Getting the help to get health coverage
Laura Line oversees the Health Insurance Navigator Program at Resources for Human Development. She wrote this for the Checkup blog on Philly.com and Inquirer.com
With the marketplace rollout of the Affordable Care Act, we are experiencing two realities - one heard far and wide, one making hardly a peep.
The first is the chorus of critique swirling around us about the shortcomings of healthcare.gov.
No doubt these are important issues. But there is another more compelling part of the picture.
Hundreds of thousands of people in Pennsylvania - our neighbors, friends, and family members - stand to benefit from the affordable plans in the marketplace.
As certified navigators, we talk seven days a week, to people who are eager, and often desperate, to get insurance. And while people have been frustrated, they have not given up.
What are a few weeks of challenges compared to long-term coverage that can be lifesaving?
These are the voices and faces behind the 1.3 million uninsured in our state. And it might be surprising how well you know these folks.
They cut your hair at salons, provide child care for your kids. They do bookkeeping, teach music, serve food, and run consulting businesses. They drive taxis, offer home-improvement services, and deliver goods by truck.
We've assisted many of these folks. Yet many more could qualify for affordable coverage. (Individuals who make less than $45,960 may qualify for subsidies, and the limit is $94,200 for a family of four.)
If you need affordable insurance by Jan. 1, now is the time to act. The online enrollment process has improved greatly.
To get covered by New Year's Day, you must enroll by Dec. 23. If you know people who need this coverage, help by asking them to enroll. If you aren't ready by Jan. 1, you can continue to enroll between now and March 31.
To prepare, you can:
Consider who in your household is going to be covered. What specific services and drugs are important to you and them? Do certain providers or hospitals need to be in the plan network?
Consider what is affordable. Are you or your family likely to use a lot of services? Would lower out-of-pocket expenses be a priority? Is your income consistent through the year or variable? What monthly premium amount works?
Review the plans at www.healthcare.gov. And ask for assistance enrolling: Meet with a navigator or certified application counselor.
Our group, Resources for Human Development, won a federal grant to help enrollees in Pennsylvania. Our navigators will sit with you and help you enroll, providing fair, impartial, and free assistance. Call us at 855-668-9536 or e-mail us at firstname.lastname@example.org. Or try the marketplace call center at 800-318-2596.
New Jersey residents can call 877-922-2377.
Encourage others to consider the health- insurance options available through the marketplace.
Coverage is there - it is up to us to take advantage of it.