Health insurance questions answered
The 40 or so people who gathered at the Waynesville library Tuesday were full of questions about the insurance options under the Affordable Care Act that can become effective as early as January.
The occasion was the first public information meeting held in the county by Mountain Projects, which was awarded a grant to provide health care navigator services in seven Western North Carolina counties.
Charles and Linda Hallett of Bethel need a gap policy to provide coverage until the are eligible for Medicare, coverage that isn't currently available to them because of pre-existing health conditions insurance companies won't cover.
"We're here to find out if the insurance is going to be affordable," Charles Hallett said.
Linda Hallett was concerned about what will happen once the act requiring health insurance for everybody kicks in.
"If I need attention, will I be able to see someone right away or will I have to wait?" she asked.
Patsy Dowling, the organization’s executive director, told the group that while political issues surround the new federal legislation, in her mind the navigator service is about helping people understand options.
“This is the law, and we all need to comply,” she said.
Jan Plummer, the healthcare navigator coordinator for the $360,000 grant, explained her interest in program came from years of working inside the health care system and seeing cases where folks that needed services were unable to get insurance coverage or the care they needed.
The goal, Plummer said, is to provide information about the law and help people find their way through the “shopping mall for health insurance at healthcare.gov.
Consumers were supposed to be able to search the healthcare.gov web site beginning Oct. 1 to compare available insurance plans and find out whether they qualified for a subsidy to make the coverage affordable, but a rocky start has prevented most from gaining access to the site.
Plummer said more capacity was added he certified paid and volunteer navigator staff has had some success in getting applications submitted, and helped others fill out paper applications.
Navigators will meet with individuals at the Haywood County Department of Social Services and will meet with organizations or groups to explain the process. Call 452-1447, ext. 115 to arrange for an appointment. All navigator services are free to individuals and businesses. Also, check out Healthcare.gov.
Following the 30-minute overview, the navigator staff fielded questions, including:
Who qualifies for subsidies?
Assistance is available for those making up to 400 percent of the federal poverty level (guidelines can be found at the Mountain Projects website at www.mountainprojects.org)
Will my information remain confidential?
Absolutely. Income or other information brought to a navigator meeting will be sent home with the individual or shredded. Only contact information will be retained.
What if I can’t get on the marketplace website?
Mountain Projects has paper applications and has had limited success in helping clients through the logjam caused by more a higher-than-expected number of users.
Is there a deadline?
To receive coverage on Jan. 1, 2014, individuals must enroll before Dec. 15. There will be no penalty for those who sign up for coverage by the end of March 2014. Penalties won't be assessed for those who would have to pay more than 9.5 percent of their income for insurance.
What do I need to apply?
Have your Social Security number, proof of income such as a wage statement, pay stub or W-2 form; and your insurance plan number for all in the family if one is in place.
Do business owners have to provide coverage?
Businesses with fewer than 50 employees are exempt from the act. Larger businesses have the option of offering coverage or paying a penalty. There are tax incentives available to businesses that do offer health insurance for employees.
Does the program offer coverage for vision?
There are multiple options available depending on which plan is chosen, but vision coverage is not included in the basic minimum plan companies must provide.
Is it true there is a gap in coverage because North Carolina didn't expand Medicaid?
Yes. The federal government would have paid 100 percent of the costs of expanding the minimum income levels for the Medicaid program so more people would have been covered. After three years, the state would have picked up 10 percent of the extra costs. Since North Carolina passed on this, there will be about 15,000 in Haywood and Jackson counties earning $8 an hour or less who won't be able to afford insurance.