Health insurance enrollment period starts Tuesday
Tuesday is the first day of a three-month open enrollment period for Affordable Care Act health insurance through the Marketplace.
By Marilyn Meyer
Tuesday is the first day of a three-month open enrollment period for Affordable Care Act health insurance, often called Obamacare, through the Marketplace.
As always, how much the monthly cost will be for applicants will vary widely. Most people are eligible for subsidies and tax credits that bring down the cost of premiums cited on initial paperwork from the Marketplace.
Although news reports have reported big jumps in premiums in some parts of the country, Healthcare.govsaid in an Oct. 24 news release that 72 percent of those who sign up under the Marketplace will be able to find premiums for less than $75 a month and 77 percent will find premiums for less than $100 a month.
Everyone who makes between 100 percent and 250 percent of the federal poverty level is eligible for subsidies — the subsidy is determined by how much the families estimate their incomes will be for the year.
For example, subsidies are offered to single people with annual incomes of $11,800 to $29,500. On top of those subsidies, they and those who make up to 400 percent of the federal poverty level, or $47,200 for a single person, are eligible for tax credits.
Unfortunately, Florida residents ages 19 through 64 who earn less than the poverty level, which is $11,800 for a single person, are not eligible for subsidies. Under the federal program, those people were to be covered by an expanded Medicaid program. But Florida is among 18 states that rejected expanding Medicaid benefits. The result is that those in poverty would have to pay the full premiums, which can be very high, and most remain uninsured. That includes an estimated 40,000 Polk residents.
“There are always questions concerning changes to premiums, deductibles and out-of-pocket limits before open enrollment launches each year,” Ann Barnhart, chief executive officer at Heart of Florida Regional Medical Center in Haines City, said in a news release. “This will always be the case as insurers enter and exit different markets.
“But what is consistent, year-to-year, is the value of the Marketplace," she said. "Millions of people are able to sign up for insurance who otherwise wouldn’t have access to care or who would face a financial crisis due to medical bills.”
Free personal help is offered through licensed navigators and certified application counselors, who are available by appointments in locations across Polk County.
“They know how to explain the pros and cons of each option, and they carefully screen each person to make sure any subsidies toward premiums, or any discounts available for deductibles or co-pays, are accessed,” Rebecca Brewer, chief executive officer of Lake Wales Medical Center, said in a news release.
The Marketplace offers different levels of insurance coverage at different prices — although all must offer a comprehensive set of benefits, including preventive care, doctor visits, prescription drugs, hospital and emergency department care, lab services, and mental and behavioral health treatment.
“We are suggesting making an appointment with a navigator to go through the options,” said Angel Neubrand, spokesperson for Winter Haven Hospital. “Because the sign-up period goes from Nov. 1 through Jan. 1, you can make an appointment for Dec. 1, look at your options and can even come back in a week to finish signing up. There is so much information to go through and absorb, a lot of people do that.”
Ermelinda Centeno, director of enabling services for Central Florida Health Care — a federally qualified community health clinic — said, that until the counselors and navigators start working with the plans and helping people through them, it will be difficult to assess whether people will be seeing year-to-year increases in the amounts they pay for insurance through the Marketplace.
“As counselors, we don’t tell them which plan to choose, which doctor to go to,” Centeno said. “If you are currently taking medications or have a doctor you don’t want to change, obviously you would want a plan your doctor accepts and a plan that pays for your medication. We can guide you to those plans.”
If you want to sign up without assistance, go online to healthcare.gov; for Spanish-speakers, CuidadoDeSalud.gov.
If you want assistance over the phone, call the Marketplace at 800-318-2596. (TTY users call 855-889-4325). Lines are open 24 hours a day and assistance is available in 150 languages.
If you want in-person assistance, licensed navigators and certified counselors are available:
— Baycare Health Navigator Line: Call 855-404-3334, option 1, and set an appointment at Winter Haven Hospital, 200 Ave. F SE; Bartow Regional Medical Center, 2200 Osprey Blvd.; or South Florida Baptist Hospital, 301 N. Alexander St., Plant City.
— Central Florida Health Care: Call 866-234-8534 to set up an appointment at any of the free and low-cost clinic locations in Polk County — Frostproof, 109 Wall St.; Lake Wales, 305 W. Central Ave.; Lakeland, 1129 N. Missouri Ave.; Mulberry, 106 N.W. Ninth Ave; Winter Haven, 1514 First St. N.; Dundee, 916 State Road 542.
— Heart of Florida Regional Medical Center: Call 863-419-1506 to set up appointments at the hospital, 40100 U.S. 27, Haines City.
— Lake Wales Medical Center: Call 863-678-2734 to set up appointments at the hospital, 410 S. 11th St., Lake Wales.
— Indigent Health Care Division of Polk County: Call 863-533-1111 or 863-534-5386 to make an appointment to be seen at the administration building at 2135 Marshall Edwards Drive, Bartow; Eloise Resource Center, 710 Snively Ave.; or the Lakeland Courthouse, 930 E. Parker St.
— Suncoast Community Health Centers: Call 813-349-76000 to make an appointment to be seen in the Plant City office at 508 N. Maryland Ave.. The Suncoast Lakeland Office does not have a counselor available.
— Assistance Access Community Center: Call 407-910-4045 to make an appointment at 4543 Pleasant Hill Road, Suite E., Poinciana.
In addition to those cost-free services, there may be locations where sales people may be paid by specific plans for steering clients to their plans.
— Marilyn Meyer can be reached at firstname.lastname@example.org or 863-802-7558. Follow her on Twitter @marilyn_ledger.
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