Social Services

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 Social Services

Jesse LaBrecque
Outreach & Enrollment Specialist

 

The Health Center has trained staff members to assist clients by connecting them to resources throughout the community, and accessing health and social service programs. These can include food, transportation, housing, heating assistance and many other programs. Please see the “Resource Directory” tab for a list of helpful resources. The Outreach and Enrollment Team can help clients complete applications for MaineCare, Medicare, other health insurance programs and Sacopee Valley Health Center’s Fee Discount Program.

MaineCare Enrollment Assistance

The Health Center is a Certified Application Counselor Organization. This means we have staff members trained to help people complete their applications and enroll in plans through the new health insurance marketplace. For more information, please see the Health Insurance Marketplace tab below.

Anyone can schedule an appointment for these services and you do not need to be a patient of the health center. There is no charge or fee for this assistance. If you have questions about any of these programs, please call:


Jesse LaBrecque at 625-2239

FEE DISCOUNT PROGRAM

What is the Fee Discount Program?

The Health Center provides discounts on services to patients who are eligible for our Fee Discount Program. The fee discount can help you pay for costs not covered by your insurance.

What are the Income Guidelines?

You may be eligible if your income falls below these guidelines, EVEN IF YOU HAVE INSURANCE!

Family Size Annual Income
1 $24,120
2 $32,480
3 $40,840
4 $49,200
5 $57,560
6 $65,920
7 $74,280
8 $82,640

Revised February 2017

How do I apply?

Complete the application form. The following must be attached:

- Proof of current family income (paycheck stubs, copies of unemployment checks, Social Security award letters, child support, etc.)

- If you are zero income, you will need to provide a letter of support from the person that is supporting you or a written statement from you of how you meet your basic needs.

- If you are self-employed, please complete the self-employment sheet (three months profit/loss).

If there are special issues you would like us to consider when we review your application, please write them on a separate piece of paper.

Return your completed application form with attachments to the Health Center, either in person or by mailing to:
Outreach & Enrollment 
Sacopee Valley Health Center
70 Main Street Porter ME 04068

All information you provide us in your application is kept completely confidential.

Fee Discount Application

Self-Employment Form

What Services are Covered?

Most Health Center services are covered, including medical, counseling, optometry and dental appointments. These are discounted at the same fee depending where you fall on the income guidelines. You will receive a letter explaining the fee amounts for which you qualify.

When can I apply?

You can apply for the Fee Discount Program at any time. Once you qualify, your enrollment generally lasts for one year. Please submit a new application before your expiration date to avoid a gap in fee discount coverage.

Other Benefits of our Sliding Fee Program

- Enrollment in the SunRx prescription discount program.

- Discounts on some services provided through MaineHealth hospital free care program.

- Discounts on NorDx Lab Services provided at the Health Center.

Once you are enrolled, you will receive more specific information about these benefits.

For more information call:
Jesse LaBrecque
Outreach & Enrollment Specialist
 (207) 625-2239

 

HEALTH INSURANCE MARKETPLACE

The next Open Enrollment Period is November 1, 2017-January 31, 2018

Special Enrollment Period

You may still be able to apply for a Special Enrollment Period if you have any of the following "life events".

- Marriage
- Having a baby or adopting a child
- Moving to a different state
- Gaining citizenship
- Leaving incarceration
- Losing health coverage due to losing a job, divorce, individual poliacy ending or aging off a parent's plan.

You can apply for MaineCare at any time during the year.

About the Marketplace

The Marketplace helps individuals, families and small business to find and buy health insurance coverage. Before you enroll, you will be provided with a clear picture of the premiums you will pay and the benefits and protections you will receive. You may be eligible for Tax Credits to help pay the monthly premiums. Coverage through the Marketplace will be based on income, household size, age and tobacco use. You can not be denied coverage or charged more because you have a pre-existing condition. Dependents can stay on their parent's plan until they are 26 years old.

 Who is eligible for the Marketplace health coverage?

Many people may be eligible for Marketplace coverage. To receive coverage through the Marketplace, you:

- Must live in the United States
- Must be a U.S. citizen or U.S. national (or be lawfully present)
- Cannot be incarcerated

Most people also qualify for a Premium Tax Credit. An individual's yearly income needs to be above $11,880 and for a family of 4, it needs to be above $24,300 yearly.

How can I get help?

The Marketplace will offer several kinds of assistance to help you apply for coverage and choose a plan that meets your needs.

- Online questions and answers (healthcare.gov)
- Online chat (healthcare.gov)
- A toll-free call center (1-800-318-2596, 24 hours a day, 7 days a week)
- People in your community trained to help you apply and enroll (SVHC Certified Application Counselors

Who is already considered covered?

If you are covered by any of the following, you are considered covered and don't have to pay a penalty.

- Any Marketplace plan, or any individual insurance plan you already have
- Medicare
- Medicaid
- The Children's Health Insurance Program (CHIP)
- TRICARE (for current service members and military retirees, their families, and survivors)
- Veterans Health Care Programs (including the Veterans Health Care Program, VA Civilian Health and Medical Program (CHAMPVA), and Spinal Bifida Health Care Benefits Program)
- Peace Corps Volunteer plans

Other plans may also qualify. Ask your health coverage provider.

What if I don't have coverage?

People who do not have coverage that qualifies as minimum essential coverage may have to pay a penalty. They will also have to pay the entire costs of their medical treatment throughout the year. There may be exemptions from this penalty and it is important to see if you qualify.

Who do I contact?

If you have questions or want to see if you qualify for the Marketplace, please contact our Certified Application Counselor:

Jesse LaBrecque
Outreach & Enrollment Specialist
 (207) 625-2239