How can you pay for your health care? We have options.

Nov 22, 2022

By Stacie Bridge, Chief Operating Officer, Oak Orchard Health  

There are many ways to pay for healthcare and we are here to help. Oak Orchard Health strives to make it simple for you.

Here are our accepted forms of payment:

  • Most private health insurance and managed care plans
  • Public health insurance (Medicare, Medicaid, Child Health Plus)
  • Cash, check, credit/debit card
  • Sliding fee scale, based on family size and income

Sliding Fee Scale Program

If you don’t have insurance, we offer a sliding fee scale program that makes sure you can still get the health care you need regardless of income or insurance status. This program offers patients discounts on services based on family size and annual income. Patients approved for the Sliding Fee Program must also pay their co-pay at the time of the visit. If you qualify for this program, chances are we can enroll you in a health insurance program.

Do I qualify for health insurance?

Many people qualify for health insurance but don’t know the guidelines. You may be surprised to know that a family of four, earning $52,000 per year or less qualifies for free health insurance (Medicaid) through the New York State of Health. There is no monthly payment. Another example is if you are a family of three and earn about $43,000 or less, you would also qualify for Medicaid.

If you earn more than the income limits for Medicaid, then you may qualify for the Essential Plan or the cost share reduction plan. With the Essential Plan, there may be co-pays depending on income levels. The bottom line is that there are many options, so talk to an Insurance Enroller at Oak Orchard Health to find out what is right for you and your family.

What do I need for my insurance application?

Your application will require your contact information, Social Security number, and basic household size which is based on your tax status. So, if you are married, put two but if you claim dependents on your income tax then you need to add them. NYS will verify what is in your application including your income.

Child Health Plus

Child Health Plus is for kids under 19 years of age. There are no out-of-pocket costs, no co-pays, or deductibles through this program. Like Medicaid, qualifying for it is based on income.

New York State has been automatically recertifying Medicaid

Yes, during COVID, NYS has been automatically recertifying everyone so that you did not have to file a new application. We will find out on or about November 15th how NYS will manage this moving forward.

 College Students and Graduates

If you are in college or graduated, how can you get health insurance? The first question is whether you are a dependent on your parent’s insurance. If you are not a dependent, then the insurance application is filed with the student’s income which is typically low. Look to the New State of Health website to apply or an insurance enroller at Oak Orchard to help.

 Key Enrollment Dates

The 15th of the month is especially important. If you are eligible for a qualified health plan like the Essential Plan or Child Health Plus, you must file before the 15th if you want insurance to start the first of the following month. If you want insurance to start on January 1, your application needs to be filed before December 15th. The earlier the better.

For Medicaid, they typically backdate to the first of the month that you applied.  For example, if you applied on November 15th, your Medicaid insurance will start on November 1. If you choose a managed care plan (like the Essential Plan), then it would start on December 1st.

We hope this has helped but if you have questions, we can help you enroll in health insurance coverage. Insurance Enrollers are here and trained to educate and provide enrollment assistance to everyone applying for coverage through the New York State of Health.

Just call (585) 637-3905 to make an appointment.

 

 

 

This article gives you a peek at diabetes and nutrition. There is so much more to know so if you have questions, talk with your primary care physician or contact me, Chrissy Krueger, at ckrueger@oochc.org

 

 

 

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