Uninsured Howard County residents began signing up this week for health coverage under a pilot program believed to be the first of its kind in the nation.

Starting Oct. 1, residents could enroll electronically in the Healthy Howard Access Plan and begin getting medical care as early as Jan. 1, 2009, said Dr. Peter Beilenson, health officer of the Howard County Health Department.

Participants will pay $50 to $85 per month depending on their income level and will receive free primary and emergency medical care, a "health coach" who develops a plan to keep them healthy and discounted or free prescription drugs.

Dental care also will be offered, though participants will pay some out-of-pocket cost per visit or procedure, Beilenson said.

"This is the first place in the country where everything has been put together," he said.

To qualify, residents must be 19 to 64 years old, not eligible for any other health insurance programs and meet income requirements, a maximum of about $64,000 a year for a family of four.

Although about 20,000 residents are without health coverage, the program will initially be open to only 2,200, County Executive Kenneth Ulman said. If it is successful, it could slowly open up to more residents, he said.

The program is run by a non-profit organization, Healthy Howard Inc., on a first-year budget of $2.8 million. About $1.6 million of that will come from fees paid by participants, $500,000 from the county and the rest from private sector contributions, Ulman said.

Initial checkups

In January, participants will begin getting initial checkups through the Chase Brexton clinic in Columbia, followed by an evaluation by their health coaches. The coaches will create a personalized "action plan" with medical advice and nutrition and exercise tips designed to keep the person out of doctor's offices and emergency rooms.

A team of professors at Johns Hopkins University, Harvard University and the University of Maryland system will evaluate the program and issue a first report within three to six months of the first patients' being treated, Beilenson said. Researchers will be looking at changes in health, how often residents are using emergency services, whether unnecessary medical procedures have been avoided due to preventive care and how patients are complying with their health action plans.

A team also is analyzing the best ways to keep physicians in the program, maintain long-term funding and keep residents following the health plans, Beilenson said.

"How we ramp up and how we tweak the program depends on the evaluations," Beilenson said.

The city of San Francisco has elements of the same plan, but it is not evaluated like Howard County's, Beilenson said. Howard County is also unique in adding a health coach to the requirements.

National attention

The program already has gained national attention within the medical community, and several other Maryland counties have expressed interest, Beilenson said. Maryland's congressional representatives are also interested in whether the basics of the program might work as part of any future national health care reform, Ulman and Beilenson said.

"Mostly what we hear about from folks is an interest to see how this works before they try to replicate it," Beilenson said. "I think most people have a wait-and-see approach."

A spokesman for America's Health Insurance Plans, an industry trade group representing 1,300 health insurance companies, endorsed the plan.

Spokesman Robert Zirkelbach said Americans spend $50 billion a year to provide coverage to uninsured Americans, which amounts to some $1,000 per year per family in higher premiums.

"We think this is a positive development that the policymakers in Howard County are making this a priority and moving forward with this initiative," Zirkelbach said.

* Who is eligible?

Participants must be Howard County residents who are U.S. citizens or permanent legal residents, at least 19 years old and less than 64 years old and not eligible for any other health programs (such as Medicaid or Medicare). They must be uninsured for at least six months. In addition, there are income requirements: less than $63,600 annually for a family of four, although people with slightly higher incomes might qualify depending on other factors, such as the amount of their child care, child support or alimony expenses.

* How do you apply?

Interested residents can apply at the East Columbia Branch Library, 6600 Cradlerock Way, from 4 to 7 p.m. every Tuesday and Thursday in October, beginning Oct. 2. Other enrollment locations will be added in the coming months. The entire process is electronic and must be done in person. It will take about 30 to 45 minutes.

*What do you need to apply?

You will need personal identification (such as a driver's license or passport), proof of legal status (such as a Social Security card or birth certificate), two items proving Howard County residency (such as a vehicle registration card, utility bill or lease agreement) and two items proving household income (such as pay stubs, last year's tax return or a W2). If you plan to enroll with a spouse or partner, that person will need to also come along and bring proof of the marriage or domestic partnership.

For more information on the county program, go to www.healthyhowardplan.org

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user comments (1)

user likena says...

Health plans in the US are comprising medical care in a few levels? For example, how could anyone use medical devices model of HADASIT with normal procedure or just middle man subroutine?

Posted 6:43 AM, 03.23.09

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