Health Insurance Counseling
Need Health Insurance? Apply for Private Health Insurance or Medicare Coverage.
RCH offers FREE counseling services to complete applications for private health insurance coverage and assistance in navigating the complex coverages provided by Medicare. Plans are available for everyone and cover essential health benefits, pre-existing conditions and include preventative care. Visit with RCH’s Certified Application Counselor:
Cricket Schmidt
cricket.schmidt@rch.health
(785) 688-4443
Available by appointment.
Medicare Part D Coverage
- Open Enrollment October 15 through December 7
Medicare is a federal health insurance program for patients age 65 and older, or younger patients with disabilities or patients with permanent kidney failure. Different parts of Medicare help cover specific services. Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Part B covers certain doctors’ services, outpatient care, medical supplies, and preventive services. And Part D encompasses prescription drug coverage. Visiting with RCH’s Insurance Counselor can help you verify if your drug plan and/or Medicare Advantage plan is the most cost effective for the next year.
Private Health Insurance
- Open Enrollment November 1 through January 15
Step 1: Complete Application
RCH’s Certified Application Counselor offers full-service assistance to complete your application. Application results are immediate and no one will be denied coverage based on pre-existing conditions. Your income will determine if you qualify for premium tax credits and savings on out-of-pocket costs. With these budgetary items known, you can now pick your plan.
Step 2: Pick a Plan
You have the freedom to select the coverage you want based on your needs. Some plans offer low monthly payments and have higher deductibles/co-pays while others offer lower deductibles/co-pays with higher monthly premiums. The choice is yours.
Step 3: Coverage Begins
Coverage can begin as early as 15 days depending on date of enrollment. Those enrolled by the 15th of the previous month receive coverage sooner than those who enroll after the 15th of the month.
Example:
A 28-year-old female, non smoker with an annual income of $22,000 selects a plan with $3,500 out of pocket maximum and $1,500 deductible. If she does not qualify for subsidies, her plan would cost $472.86 per month. However, in this case, her income may potentially qualify her for subsidies dropping her monthly payment to just $54.68.*
*A variety of factors contribute to final premium costs.
When to apply:
Open Enrollment is typically held in the fall for coverage beginning on January 1 of the following year. Visit healthcare.gov for this year’s open enrollment dates. Special Enrollment outside of the designated open enrollment period requires a life-changing event to qualify. Examples of life change events include, but are not limited to:
- Marriage / divorce
- Becoming pregnant / having a baby / gaining or losing a dependant
- Moving out of state
- Change in disability status
- Change in employment / income
- Change in health coverage through employment or other programs
Open enrollment for 2023 coverage is November 1, 2022 to January 15, 2023. Special enrollment outside of these dates is available if you’ve had a life-changing event that qualifies as listed above.
What is needed to apply:
- Home and/or mailing addresses for everyone applying for coverage
- Social Security Numbers
- Employer and income information for every member of your household (for example, from pay stubs or W-2 forms; no financial information is required for Medicare coverage)
- Other forms as necessary based on legal residence, income and employer based programs
Visit with RCH’s Certified Application Counselor for a complete list or go online to healthcare.gov.
Get the most from your insurance:
Did you know your insurance may cover preventative screenings entirely?
By law, a number of preventative screenings are available at no cost to you, if you meet the criteria for the specific screening. You can find a list of the screenings online at healthcare.gov. You’ll want to visit with your primary care physician to decide the appropriate screenings for you.
Did you know your insurance may cover your wellness exam and immunizations?
Each year, you and each member of your family on your insurance plan are entitled to an annual wellness exam by your primary physician. This may include free immunizations if needed. These services are provided to you with no out of pocket expense by law through your insurance. Visit with your primary care provider for details.
Did you know your insurance may cover your mammogram?
Rooks County Health Center offers mammograms on-site 8 a.m. to 4:30 p.m. Monday through Friday. The second Tuesday of every month from 5 p.m. to 9 p.m., RCH hosts “Smash-n-Dash”, an after-hours mammogram screening for those whose schedule does not permit them to take time during the day.
