Covering Wisconsin in the News
THU AM News: GOP bill would require insurers to cover certain clinical trial costs; Open enrollment period begins
— Sen. Andre Jacque is seeking cosponsors for a bill that would require health insurers to cover certain costs related to participating in a clinical trial.
In a memo sent to other lawmakers, the De Pere Republican says the legislation aims to ensure clinical trial participants don’t face “unnecessary denial and interruption of coverage and delays in life-saving care” due to their insurer not covering related costs.
He notes these patients may need to see out-of-network specialists during clinical trials, and denial of coverage can lead to them missing out on participating and receiving potentially lifesaving treatment.
“The Clinical Trial Coverage Act would address this problem by requiring insurers to cover out-of-network routine care costs for clinical trial participants if no in-network provider is available, ensuring families have at least some peace of mind at a time of great stress and access to clinical trials without paying significant out-of-pocket costs for physician services,” Jacque wrote in the memo.
Federal law currently requires private insurers to cover “routine services” for these trials from in-network providers, the memo shows. But some patients’ networks may not include the correct providers, leaving them to pay the full price for clinical trial-related services.
Gov. Evers, Insurance Commissioner Houdek Encourage Wisconsinites to Sign Up for Healthcare Coverage During Open Enrollment
MADISON — Gov. Tony Evers, together with Office of the Commissioner of Insurance (OCI) Commissioner Nathan Houdek, today urged Wisconsin residents to sign up for high-quality, affordable healthcare coverage during the 11th annual ‘Open Enrollment’ period.
On Wed., Nov. 1, 2023, open enrollment will begin and continue through Jan. 15, 2024. During this limited time, Wisconsinites are eligible to enroll in one of the health plans available on the individual health insurance marketplace. Those who already have insurance through the marketplace can also renew, update, or upgrade their health plans during this period.
“Healthcare shouldn’t just be for the healthy and wealthy, and that’s why expanding access to healthcare has been a top priority of my administration since Day One,” said Gov. Evers. “I encourage folks to explore all the available plans and take advantage of the Open Enrollment period so we can continue building a healthier, stronger state together.”
Wisconsinites encouraged to sign up for healthcare coverage during open enrollment
Gov. Tony Evers, together with Office of the Commissioner of Insurance (OCI) Commissioner Nathan D. Houdek, on Oct. 31 urged Wisconsin residents to sign up for high-quality, affordable healthcare coverage during the 11th annual open enrollment period.
On Wednesday, Nov. 1, open enrollment will begin and continue through Jan. 15, 2024. During this limited time, Wisconsinites are eligible to enroll in one of the health plans available on the individual health insurance marketplace. Those who already have insurance through the marketplace can also renew, update, or upgrade their health plans during this period.
“Healthcare shouldn’t just be for the healthy and wealthy, and that’s why expanding access to healthcare has been a top priority of my administration since Day One,” Evers said. “I encourage folks to explore all the available plans and take advantage of the open enrollment period so we can continue building a healthier, stronger state together.”
Pandemic brings telehealth boom to rural Wisconsin, but barriers linger
Marshfield Medical Center family nurse practitioner Brianna Czaikowski says telehealth appointments are a game-changer for some patients. But in serving a mostly rural community, Czaikowski often fights spotty connections and miscommunication when providing virtual care.
"They feel a lot that I’m talking over them, which sometimes I probably am because (of) the delay," said Czaikowski, a doctor of nursing practice and pediatric urology specialist who sees patients as far away as Michigan’s Upper Peninsula. "You’re not getting that full connection."
Fresh off a COVID-19 pandemic boom, telehealth is increasingly connecting Wisconsinites living in remote areas to a web of health resources. Telehealth claims in 2020 swelled to a 6.3 percent share of total claims in Wisconsin — an increase of more than 2,400 percent from the previous year, according to a report from the Wisconsin Health Information Organization. Some northern counties reported high gains compared with the rest of the state….
Health coverage experts: Sidestep intimidation, prepare to enroll
The fall season is here, meaning many Wisconsinites will soon make decisions about their health coverage. Experts say early preparation with trusted voices can help overcome any fears.
The enrollment period starts November 1 for Wisconsin's health insurance marketplace tied to the Affordable Care Act.
For employer-sponsored coverage, it's typically between September and December. And for Medicare, annual enrollment runs from October 15 through December 7.
Allison Espeseth is the director of Covering Wisconsin, which has navigators who provide unbiased information for free on a lot of these topics. They can also calm nerves about assumptions that all insurance is too expensive…
Bill Kaplan: Governor Evers has common sense and a heart
The column below reflects the views of the author, and these opinions are neither endorsed nor supported by WisOpinion.com.
