FAQs: ACA, UMHS & You

Updated November 2015

Questions & Answers about the Affordable Care Act

 

On this page, we will post answers to questions about options for health care coverage available under the Affordable Care Act (sometimes called Obamacare), and the Healthy Michigan Act for Medicaid expansion -- and the other ways the U-M Health System is adapting to this new era in health care and assisting patients and community members in doing so.

Q: Which private insurance and Medicaid expansion plans does UMHS accept for care this year?

A: A list of the individual Marketplace private plans that we accept in 2016 is here. Keep in mind that even if we are not participating in a particular plan, our advanced care may still be available under other plans if they give authorization.

A list of st of small business plans we accept in 2016 is included here.

A list of the Healthy Michigan (expanded Medicaid) plans we accept is on this page. (General information about what these plans will cover is available from this state web page.)

Q: What ACA plans will you accept in 2016?

A: Here's a full list.

Q: Can I get enrollment help from anyone at U-M? 

A: Yes, we have a number of staff who have received training to become Certified Application Counselors. Contact them to discuss your needs, and arrange an in-person appointment. Call 877-326-9155 between 8 a.m. and 8 p.m. Monday through Friday, or email PFC-Counselors@med.umich.edu.

We also have trained staff available by appointment through our Regional Alliance for Healthy Schools. Call 734-998-5795 between 8 a.m. and 4 p.m. Monday-Friday, or email UMHS-RAHS@umich.edu.

Our Student-Run Free Clinic also offers appointments on Saturdays in Pinckney, Michigan to help uninsured people explore their options and enroll, with the help of medical students trained as Certified Application Counselors. Find out more here. 

Q: Do I have to be a U-M patient to get help from these counselors?

A: No - we are here to serve the community!

Q: Is it too late to enroll?

A: Enrollment in Healthy Michigan (expanded Medicaid) happens year-round.

For private plans, "Open Enrollment" began November 1, 2015 and continues through January 31, 2016. But someone who has a qualifying life event any time can enroll in a Marketplace plan.

Q: I run a community organization. Can your counselors come to our location to help our clients?

A: Yes! Please use this form to make a request from the Washtenaw Health Initiative.  Or email ACAquestions@umich.edu.

Q: What else is the U-M Health System doing to adapt to the new era of health care, keep costs down and improve quality?

A: A lot. Please see this article for a summary.

Q: Does UMHS offer charity care to people who don't have insurance, or help for people whose ACA plans make them responsible for a percentage of costs?

A: We do offer M-Support (charity care or financial assistance) for certain patients. The requirements are listed here. We encourage you to connect with our counselors (contact info above) as soon as possible to discuss you options.

M-Support will still be available for those who "fall through the cracks" of the Affordable Care Act's coverage options. Applying for Medicaid or a Marketplace plan is a pre-requisite for those seeking new or continued charity or M-Support coverage for UMHS care. If you meet any of the exemptions to the health care law (which are listed at https://www.healthcare.gov/exemptions/) or do not qualify for a plan under the Affordable Care Act, you will be considered for ongoing M-Support coverage.  You will be required to  apply for one of the new plans and show documented proof of denial.

Q: I am a veteran and I have VA care. What should I do?

A: See this page on the VA website. 

Q: Will UMHS be able to handle all the new patients that might come to you as a result of the new coverage?

A: We are building our capacity to serve all patients. We especially look forward to providing advanced care to those who need it, on the advice of their own primary care provider. We believe in the right care, at the right time, and the right place.

Q: If I am a U-M employee or graduate student, do I need to shop on the Marketplace for insurance?

A: If you have U-M benefits, probably not - all U-M plans meet federal requirements and part of the cost is paid by U-M. However, if you are not eligible for U-M benefits, if you are on a U-M COBRA plan, or if you work part time and need to cover other adults, you may wish to explore your options. Please contact one of our counselors (information above).

Q: My relative/friend does not speak English well. Can you help them?

A: Yes - we have medical interpreters for many languages available to assist with any conversations between our counselors and community members. You can also share with them these flyers in Spanish, French, Arabic, Japanese, Koren, Russian and Chinese.  You can also call our Interpreter Services office at 734-936-7021.

Q: I've seen materials from UMHS that use the term "Obamacare" - isn't that a term used by critics of the Affordable Care Act?

A: Yes - but it's also used by its supporters, the mainstream news media, and Obama administration. It's a common term that isn't an "official" name but still has more widespread recognition than "ACA" or "Affordable Care Act". We're using the term because it's widely used and understood, not because we're taking a stand for or against the ACA or its programs. Learn more about all the things our health system is doing under the ACA and other federal health reform provisions in this article

Q: I bought insurance on the individual market before the Affordable Care Act plans took effect. Can I keep my plan?

A: Michigan's insurance commissioner allowed insurance companies to extend existing plans, though companies can decide not to continue offering these plans. However, you should also check the individual Marketplace, because the plans available there may be less costly or cover more than your current plan. Be sure to look at all out-of-pocket and premium costs, and any subsidies or credits you  might qualify for, when comparing.  

Got more questions? Here are two sites that have lots of answers:

 

Q&A from the non-profit, non-partisan Kaiser Family Foundation

 

Q&A from the official U.S. source: www.healthcare.gov