New health care option available in Douglas County soon

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A new health care program, created by PrimeWest Health, may soon be available for the uninsured or underinsured residents in Douglas County.

Matt Magnuson, manager of PrimeWest Health Member Services, along with Mike Woods, director of Douglas County Social Services, presented information about the new Values Health program at the September 28 Douglas County Board meeting.

The two also spoke more in-depth about the program with the newspaper.

Magnuson explained that Values Health is affordable and comprehensive individual and family health care coverage for the working uninsured available in 2011 through PrimeWest Health.

The program offers affordable health care coverage because of the emphasis on prevention, wellness and disease management and the fact that it’s based on a multi-share financing approach where the cost of the coverage – the premium – is shared among the individual, the employer, community and federal government.

There is only enough federal funding, however, for Values Health to provide coverage for about 2,000 people in the 13-county area represented by PrimeWest.

PrimeWest is a health plan jointly owned by 13 counties – Beltrami, Big Stone, Clearwater, Douglas, Grant, Hubbard, McLeod, Meeker, Pipestone, Pope, Renville, Stevens and Traverse.

Because the amount of federal funding is limited, Values Health will only be offered on a first-come, first-served basis to working uninsured residents in PrimeWest counties that have developed a fund for paying the community share of the monthly premium.

At last week’s county board meeting, the commissioners approved funding for its share of the Values Health community fund, which would come out of the Social Services budget.

The cost would be approximately $15 per member per month. Woods said there would be an estimated 400 individuals who would be able to participate in the program. This would amount to $72,000 per year – for the next four years.

Woods explained that with the program in place, it would help to reduce the cost of other areas such as mental health ($15,000), commitment ($20,000) and children’s mental health (between $30,000 and $35,000).

He told commissioners that he could adjust the social services budget to accommodate the funding for the Values Health program.

Money from other organizations and community partners, along with the federal funding, will help pay for the rest of the cost of the program.

Woods made it clear that this is not a county program.

“We are a catalyst for the program,” he said. “But we don’t run the program.”

A county’s community share can be funded by local government – both county and city – and/or non-government sources such as churches, civic groups, hospital, clinics, economic development organizations and charitable organizations.

The community share of the monthly premium is $60 per enrolled county resident per month. The county approved $15 per member, per month. Another $45 per member per month will need to be funded before the program can get up and running in 2011 for eligible Douglas County employers and their employees.

“We are excited about this groundbreaking program,” said Woods. “A program that involves the whole community instead of just government.”

For more information about the program, call Magnuson at (320) 763-4135 or toll-free at 1-888-588-4420.

TO QUALIFY

Individuals who want to enroll in the program must:

•Work in a PrimeWest Health owner county that has a Values Health Community Share Fund.

•Be an employee or dependent of an employee of an employer participating in Values Health.

•Not be enrolled in or have currently available health coverage, except for catastrophic health care coverage.

•Not be eligible for or enrolled in medical assistance or not be enrolled in MinnesotaCare or Medicare.

Businesses that want to sign up for the program must:

•Employ at least one but no more than 50 employees.

•Have a payroll with an employee-wide median wage equal or less than 350 percent of the federal poverty guideline ($18.22 hourly).

•Not have offered employer-subsidized health coverage to its employees for at least 12 months prior to the initial enrollment of the program.

Tags: local news, douglas county, news, health, primewest, healthcare