As deadline looms for health plans, navigators help consumers sign up

The newest deadline for Affordable Care Act plan enrollment is coming in just a little more than two weeks, so area agencies are upping their efforts to help people who need it in signing up for government marketplace insurance.

East Missouri Action Agency navigator and certified application counselor Gina Harper said the agency can guide people through enrollment on the health insurance marketplace website or help them discover whether they may qualify for an exemption. That, in turn, will help them avoid paying a penalty with their tax returns next year.

The deadline for sign-ups is Feb. 15, so the agency has two local events planned for that weekend.

Harper said anyone who needs help with enrollment or exemptions can attend the events, which are from 3 to 7 p.m. Feb. 12 and from 1 to 4 p.m. Feb. 15 at the Cape Girardeau Public Library. Harper helps residents of Bollinger, Cape Girardeau and Perry counties with their marketplace purchases, while the Delta Area Economic Opportunity Corp., or DAEOC, will help anyone who attends the event from nearby southern counties.

Another set of open enrollment events headed by the Missouri Bootheel Regional Consortium continue in Scott, Mississippi, New Madrid and Dunklin counties. One is planned for 10 a.m. to 5 p.m. today at the Bowden Center in Charleston, Missouri. Others are planned for 10 a.m. to 3 p.m. Feb. 5 at VFW Post 3127 in Chaffee, Missouri, and from noon to 5 p.m. on Feb. 15 at the consortium office in Sikeston, Missouri.

Navigators said the demand for help with enrollment continues, even as the systems used for signing up have improved.

"It's so much better this year. All of us navigators and [certified application counselors], we have just seen night and day when compared to last year, with the call center being a thousand times better, the website a million times better," Harper said.

As of last Wednesday, 7.2 million consumers nationwide had signed up for plans since the current open enrollment period began Nov. 15, according to a release from the U.S. Department of Health and Human Services. Nearly 210,000 had signed up in Missouri, up from 197,539 the week before, and officials are expected to release new enrollment numbers today.

In Missouri, enrollees can choose from seven marketplace issuers, including several that are deemed "in-network providers" at area hospitals.

When insurance plan participants use an in-network provider versus an out-of-network provider, they generally will have more of their medical bill covered by insurance, dependent on contracted amounts for services agreed upon by the providers and insurance companies.

Saint Francis Medical Center is a provider for the Coventry product available in the online marketplace, said the medical center's marketing director, Felecia Blanton. SoutheastHEALTH is a provider for Coventry, Anthem Blue Cross/Blue Shield and UnitedHealthcare plans on the site, navigators said.

As they go through the enrollment process on the website, people can look up whether prescriptions are covered, which doctors and hospitals are considered "in-network providers," and other details, Harper said, to make sure they can keep their doctors or other preferred providers with the plan they choose.

Meagan Smith, a navigator for the consortium, said up to 50 people seek help at its events, and most are able to sign up for a plan or determine if they qualify for an exemption.

Taxpayers have to report with their income tax return whether they had health insurance in 2014 and will be charged a penalty if they were uninsured, unless they qualify for an exemption.

Still many others who come to the events seeking help qualify for Medicaid, and can receive help with sign-up for that program from navigators, or fall into the "Medicaid gap," Smith said, meaning they make too much money receive Medicaid and too little to qualify for the subsidies offered to help buy a marketplace plan.

An overview of plans, guidance for enrollment and a list of area navigators can be found online at healthcare.gov.

eragan@semissourian.com

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711 N. Clark St., Cape Girardeau, MO