Wisconsin is fortunate that Governor Tony Evers and his health care team are in charge with the end of the COVID-19 public health emergency (PHE). They are newly required by federal law to end continuous Medicaid enrollment. Medicaid enrollees must now apply for renewal to see if they are still eligible. The Medicaid ‘unwinding’, as required by the end of the PHE, is proceeding across the nation…
States’ varying approaches complicate effort to determine impact of Medicaid redeterminations
States are taking differing approaches to Medicaid redeterminations, making it difficult to make apples-to-apples comparisons of disenrollment data or determine if the process is widening health inequities, experts say.
After years of continuous enrollment during the pandemic, states have begun the complex and unprecedented process of figuring out which beneficiaries are still eligible for coverage under the public insurance program for low-income Americans.
States could begin disenrolling beneficiaries from Medicaid beginning in April. Since then, nearly two million people have been removed across 29 states and Washington, D.C., according to KFF.
Cap Times' Evjue Foundation announces over $900,000 in grants
The Evjue Foundation, The Capital Times' charitable arm, today announced its board has approved $911,200 in grants to support area nonprofits and educational institutions.
Included in the gifts is $322,500 for 31 projects at the University of Wisconsin-Madison and $588,700 for 64 organizations to support the work they do to better communities in the Madison area.
Among today's major recipients is the UW's longtime Odyssey Project, which received $35,400 for the college classes it offers in south Madison to adults who never had a chance to attend college and $50,000 to Access Community Health's efforts to bring dental care to people without insurance coverage.
Wisconsin DHS urges timely Medicaid renewals to avoid coverage gap
MADISON, Wis. (CBS 58) -- The Wisconsin Department of Health Services is urging residents enrolled in BadgerCare Plus or Wisconsin Medicaid to submit their renewals in a timely manner.
DHS says they sent renewal packets to nearly 53,000 households with renewals scheduled for June on May 15.
To avoid coverage gaps, these members are advised to submit their renewals by Friday, June 16.
In a Wednesday, June 14 press release, State Medicaid Director Jamie Kuhn emphasized the importance of submitting renewals. "If a member is still eligible, we want them to keep their state coverage. If they’re not, we want to help connect them to resources to help them find other options," said Kuhn.
Renewals can be completed online at ACCESS.wi.gov, through the mail or over the phone. Members should refer to the DHS renewal status webpage to find the "just right" renewal period for each month…
DHS Reminds Medicaid Members to Submit Renewals on Time
The Wisconsin Department of Health Services (DHS) reminds residents who are BadgerCare Plus or Wisconsin Medicaid members that renewals are underway, and there is a "just right" time to renew to avoid delays or gaps in coverage. For example, on May 15, DHS sent renewal packets to approximately 53,000 Wisconsin households scheduled to renew in June. DHS encourages these members to submit their renewals by June 16 to avoid any gaps in coverage. Packets are in the mail to members with a July renewal date and they should send in updated information by July 18 to avoid coverage gaps. The new DHS renewal status webpage shows the "just right" renewal period for each month. Members are encouraged to renew online at ACCESS.wi.gov or by mail.
"If a member is still eligible, we want them to keep their state coverage. If they’re not, we want to help connect them to resources to help them find other options. Either way, the process starts with submitting their renewal," said State Medicaid Director Jamie Kuhn. "It’s been more than three years since any of our members have done one and for many, it’s the first time. That’s why we’re working hard to get the word out and why we’re sharing information with more than 100 partner organizations from all over the state to help raise awareness and provide assistance."
DHS reminds Medicaid members to submit renewals on time
The Wisconsin Department of Health Services (DHS) reminds residents who are BadgerCare Plus or Wisconsin Medicaid members that renewals are underway, and there is a “just right” time to renew to avoid delays or gaps in coverage.
For example, on May 15, DHS sent renewal packets to approximately 53,000 Wisconsin households scheduled to renew in June. DHS encourages these members to submit their renewals by June 16 to avoid any gaps in coverage. Packets are in the mail to members with a July renewal date and they should send in updated information by July 18 to avoid coverage gaps. The new DHS renewal status webpage shows the “just right” renewal period for each month. Members are encouraged to renew online at ACCESS.wi.gov or by mail…
Navigating Post-COVID Medicaid Healthcare Coverage
With the end of the “Families First Coronovirus Response Act”, there exists a lot of confusion in who is covered by Medicaid, how to renew coverage, and how to check eligibility, according to Joan Alker, Executive Director and Co-Founder of the Georgetown University Center for Children and Families. Medicaid covers half of the children in the U. S., and many parents don’t know their children are eligible, and with the coronavirus program ending, checking the eligibility of 90 million individuals is likely to be fraught with mistakes. Covering Wisconsin is a state program as a part of the University of Wisconsin Extension which can help navigate Medicaid questions and renewal.
