Minnesota Vols Get Health Coverage

Sure, I’d be willing to help. But what if I get hurt? Who’s going to pay those bills?

A lot of people in your volunteer ambulance service’s vicinity probably think things like this. It’s a legitimate concern with vols, and a big barrier to getting and keeping good people. Investigation bore that out in Minnesota when the state’s ambulance and fire chiefs’ associations sought ideas to boost their recruitment and retention of volunteers. At hearings around the state, what they heard consistently was that uncovered vols needed access to affordable health insurance.

“That came out of every single hearing,” says O.J. Doyle, legislative consultant for the Minnesota Ambulance Association. “The top thing was always people not having health coverage.”

So the MAA and Minnesota State Fire Chiefs Association set to work to get it for them. A bill drafted by Doyle and MAA past president Buck McAlpin made fire and EMS volunteers eligible for the subsidized, state-run health insurance program MinnesotaCare. They got it introduced into both houses of the state legislature, where it passed and was signed into law in 2010, to take effect in spring 2011.

Then politics got in the way. With an escalating budget fight consuming energies in the capital (and eventually resulting in a 20-day shutdown of state government in July), Gov. Mark Dayton moved to delay the program’s effective date until October. When that month rolled around, a call from Doyle to Scott Leitz, assistant commissioner for healthcare administration in the state’s Department of Human Services, got it moving again, and the MinnesotaCare for Volunteer Firefighters and Ambulance Attendants (MVFAA) program officially will begin on Dec. 1.

“The ideas we heard to help recruitment and retention were all over the board,” says Doyle. “We heard everything from subsidizing uniform purchases to getting new ambulances. But people agreed at all of the hearings that access to affordable health insurance would be a key tool. People felt if they had reasonably priced insurance available that was more affordable than going on the open market, that would help people who were thinking of retiring stay on, and for people in the community who had kind of toyed with the idea of volunteering, it would be a clear benefit.”

There’s one big difference in how volunteer ambulance and fire personnel will use MinnesotaCare: They will be exempt from the income/asset eligibility test given to program applicants. As a program intended for the working poor, MinnesotaCare typically means-tests applicants for eligibility, but “the need for volunteers is so dramatic,” Doyle says, “that we needed to do something dramatic to address it.”

Beyond that, ambulance/fire vols will be eligible even if they have other insurance. And enrollees are exempt from the prescribed four-month penalty period if they fail to pay premiums or request closure of their coverage. Qualified vols can enroll and re-enroll in MVFAA at any time; they just have to verify their volunteer status once (unless they change departments), and will not have to renew their enrollment each year. Ambulance volunteers who get hourly stipends for answering calls are eligible unless their stipends exceed $6,000 a year.

The premium will vary based on the average capitation payment for MinnesotaCare adults without children; that was $427 a month in 2011. For this enrollees will receive the program’s Basic Plus One benefit set, which includes copayments and a $10,000 annual limit on inpatient hospital services. Covered services include doctor visits; hospital care; prescriptions and immunizations; eye, chiropractic and some dental care; mental health services and more. Spouses and children aren’t covered. 

By next summer the MAA hopes to have an idea of how many volunteers are taking advantage of the program, and eventually to be able to demonstrate that it’s meeting the intended need.

“I think what we’re going to do,” says Doyle, “is send out a survey to the volunteer ambulance services in the state—and probably work with the fire chiefs to send one out to the volunteer fire departments—and find out the level of participation, the amount of support, that sort of thing, so we can do an assessment. It’s difficult to continue to support something like this, which does cost money, without being able to show some efficacy. And it kind of goes to our credibility: We pushed really hard for this, and we didn’t have hard, cold facts, but we did have a lot of anecdotal evidence and the results of our hearings. So we wanted to make sure we did the right thing and that the legislators who supported us put their trust in us for the right reasons.”

Find more on the Minnesota volunteer insurance program, including an application link, here.