Healthcare Cost Assistance
Access the care you need to thrive.
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 $7,165 of out-of-pocket medical expenses for claims covered by Medicare or your approved Marketplace plan in 2024. 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 credit 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).
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 $7,165 in 2024 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 in an approved plan on a Health Insurance Marketplace or into Medicare. Call us — 1-844-503-7348 — we’re here to help walk you through the process!
- In most cases, you need to wait until Open Enrollment to enroll. Open Enrollment on the federal Marketplace is generally between November 1 and December 15 for the following year. There are some exceptions that may qualify you to enroll through a Special Enrollment Period. See the Frequently Asked Questions for more information.
- In April 2023, the Oregon Health Authority (OHA) began redeterminations of eligibility for the Oregon Health Plan (OHP). Redetermination is when OHA reviews your information to figure out if you still qualify for the Oregon Health Plan (OHP).
If you are on OHP, Apple Health (in Washington), or another Medicaid plan, you might receive a letter letting you know that your medical benefits are ending. If you have questions about this letter, the fastest and best way to get help is to call the phone number in the letter.
However, there are several ways you can update your contact information, including:
- Online at: benefits.oregon.gov or oregon.gov/or-benefit-changes.
- Via your coordinated care organization (CCO). Members can find their CCO contact information by visiting: CCO Plans.
- By mail at: ONE Customer Service Center, PO Box 14015, Salem, OR 97309.
- By phone at: 1-800-699-9075 or TTY 711. Phone lines are open Monday through Friday 7 a.m. to 6 p.m. PST. Hold times are shortest in the morning from 7 a.m. to 8 a.m.
- By calling a toll-free language line. Interpreters are available in 16 languages.
If your medical plan is ending, we may be able to help you enroll in a medical plan through the Health Insurance Marketplace (Healthcare.gov). If you’re eligible, we may be able to enroll you in Healthcare Cost Assistance benefits through Carewell—which would pay for your monthly premium and up to $7,165 in out-of-pocket medical costs. Please call 1-844-503-7348, Monday—Friday, 8am—6pm PST to let us know that you are a care provider who is losing medical benefits.
To find out your eligibility instantly, answer a few questions on the eligibility questionnaire.
Please read the eligibility requirements below carefully.
You are likely to be eligible for Healthcare Cost Assistance benefits if you:
You worked at least 40 eligible working hours* for 2 months in a row to be eligible for these benefits. Once you have met this requirement, there will be a 1-month waiting period after you turn in your timesheets and/or payroll vouchers. During this waiting period, the State, Acumen, or PPL will report your hours to Carewell SEIU 503.
Turn in your timesheets and/or payroll vouchers on a regular basis.
These eligibility requirements are the same for the Dental, Vision + Hearing, and Employee Assistance Program (DVE) benefits.
* Eligible working 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.
If you go 2 months in a row without working any eligible working hours — or if 0 hours are reported, after a grace period of 1 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.
Losing Carewell SEIU 503 benefits does not mean you’re losing your health insurance coverage! But at the end of your grace period month, your Benefit Convenience Card (BCC) will be turned off and you will have to start paying your own premiums and out-of-pocket medical expenses.
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 Health Insurance Marketplaces.