For Hawaiians on Medicare, opening the mail is the first step in successfully navigating 2025 health-care coverage. It's open enrollment season, and many of those eligible delay responding because the necessary paperwork can feel daunting. But experts say successfully navigating the process can save people a lot of money.
Dr. Rhonda Randall, chief medical officer with UnitedHealthcare, employer and individual, recommends folks review of their current situation before making changes for next year.
"So, you want to consider, are your current benefit plans still meeting your health-care needs and your budget needs? Is your doctor still in the plan? Is the medication you take still covered by the plan?" she said.
Hawaii is often considered the most affordable state for health care, with only 3.6% percent of the total state being uninsured due to Medicare, employer mandates and state-sponsored insurance programs. At the same time, the state has a high cost of living, so new caps on the cost of prescription drugs and out-of-pocket expenses should help.
People can look online at Medicare.gov or call 1-800-Medicare.
The 2023 Lahaina fire on the island of Maui underscored the kind of events that can suddenly affect health care and budget needs. Nearly half of residents there reported a decline in health and said accessing medical care and medications became a challenge. That's why Randall says it's important to know a new plan's fixed costs.
"Pay attention to more than just that monthly premium - that's the amount that's coming out of your paycheck once a month if you're getting your coverage through an employer-sponsored plan, or coming out of Social Security," she addd. "You also want to look at deductibles; what is your out-of-pocket responsibility going to be?"
In 2023, about 21% of Hawaii's population was enrolled in Medicare. Randall also encouraged people to ask about mental-health benefits, as many plans now offer zero copays for telehealth visits with a counselor.
She recommended websites such as 'JustPlainClear.com' which can lay out the differences between Medicare and Medicare Advantage plans before the Dec. 7 open enrollment deadline.
People with employer-sponsored coverage typically select a plan during a two-to-three week period between September and December. And open enrollment for Affordable Care Act plans runs from November 1 to January 15 in most states. More information is available at www.UHCOpenEnrollment.com.
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Despite uncertainty about Medicaid funding in Congress, Tennessee is moving ahead to help improve people's health outcomes with a program for community health workers.
Tennessee's Medicaid program, TennCare, is partnering with the Tennessee Community Health Worker Association to offer an accreditation program to promote best practices for training and supporting the workforce.
Nikayla Boyd, executive director of the association, said community health workers link people to care and promote healthy habits. She noted the pilot accreditation program is underway, with a full launch expected by 2027.
"In addition to CHWs having individual certification, we are also accrediting the actual CHW program," Boyd explained. "Accrediting that program, that organization, that employer."
TennCare will fund grants for up to 14 organizations to complete the accreditation process. There are about 600 community health workers in the state, according to the U.S. Bureau of Labor Statistics, but Boyd argued more are needed.
Boyd pointed out they partner with the National Committee for Quality Assurance to design the accreditation programs. Some are centered on specific diseases, while others primarily address the social determinants of health.
"To date, we have six programs in Tennessee that have been accredited," Boyd outlined. "Two at Methodist Le Bonheur Community Outreach, two at Siloam Health, one at Regional One Health and then, another at the Mental Health Cooperative."
Boyd added an organization must meet seven standards in order to be accredited. For those working with community health workers, they include the full scope of training from recruitment to evaluations, support and supervision.
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Republican lawmakers are considering billions of dollars in cuts to Medicaid. But a new report finds those spending cuts might impact health-care coverage for thousands of Maryland military families.
The report by the Georgetown Center for Children and Families finds more than 850,000 people enrolled in Medicaid have military health insurance, known as TRICARE, as their primary coverage. One in 10 children of service members with TRICARE is also enrolled in Medicaid.
Joan Alker, executive director of the Georgetown University Center for Children and Families, said Medicaid is important for service members with children who require more intensive health care.
"The TRICARE benefit package just isn't enough, so Medicaid is making TRICARE work for those families by covering the high cost of services and some benefits that those children otherwise would not have access to," Alker explained.
Republicans in Congress are trying to reel in what they view as out-of-control spending by $2 trillion in the next budget. But cuts to Medicaid are not universally agreed upon among Republican lawmakers.
Medicaid also serves 40% of children in the U.S. with a benefit that allows them to receive preventive and ameliorative care. That benefit began after a military report in the 1960s found young men were not qualified for military service in Vietnam because of preventive medical issues during their childhoods.
Retired Army Brigadier General George Schwartz said Medicaid cuts could have a negative impact on recruiting numbers as well. If troops lack proper coverage for their families, he thinks they may seek other career paths that can provide that coverage.
"As those young people reach the age where they're eligible for military service, the military is competing with private industry and all sorts of organizations for these young people. From a mission readiness point, this is a matter of national security," Schwartz contended.
Maryland is home to more than 100,000 active-duty service members and more than 35,000 military-connected children in the state.
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With Mother's Day coming up, some Pennsylvania lawmakers are backing a set of bills that could help improve maternal health.
The Black Maternal Health Caucus introduced the updated "PA Momnibus 2.0" package in April, focused on tackling disparities in maternal health care by improving access to services.
Black women in the state are nearly twice as likely to die from childbirth complications. Rep. La'Tasha D. Mayes, D-Allegheny County, said 93% of maternal deaths are preventable.
"All the bills are for all moms, and because we know when we fix and address and take on maternal mortality and morbidity for Black moms, we solve it for every mom and birthing person in the Commonwealth," she explained.
The nine-bill package builds upon a 2024 "Momnibus" introduced by Mayes and Reps. Morgan Cephas and Gina Curry, both Republicans. Mayes said the caucus is working towards moving the bills toward votes, and then action in the Senate.
Two of the measures would expand access to blood pressure monitors and ensure they are covered through private insurance and Medicaid. Mayes added another measure would expand the reach of midwives, who provide care throughout pregnancy and childbirth, as well as postpartum.
"The Midwifery Practice Innovation bill that's going to help us advance midwifery as an occupation in this commonwealth, because it's very challenging to become a midwife, as well as be able to practice fully in a way that can serve moms," she continued.
The "Momnibus" also includes supports for nursing mothers, and invests in a Maternal and Newborn Supply Kit program, and maternal-health deserts. Mayes says more than 12% of women have no birthing facility within 30 minutes of their home, and Black women are three times more likely to die during or after birth compared with other women.
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