By Marilyn Littlejohn
Ah, November – the season of colorful leaves, pumpkin spice everything, and open enrollment for various health plans. Alas, figuring out Medicare, Medicaid or other health insurance options can be a daunting task. Plowing through the numerous plans with their foreign terminology can leave one feeling as down as a dreary fall day, yes? Fortunately, the Burien Community Resource Center can help you cut through the confusion of health insurance plans.
“The City of Burien adopted the Framework for Strengthening Families in 2018 in order to align human services efforts with the goal of supporting healthy communities,” says Colleen Brandt-Schluter, human services manager for the City of Burien. “One way to ensure community members are healthy is to help them access health insurance. Among many other services available in one spot, the Burien Community Resource Center has multiple organizations that can help you cut through the confusion of enrolling in a health plan.”
The organizations to which Colleen refers include Public Health – Seattle & King County, Community Health Plan of Washington and United Healthcare. You can find at least one of them at the Burien Community Resource Center on Mondays (except holidays), 10 a.m. to noon at the Burien Community Center, 14700 6th Ave SW.
Public Health – Seattle & King County
“Our goal is to ensure that every resident in King County has access to health insurance and quality health care,” says Daphne Pie, the health services administrator who manages the Public Health Department’s Access and Outreach Program. She shares the story of how one of Public Health’s Outreach and Access staff (Cindy Mai) helped a mother with a sick daughter living out of state, homeless and without healthcare:
We helped the mother find a medical provider for her daughter and schedule an appointment. The day her daughter returned to Washington, she called us and we immediately enrolled her in health insurance. The daughter wrote to us, saying, “I can’t even begin to explain how much your help meant to me. You are a wonderful person, Cindy, and I value and respect your thoughts. I certainly appreciate everything you did and shared with me today.”
Ms. Pie continues, “The Public Health team can help you enroll in Apple Health (Medicaid) any time of year. However, for those over the income limit for Apple Health, we also can help you enroll in a qualified health plan (QHP). With health care open enrollment now under way, it’s extremely important that individuals who are over income for Apple (Medicaid), who simply want to change their health plan or who want look at their health insurance options, to take action.”
Community Health Plan of Washington
Founded in 1992, Community Health Plan of Washington (CHPW) provides Medicaid and Medicare health coverage to Washington residents in their own communities. Its Medicare Advantage plans offer extra benefits that traditional Medicare doesn’t cover, including vision, dental, prescription drugs, and alternative medicine coverage.
Noting that enrolling in Apple Health (Medicaid) or Medicare can be confusing and even intimidating, Penelope Zorzi, marketing programs manager for CHPW, says that “Our knowledgeable, friendly, and local staff try to make the process as smooth as possible.” She notes as an example, Tommy Khuu, a CHPW outreach and enrollment specialist, who recently helped a 74-year-old King County woman switch from one Medicare Advantage plan to another that saved her money every month. Mr. Khuu assisted the former school teacher, who had fallen on hard times, in applying for programs from the state and from the Social Security Administration to help pay for Medicare costs and prescription drugs. The extra financial help the woman received covered the $26 monthly premium of her new Advantage plan as well as copays for her prescriptions, meaning she would get better health coverage at $0 additional cost to her.
“Today, I was/am profoundly fortunate to be served by the most informative, patient and highly qualified Mr. Tommy Khuu, who expertly guided me through the numerous and varying questions I had about Medicare and its enrollment plan(s),” she wrote in a thank you letter. “He has enhanced my awareness of the yearly enrollment, benefits available, contact info and much, much more. I am thoroughly pleased with my received service today, rating Mr. Khuu a ‘TEN PLUS, PLUS, PLUS’ (from a rating with 10 being tops) and an award of ‘TEN Gold Stars’ (with five being tops).”
As part of its mission of helping people live healthier lives, United Health Care offers what it calls a “Dual Special Needs Plan.” It serves members who have both Medicaid and Medicare. “These members often have multiple chronic illnesses and are on a limited income,” says Melissa Anderson, community outreach representative for United Healthcare. “By identifying and responding to medical, social and behavioral factors in an integrated way, we can drive more positive outcomes and reframe the health care challenge for these disadvantaged and underserved community members.”
In addition to medical, dental, vision and behavioral benefits, Dual Special Needs members also receive in-home assessments, access to a 24 hour nurse line, over the counter benefits, transportation to medical appointments, and an advocate who serves as one point of contact to navigate and simplify their complex health systems and needs.
Elliot is an example of someone who was helped by this program. He is a once successful photographer who had endured a combination of homelessness, illness and severe anxiety that put him in a wheelchair. After United Healthcare helped him find stable housing for the first time in years, and designed a personal package of medical and social services, Elliot decided he had the strength to “get going again.” He continued to work on his health, was able to get out of his wheelchair and eventually starting to take photographs again. Given a new foundation, Elliot is now actively working to shape a better future for himself.
To start on your own journey of getting medi-smart, visit these and other service providers at the Burien Community Resource Center – a partnership between King County District Court and the City of Burien.
Marilyn Littlejohn is a community court coordinator with King County District Court. Among other things, she has done community & intergovernmental relations for the City of Seattle Human Services Department, as well as managed its Domestic & Sexual Violence Prevention Office, and worked for the Refugee Women’s Alliance (ReWa) in the adult education, employment training and naturalization programs.