The screening takes 20 minutes. Visit with your primary care provider to see if you need a mammogram screening. You can also call RCH’s billing department to pre-qualify your screening to ensure it is 100% covered by your insurance.
I don’t have health insurance, how can I get a mammogram?
You may qualify for assistance through an early detection works program available through the Rooks County Health Department. It is provided through grant funding from Susan G. Komen. They can assist you in securing low-cost mammograms if you qualify. They also offer cervical screening. Should cancer be detected, the grant will help provide funding for additional care. Also, help is available for expedited Medicaid enrollment.
Did you know your insurance may cover screenings for osteoporosis?
Rooks County Health Center offers painless, 10-minute screenings for osteoporosis 8 a.m. to 4:30 p.m. Monday through Friday. Visit with your primary care provider to determine if you need a screening. You can also call RCH’s billing department to pre-qualify your screening to ensure it is 100% covered by your insurance.
Did you know your insurance may cover screenings for lung cancer?
Rooks County Health Center offers painless, 15-minute screenings for lung cancer 8 a.m. to 4:30 p.m. Monday through Friday. In order for the screening to be of no cost to you, you must meet the criteria of being age 55 to 77, show no current signs of illness or disease, smoked at least one pack per day for 30+ years and are currently smoking or have quit smoking within the past 15 years. If you do not meet the criteria, the screening is still available with or without insurance. Visit with your primary care provider to order the screening. You can also call RCH’s billing department to pre-qualify your screening to ensure it is 100% covered by your insurance.
Did you know your insurance may cover counseling for breastfeeding?
All insurance plans, mandated by the Affordable Care Act, are required to offer new mothers lactation counseling services. Visit with RCH’s certified Lactation Counselor today to schedule counseling sessions before and after delivery with no out-of-pocket expense.
Do you know why some insurance programs are classified as Bronze, Silver, Gold and Platinum?
All insurance plans must cover at a minimum 10 essential health benefits. The labeling of the plans does not reflect the quality of the plan so much so as it serves as an indicator of the out of pocket expenses involved with securing a plan.
For example, Bronze plans are named so because they typically offer lower monthly premiums but higher deductibles and co-pays. Conversely, Platinum plans are typically identified as having higher monthly premiums, but lower out of pocket expenses.
Rooks County Health Center offers free insurance counseling and can guide you through the enrollment process to find the health insurance plan that will work for you. RCH’s Certified Application Counselor is available by appointment.
Did you get a new job but the health benefits don’t start right away?
You can purchase short-term, backup insurance for up to 90 days until your new employer paid health insurance is activated. Rooks County Health Center offers free insurance counseling and can guide you through the enrollment process to find the health insurance plan that will work for you. RCH’s Certified Application Counselor is available by appointment.
If you have to change jobs, you can find new insurance that will work for you?
Change in employment benefits is considered a life event and enables you to enroll in a new health insurance plan. You have 60 days from the last day employment to enroll. Rooks County Health Center offers free insurance counseling and can guide you through the enrollment process to find the health insurance plan that will work for you. RCH’s Certified Application Counselor is available by appointment.
Did you know if you lost your insurance coverage due to a divorce or a death in the family, you qualify for special enrollment?
Losing health coverage due to a divorce or a death in the family is considered a qualifying life event and permits you to enroll in health insurance through the marketplace. Rooks County Health Center offers free insurance counseling and can guide you through the enrollment process to find the health insurance plan that will work for you. RCH’s Certified Application Counselor is available by appointment.
When can I enroll in health insurance?
You can enroll in health insurance annually from November 1 to January 15. You can also enroll if you have a qualifying life event that permits you to enroll in health insurance through the marketplace. For a list of qualifying life events visit healthcare.gov. Rooks County Health Center offers free insurance counseling and can guide you through the enrollment process to find.
