Confusion remains as insurance deadline looms

 

With only days left for eligible persons to enroll in insurance through the Affordable Care Act, confusion remains among many people as to what and when and how to navigate the system.

Lisa Marum of Holy Rosary Healthcare said that while most computer-savvy people will have no problem working through the government site, she and Marybeth Squires can assist anyone with the enrollment process. OneHealth, the former county health department that just merged with the community health center, also has a patient navigator, Megan Burton.

Marum said there has been some confusion about obtaining health insurance, especially among people who have never had insurance before. While Marum and her colleagues can assist in filling out the forms, when it comes to choosing plans, the applicant must do that himself. As Marum said, “There are lots of options to work your head around.”

Some plans have high deductibles and others have regular co-pays. Depending on general health needs, one plan may be better than another for each individual. In addition, some applicants have chosen plans but did not understand that they had to pay premiums and consequently found they were not covered.

For persons qualifying for subsidies, there are also different ways to get the subsidy. Some choose to have the premium subsidized monthly, while others may prefer to process their subsidy with their tax return annually.

According to recent national polls, many people who are uninsured but eligible for insurance do not realize that March 31 is the deadline for application. If a person has started an application and not completed it, the deadline does not apply. However, if the process has not been started at all, then March 31 is the last day to apply. 

If an applicant does not quality for adequate subsidies to pay for insurance, he or she will not be fined. The system can determine if applicants are choosing not to be insured or if they cannot afford insurance. The original plan was for Medicaid to be expanded to cover those who made too little income to afford insurance even with subsidies, but that was not carried through in many states, including Montana.

Applicants who can qualify but elect to remain uninsured may be fined $95 the first year, with that fine collected when an income tax return is filed. Subsequent fines for being uninsured increase significantly.

In addition, there is an 800 number for questions about applying. Those who prefer can call the number and a representative will help them through the process. That number is 1-800-318-2596. TTY users should call 1-855-889-4325

To have either Marum or Squire provide assistance through Holy Rosary Healthcare, call 233-2685 to reach Marum or 233-2596 to reach Squires. Appointments are necessary for assistance, as the process does take some time. Megan Burton can be reached at 234-8793 or 874-3377 at OneHealth.

Interested applicants can also email HRH-GetCoveredNow@sclhs.net for questions.

The government website is healthcare.gov, and a paper application can be printed at www.marketplace.cms.gov. All insurance plans cover a comprehensive set of benefits, including doctor visits, hospitalization, preventive care and prescriptions. Plans in the Marketplace cannot deny you coverage because of a pre-existing condition. With a single application, you can find out if you qualify for Medicaid, the Children’s Health Insurance Program (CHIP) or subsidies you can use right away to lower your insurance costs.