Patience is key
When it comes to exploring health insurance options under the Affordable Care Act, local residents will need patience, not only with an online application process, but also when trying to find face-to-face help.
Certified application assistants will be available in the future to help Blair County residents, according to agencies and organizations planning to offer such help.
But as of last week, when the Health Insurance Marketplace went online at www.healthcare.gov, informational pages listed no certified application assistants working in Blair County. The closest ones were in Indiana and Huntingdon counties.
“I just became certified on Friday, and I think I’m the only one in Huntingdon County,” Shauna Hess said Wednesday, the day after the online health insurance program became available.
She was assigned by the Pennsylvania Association of Community Health Centers to work with applicants at the Broad Top Area Medical Center, which has offices in Broad Top and Huntingdon. Hess said she also expects to travel within Huntingdon County to health fairs and to workshops so she can educate those interested in the new health insurance option.
“I think it’s going to be a lot of learning for some people,” Hess said. “And I’m still learning, too, so if I don’t know an answer, I’ll have to find out.”
While the association is not placing someone in Blair County, it will make certified application assistants available to help Blair County residents through a toll-free number to be established and possibly by scheduling open enrollment sessions in Altoona, said spokeswoman Melanie Mudrinich, who is in the process of becoming a certified application assistant.
The Mental Health Association of Pennsylvania is also offering personal assistance to Blair County residents in the form of a toll-free number, 855-274-5626.
Its personnel are trained to help people who use or need behavioral health services, especially those with serious mental illness or serious psychological distress, the organization’s website states.
Help is also available, according to the www.healthcare.gov website, via online chats, a toll-free number, at 800-318-2596. But website visitors reported delays and system crashes last week, both attributed to heavy usage.
Healthcare.gov had 4.7 million visitors, 190,000 calls and more than 104,000 Web chat requests in the first 24 hours of operation, according to a spokeswoman for the U.S. Department Health and Human Services.
That overload prompted a first-day reminder that consumers have until Dec. 15 to sign up for coverage that starts Jan. 1.
What help is available locally?
Meanwhile, some local union members have embarked on an education campaign associated with the new health insurance program.
Local nursing home employees associated with SEIU Heathcare Pennsylvania launched a door-to-door initiative Friday to distribute information and inform Altoona area residents about the options under the Affordable Care Act and the sign-up process.
They were part of a group of 500 SEIU Healthcare union members who recently met in Lancaster for two days of workshops designed to educate them so they could educate others.
The Altoona Area Public Library is offering help, too, by posting links to the healthcare.gov website on its own website and through the use of its desktop computers, which are available to the public. The library can also print applications that can be filed by mail.
“We can help them get to the site, and we can help them navigate the site, but we cannot counsel them or offer recommendations,” library administrative assistant Karin Avery said.
Lenaray Emeigh of Altoona, while researching other materials via the library’s computer, said she will direct her 61-year-old mother, a former construction worker, to the new website.
Emeigh said her mother is trying to secure disability benefits and doesn’t have any health insurance right now.
A Blue Knob man, 62, who retired from teaching in Florida, said he will take time to examine the cost and benefits of insurance plans available under the Affordable Care Act. He said he has health insurance through his former employer but pays a $640 monthly premium or $7,680 annually.
“It adds up,” the retired teacher said.
A 61-year-old Hollidaysburg woman said she has health insurance now, so she won’t explore her options immediately, but probably later.
“I hope to retire next fall,” she said. “But I will be 62 then, and I would have no health insurance unless I can find something, depending on the cost.”
Another educational resource is a health insurance literacy website developed by Penn State Extension specialists at extension/psu.edu/health/insurance.
“We have consolidated many of the key reliable resources for consumers in a no-frills format,” said consumer-issues specialist Cathy Bowen of the university College of Agricultural Sciences.
How many need health insurance?
The Department of Health and Human Services has projected that as many 7 million people will buy health insurance through the Affordable Care Act designed for those who cannot afford health insurance or have been turned away because of pre-existing conditions.
That means an estimated 88 percent of Pennsylvania residents with insurance will have more choices and stronger coverage, and an estimated 12 percent without insurance will have some options, based on the department’s calculations.
Of those without insurance, 75 percent have a full-time worker in the family, according to the department. Pennsylvania residents who seek to purchase insurance through the Marketplace will pay premiums based on variables such as income, family size, age, hometown and tobacco use. Factoring in tax credits, a family of four in Pennsylvania with $50,000 in annual income will pay an average of $282 a month for a benchmark policy known as the second-lowest-cost silver plan, the Associated Press reported. The plan costs $675 a month, excluding tax credits.
A 27-year-old Pennsylvanian making $25,000 a year will pay an average of $145 a month for the same policy, or $187 before the tax credit.
The following questions and answers come from the www.healthcare.gov:
Q: Most people must have health care coverage in 2014 or pay a fee. What happens if someone doesn’t have health care coverage in 2014?
A: If you don’t have coverage in 2014, you’ll have to pay a penalty of $95 per adult, $47.50 per child or 1 percent of your monthly income, whichever is higher. The fee increases every year. Some people may qualify for an exemption.
Q: How can you be considered covered?
A: You’re considered covered if you have Medicare, Medicaid, any job-based health insurance, any plan you bought yourself, COBRA coverage, retiree health insurance, TRICARE, VA health coverage or some other kind of health coverage.
Q: If you’re eligible for job-based insurance, can you consider switching to one of the plans offered through the Affordable Care Act?
A: Yes, but you won’t qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. You also may lose any contribution your employer makes to your premiums.
Q: What if I have a pre-existing condition?
A: Starting in 2014, being sick won’t keep you from getting health coverage … This is true even if you have been turned down or refused coverage due to a pre-existing condition in the past. The only exception is for grandfathered individual health insurance plans, the kind you buy yourself, not through an employer. They do not have to cover pre-existing conditions. If you have one of these plans, you can switch to a Marketplace plan during open enrollment and immediately get coverage for your pre-existing conditions.
Q: When does the enrollment period end?
A: Enrollment ends March 31, 2014. It opens again in October 2014 for those interested in insurance in 2015.