Lifestyle

Medicaid Plans Cover Doctors’ Visits, Hospital Care — And Now Your GED

Emilia Ford turned pregnant at 15 and, after her daughter was born, dropped out of highschool.

As she held down completely different jobs throughout the previous decade — together with housekeeping and dealing in a relative’s retail retailer — she at all times considered going for her GED to indicate she met highschool educational abilities.

But the Brookhaven, Pa., girl wanted help discovering tutors and paying for the set of 4 exams, which value $20 every.

She discovered assist from an surprising supply: her Medicaid well being plan.

AmeriHealth Caritas, a Philadelphia-based insurer with 2 million Medicaid members in Pennsylvania and 5 different states, helps join members with nonprofit teams offering GED take a look at preparation lessons, presents phone teaching to maintain members on observe and pays the testing charges.

Ford is considered one of 62 plan members who’ve earned a GED certificates for the reason that profit started in 2013.

“I could not believe this was something a health insurance company would do,” mentioned Ford, 25. “I thought health insurers only paid for medical costs.”

Not anymore.

Medicaid well being plans are beginning to pay for non-traditional providers reminiscent of meals, transportation, housing and different types of help to enhance members’ well being and scale back medical prices.

That change follows efforts by state Medicaid packages to present well being plans monetary incentives to regulate spending, mentioned Jill Rosenthal, senior program director for the National Academy for State Health Policy.

Rather than proceed to pay a set price every month to cowl members’ well being prices, many states are implementing insurance policies that permit well being plans share in any financial savings they’ll show. That offers motivation for insurers to handle elements reminiscent of literacy and poor housing, which might drive up well being prices.

“Health plans now have incentives for them to find the root causes of problems that will reduce costs that will benefit the plan, its beneficiaries and the states,” Rosenthal mentioned.

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AmeriHealth Caritas CEO Paul Tufano mentioned research present individuals with decrease academic ranges are usually in poorer well being. “Helping members attain their GED can be incredibly consequential for them to live the kind of life they want to live,” he mentioned.

But Tufano acknowledged that solely a small fraction of people that want the help attain out for it. About 1,000 members have began GED coaching via the insurer in Pennsylvania, Louisiana, South Carolina and Delaware.

“Many of our members are just surviving to keep their heads over water, holding on to jobs and dealing with issues like safe housing, access to food and transportation to get to work or doctor,” he mentioned.

AmeriHealth Caritas is considered one of only a handful of Medicaid well being plans that supply a GED profit.

EffectivelyCare, which covers 2.2 million Medicaid recipients in Missouri, Nebraska, Georgia, Kentucky, Hawaii and Illinois, had 226 members sit for his or her GED exams for the reason that plan started paying for it in 2012, mentioned spokeswoman Alissa Lawver. The Tampa-based plan doesn’t know what number of handed.

A Wellcare survey of its Medicaid grownup members in Georgia in 2012 discovered that about 20 % didn’t have a highschool diploma or a GED.

“There is a significant relationship between education and health,” Wendy Morriarty, president of EffectivelyCare’s ‘Ohana Health Plan in Hawaii, mentioned when launching the profit in 2016. “A GED is a tool that can lead to increased opportunities for our members to attend college, seek higher-paying jobs and find stable housing. This benefit has the ability to improve the health and well-being of local families and communities.”

Advocates for Medicaid reward the well being plans’ efforts.

“I think this sets the standard for the unique role of Medicaid managed care in bridging health care and social services,” mentioned Sara Rosenbaum, well being regulation and coverage professor at George Washington University.

Ford mentioned having a coach at AmeriHealth stroll her via the sign-up course of for GED lessons, assist her register for exams and name her twice every week to maintain her motivated was very important to her success. The program additionally supplied youngster care and transportation to the prep lessons and examination websites. She began in May 2017, taking two lessons every week, and handed her exams final summer season.

When she completed, AmeriHealth employed Ford as an intern in its member providers division. In December 2017, the insurer employed Ford to a full-time place — with well being advantages — to work as a GED coach for different Medicaid members.

The job meant Ford turned the primary of 9 siblings to get off Medicaid and discover employer-based protection.

“I feel like I was saved from the struggle I was going through,” Ford mentioned. “This is something big that my family was proud of.” While she was rising up, she mentioned, her father drove a faculty bus and her mother took care of the youngsters.

In the previous yr, Ford has helped 12 plan members earn their GEDs and he or she’s teaching 30 extra.

“I can tell them I have been where you are on the other side of the phone and can share my experience and it helps give them more trust in me,” Ford mentioned.

“The hardest thing is not giving up even after failing a test and being able to get back up and push yourself and get over the discouragement,” she mentioned. “There is always something good that you can take from a bad situation.”

Phil Galewitz: pgalewitz@kff.org”>pgalewitz@kff.org, @philgalewitz

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