Teri Johnson of the Springfield Health Alliance team, are taking their message to the community, both social service agencies and individuals.

“We are here to educate the community and health organizations,” Teri said. “We want to make sure they’re aware of the type of coverage that is out there. We are a resource. They can rely on us.”

Both women, along with the other Health Alliance community liaisons, bring a vast and varied background in health care and coverage.

“When I came to Health Alliance, what I found really neat was that all of the community liaisons come from different backgrounds,” Teri said. “All that knowledge was combined.”

Jamie is a graduate of the University of Illinois with a degree in Community Health, Health Education with a focus in rehabilitation. She worked for several years in the youth and adolescent mental health field and gained a lot of experience in the Medicaid area.

Teri began her career in a family insurance agency, working mainly with people 60 and older. She then worked in Medicare appeals and also spent time in patient billing at Memorial Hospital in Springfield. She also worked for the Area Agency on Aging for Lincolnland as a benefits specialist/SHIP counselor to support those on Medicare.

New Choices, New Challenges
The Affordable Care Act brought many changes to the way people obtain health insurance, and the changes continue. Through these changes, Health Alliance has been able to reach out to more and more people in different situations to help them with their health insurance needs.

Health Alliance Connect is a Medicaid managed-care option, and Health Alliance Connect also helps those who qualify for both Medicare and Medicaid (called Dual Eligible) in 15 counties in Central Illinois. These plans offer individuals so much more than health coverage; they provide the assurance that the health care providers they visit are among the most trusted.

“The Health Alliance name stands out,” Jamie said. “People know they can trust us. They can stop in our office and talk to someone in member services, and they can call and talk to a real person on the phone.”

Managed-care plans are similar to an HMO, or Health Maintenance Organization, Jamie explained. Those covered under a managed-care plan have a list of in-network providers they can visit for all their health care needs. Health Alliance Connect goes far beyond listings of eligible physicians or hospitals. Health Alliance is committed to ensuring that each member gets the right care, from the right doctor, at the right time.

Spreading the Word
Keeping up with all the changes in health care and coverage is no easy task, but the community liaisons at Health Alliance are out in the communities they serve, spreading the word and making sure all kinds of people are fully informed and aware of the choices available to them.

“We can give agencies presentations on the ABCs of Medicare,” Jamie said. “We also do presentations on managed care, such as the Medicare-Medicaid Alignment Initiative, which is our current focus.”

Teri also works with a wide range of people to get the word out about their health care options and needs. She gives presentations at senior centers, health care facilities and more.

“Sometimes the Meals on Wheels driver is the only contact a person might have with other people during the week,” Teri said. “We go to retirement communities. We talk to people working for home health care agencies. We talk to health organizations. We bring it all together. We educate people right at these sites so they know what is out there for them. We want to make sure everyone is aware of how our programs suit their clients’ needs.”

Seniors are not the only population served by the community liaisons. They attend many community-based meetings where social service providers meet, as well as other gatherings those needing assistance might attend.

“I have worked with several housing authorities throughout the communities we serve,” Jamie said. “At times, I have gone in to their monthly meetings to do educational presentations for their residents.”

The community liaison’s day is not all presentations and educational talks. They find time to have fun with the people they serve, such as lending a hand at Red Hat Bingo day.

“We participate in a lot of Bingo events because it is a great way to be involved in the community.  This allows the community liaisons the ability to talk to members and prospective members in a more informal environment,” Jamie added.  “We will participate in parties by providing a dessert and providing an extra set of hands for whatever else a local agency might need.”

Quality Customer Service
The next change coming because of the Affordable Care Act is the new Medicaid Family Health Plan, which will allow more people to benefit from health care coverage and other assistance. While Health Alliance is growing, all members, whether new or long-time, can expect the same outstanding customer service the company is known for. Their excellent sales team and top-notch customer service team are at the ready to help individuals and families manage all their health care needs and get their questions answered.

The Health Alliance website, www.healthalliance.org, has a wealth of information for members, as well as those looking at health care coverage. The site is easy to navigate and very informative for companies seeking a group health plan, those looking to purchase individual health insurance and those looking to enroll in Health Alliance Connect.

To reach Health Alliance toll-free, call 1-888-382-9771 or TTY 1-800-526-0844 (711).
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 Health Alliance| July 08, 2014
Categories:  Feature

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