Wisconsin is checking if you still qualify for BadgerCare Plus. Here's how to keep your health coverage
Over the next year, Wisconsin residents enrolled in BadgerCare Plus or another Medicaid program will have to renew their coverage for the first time in over three years.
It is a massive undertaking — known as Medicaid "unwinding" — that could result in an estimated 300,000 Wisconsinites losing Medicaid coverage. Many of those people will have health coverage through their employer, but others could lose coverage simply because they didn't renew in time, even though they still qualify for BadgerCare Plus or another Medicaid program.
A December report by the Robert Wood Johnson Foundation and the Urban Institute estimated that about 49,000 Wisconsinites who lose Medicaid coverage will become uninsured over the next year….
What to know about medical costs in Wisconsin as federal public health emergency ends
The nationwide public health emergency is scheduled to end on May 11, bringing with it several changes to state and federal resources.
The health emergency provided a key resource specific to fighting COVID-19 known as “medical countermeasures.” This included tests, vaccines and treatments.
When and how changes take place to the accessibility of these depends largely on one’s insurance status, the state they live in and their age.
Here are some things to keep in mind.
Here’s what BadgerCare Plus recipients need to know to keep their benefits
After March 31, those who receive BadgerCare Plus will have to return to the pre-pandemic process of reapplying and being re-evaluated for coverage.
Local health care professionals want them to be prepared. BadgerCare Plus serves people who need health care coverage but who may not qualify for Medicaid.
Because of federal legislation that went into effect in March 2020, those who have received BadgerCare Plus benefits have been able to keep those benefits without having to go through the renewal process as was required every 12 months before that time, said Caroline Gómez-Tom, enrollment network and accessibility manager for Covering Wisconsin.
As COVID-19 emergencies end, Wisconsin prepares for Medicaid upheaval
With federal COVID-19 emergencies ending in May, Wisconsin health officials and advocates are preparing for upheaval in the state’s main Medicaid program, which has grown 49% since the pandemic started but is expected to lose more than 300,000 people after extended coverage ends.
Many of the people likely to be kicked off Medicaid over the coming year should be able to get insurance through their jobs, on the federal marketplace or by aging into Medicare, experts say. But the end of boosted Medicaid coverage nationwide, starting in April, could mean 49,000 newly uninsured people in the state by June 2024, a report says.
“It’s going to be difficult,” said Brynne McBride, chief operating officer for ABC for Health, a Madison-based nonprofit law firm that helps people obtain health care. “How successful are states going to be at actually doing this transition?”
Healthcare.gov enrollment breaks record in U.S., increases in Wisconsin
For all of her adult life, the federal Affordable Care Act has made a big difference for Katerina Klawes.
“I have never had a traditional job that has offered health care benefits,” says Klawes, who lives in Milwaukee. She’s mostly been self-employed as an independent contractor for small nonprofit and education organizations.
She also has multiple disabilities, including being hard of hearing, that once would have subjected her to a lifetime limit on her insurance coverage — if she could get insurance at all instead of being denied coverage or charged exorbitant premiums because of her preexisting health conditions.
Thanks to the ACA, she was covered by her parents’ health insurance until she turned 26 five years ago. Since then, she’s been able to buy health insurance on Healthcare.gov, the federal health insurance exchange that the ACA created.
WisBusiness: the Podcast with Adam VanSpankeren, manager of the Covering Wisconsin navigator program
This week’s episode of “WisBusiness: the Podcast” is with Adam VanSpankeren, the manager of the Covering Wisconsin navigator program.
He discusses the ongoing open enrollment period for Healthcare.gov plans, which began Nov. 1 and runs through Jan. 15.
Covering Wisconsin is a nonprofit group affiliated with the UW-Madison Division of Extension that has provided navigator services since 2014. Navigators provide free assistance to help people get connected with health insurance, VanSpankeren explained.
Confused about health insurance during open enrollment? A navigator can help.
Health insurance can be confusing.
Meet Quentella Perry, who helps people plow through the complexities while working for Covering Wisconsin, a nonprofit organization based at the University of Wisconsin-Madison that educates people about health insurance and helps them choose a plan.
Just as accountants are busy during tax time, Perry and her colleagues have their hands full helping people navigate the choices offered during the Affordable Care Act open enrollment period.