Carewell SEIU 503 Healthcare Cost Assistance helps eligible workers in approved health insurance Marketplace plans pay:

• The net cost of your monthly premium (see FAQ for definition).
• Out-of-pocket costs like deductibles, copayments, coinsurance, and prescription costs for services covered by your approved individual plan. Up to $6,900 of out-of-pocket expenses are covered in 2023.

This benefit applies only if you are enrolled in an approved Marketplace plan (see approved plans for 2023.)

Healthcare Cost Assistance is only available to eligible homecare and personal support workers, not to family members. If your family is included in your health insurance policy, Healthcare Cost Assistance will only cover the portion of the monthly premium that applies to your individual coverage. More information can be found in the Use this Benefit section below. 

If you are eligible for Healthcare Cost Assistance, you will receive a Benefit Convenience Card (a Mastercard debit card) to pay for your monthly premium and covered out-of-pocket expenses. The card will come from Ameriflex (the Benefits Convenience Administrator). For more information about the Benefit Convenience Card and how to use it, click here.  

Open Enrollment

If you are enrolling in a Marketplace plan for the first time, you will most likely need to wait until Open Enrollment to enroll. Open Enrollment is generally between November 1 and December 15 every year for coverage starting the following January 1. There are some special circumstances that may allow you to enroll outside of this period; see the FAQs for more information. 

Special Enrollment Period (SEP)

Outside Open Enrollment, there are limited exceptions that may allow you to enroll during a Special Enrollment Period. For example, if you lost your insurance coverage from a spouse’s plan or another employer, or you lost Medicaid coverage, you may be eligible to enroll outside Open Enrollment. Special Enrollment Periods only last 60 days from the date of the qualifying event (like termination of coverage), so if you believe you may be eligible for a SEP, call 1-844-503-7348 right away. See FAQ for more information on Special Enrollment Periods.

Starting 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 $6,900 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. 

Enrollment 2023 Steps

Please note: Open Enrollment for 2023 coverage ended on January 15. Marketplace health insurance plans are renewed during Open Enrollment.

If you are currently enrolled in an approved Marketplace plan, and did not have an appointment during Open Enrollment with Valley Insurance Professionals (VIP), it is important to update your income.

• Fill out the 2023 annual paperwork and Enrollment Information Form (EIF) together in one click here!
• Fill out just the EIF (if you’ve already submitted the 2023 annual paperwork): click here.

Where can you find this information?

• Log in to your Marketplace application at healthcare.gov.
• Ask your health insurance carrier (like Kaiser or Providence) — they may have sent you that information by mail, or it may be available in your online portal. You can also just call — phone numbers for carriers can be found here.

Steps to enroll in Healthcare Cost Assistance benefits for the first time

Important! You must complete each step in order to enroll in Healthcare Cost Assistance benefits.

1. Fill out the annual paperwork: these forms give the Carewell SEIU 503 Benefits team and their partners permission to assist you with enrolling in and maintaining your healthcare coverage.

2. Learn more about the approved plans for your area:

a. To receive Healthcare Cost Assistance benefits, you must enroll in a plan that’s approved for your area. See list of approved plans.

b. Read through Plan Benefit Summaries to find the best fit for your health needs: See Summaries of Benefits and Coverage.

3. Call Carewell SEIU 503 at 1-844-503-7348. They can help schedule an enrollment appointment with our partner insurance agents at Valley Insurance Professionals.

4. Pay your premium before the due date. If you don’t pay your premium on time, your plan will not be activated and you may find yourself without coverage throughout 2023.

5. Be sure to read and respond to requests for information from the Marketplace. If you don’t respond to a Marketplace request for information, you may lose your insurance coverage, Advance Premium Tax Credits, and/or Healthcare Cost Assistance benefits.

You will know you’re enrolled in Healthcare Cost Assistance benefits when you receive the reimbursement check for your first premium, and then the Benefit Convenience Card (BCC) in the mail. From the day of your enrollment, it can take up to 20 business days for the BCC to arrive in the mail. You should also receive reimbursement for your first premium, either by check or through direct deposit, within 20 business days of your enrollment.

If you have questions about enrolling in or accessing Healthcare Cost Assistance benefits, please call 1-844-503-7348.