Healthcare Cost Assistance
Access the care you need to thrive.
Benefit Summary
Carewell SEIU 503 Healthcare Cost Assistance benefits help make individual healthcare plans affordable for Oregon homecare and personal support workers who can’t get coverage through other means. Examples of other means include the Oregon Health Plan, another employer or spousal coverage.
This benefit is available to eligible homecare and personal support workers who have Medicare or who enroll in an approved plan through a health insurance Marketplace. The Healthcare Cost Assistance benefit covers up to $6,500 of out-of-pocket medical expenses for claims covered by Medicare or your approved Marketplace plan in 2021. It also covers 100% of your net monthly premiums for your individual Marketplace plan, or a portion of your Medicare premiums.
If you are eligible for Healthcare Cost Assistance, you will receive a Benefit Convenience Card (a Mastercard debit card) to pay for your monthly premiums (unless you have Medicare) and covered out-of-pocket medical expenses. The card will come from Ameriflex (the Benefits Convenience Administrator).
Note: Renewal information for Healthcare Cost Assistance benefits for support workers
Important Things to Know
- This benefit pays your net monthly premium (i.e., your premium after tax credits have been applied) for a qualifying individual plan purchased through the Marketplace or for Medicare. It also covers up to $6,500 in out-of-pocket medical expenses for claims covered by your qualifying individual plan or by Medicare. Carewell SEIU 503 Healthcare Cost Assistance benefits are not employer-sponsored or group coverage.
- To take advantage of this benefit, you will need to enroll into an approved plan on a Health Insurance Marketplace or into Medicare. Call us — we’re here to help walk you through the process!
- You can enroll in an approved insurance plan during the Special Enrollment Period (SEP) that lasts until May 15, 2021. President Biden ordered this SEP In response to the COVID-19 Public Health Emergency. This allows individuals and families in states like Oregon that use Healthcare.gov to enroll in 2021 health insurance coverage or update existing applications.
- The Washington Healthcare Marketplace at www.wahealthplanfinder.org is also offering a Special Enrollment Period until May 15, 2021. This SEP allows individuals and families to enroll in 2021 insurance coverage. However, it won’t allow for changes in your coverage if you’re already enrolled.
Check your Eligibility
To find out your eligibility instantly, answer a few questions on the eligibility questionnaire.
Please read the eligibility requirements below carefully.
Eligibility Requirements
You are likely to be eligible for Healthcare Cost Assistance benefits if you:
Worked 40 or more hours a month of eligible working hours — also known as bargaining unit hours — for two months in a row. There is then a one month waiting period while your hours are reported to the Benefits Administrative Office.
Turn in your timesheets and/or payroll vouchers on a regular basis
Have your basic demographic information on file with the Benefits Administrative Office. Click here to update your information now.
Have medical coverage through Medicare or through an approved Marketplace plan. See FAQs for more information.
Eligible hours
The number of eligible working hours you need to qualify for Carewell benefits are the work hours paid by Acumen, DHS and/or PPL on behalf of your consumer.
Losing eligibility
If you go two months in a row without working any eligible working hours (or if zero hours are reported), after a grace period of one month you will no longer be eligible for Healthcare Cost Assistance. To regain eligibility for Carewell SEIU 503 benefits you must complete the steps above.
Grace period for Open Enrollment 2021
If you are eligible to receive Healthcare Cost Assistance benefits in October 2020, you will continue to be eligible for Healthcare Cost Assistance benefits in November 2020 and December 2020, regardless of your hours worked. Your continuing eligibility after December 31, 2020, will be determined based on eligibility rules as described above.
If you have questions about your eligibility for Healthcare Cost Assistance benefits, please call 1-844-507-7554, option 3, option 2.
For eligible workers with Medicare
Learn more about Healthcare Cost Assistance for eligible workers covered by Medicare.
For eligible workers with approved plans
Learn more about Healthcare Cost Assistance for eligible workers with approved individual health plans on the Healthcare Marketplaces.