Local health insurance helpers busy at sign-up deadline

jholleman@thestate.comDecember 23, 2013 

  • Need health insurance?

    •  You can sign up via healthcare.gov from your own computer.

    •  You can contact a certified insurance agent.

    •  You can call one of the local Navigator groups to set up an appointment for them to help you through the process: The Cooperative Ministry (803) 799-3853, Greater Columbia Community Relations Council (803) 733-1129, the S.C. Progressive Network (803) 445-1921 and the Benefit Bank of S.C. (800) 726-8774.

    •  If you’re covered through your job, Medicare or Medicaid, you don’t need to do anything.

    •  Today’s deadline is to have coverage in place on Jan. 1. You still can continue to sign up for coverage through March 31.

Doug Street and Patrice Mack would like to have health insurance, but they weren’t going to let a deadline force a decision they might regret.

They spent about two hours Monday at the S.C. Progressive Network’s office getting enrolled on the Health Insurance Marketplace before deciding to take some time to think about which policy to select.

“I need to do some comparing,” Street said. “I’ll know in the next day or two.”

Street might still make the deadline for having coverage on Jan. 1, because federal health officials on Monday moved the deadline back to Tuesday. But Street and Mack said they would rather not have coverage on Jan. 1 than make a hasty decision.

They were among dozens of people in the Midlands Monday looking for help from groups hired to help new insurance shoppers through enrollment on the healthcare.gov website. The Navigator groups in the Midlands reported steady, but not overwhelming, traffic at their offices.

The Greater Columbia Community Relations Council, the Progressive Network and the Cooperative Ministry brought in extra workers. They had more than enough to handle the volume. The Community Relations Council sent some navigators home early. The Cooperative Ministry, with eight navigators at its Beltline Boulevard office, hit its first lull of the day in early afternoon. At the Progressive Network, all three navigators on duty were helping people at 1 p.m. and more appointments had been set for later in the day.

All of the navigators reported healthcare.gov was holding up well under the expected stress of the system’s first true deadline. Enrollees faced up to a 10-minute wait to get onto the website, but once into the process, online pages loaded relatively quickly.

Street and Mack said it took about two hours for their navigator to help them through the enrollment process. They could have walked out of the office with insurance, but they needed to consider the right mix of all of the details the navigator had mentioned — monthly premiums, deductibles and out-of-pocket expenses, for example.

“They did a great job of explaining it all,” Mack said.

Dawn Sullivan, a navigator at the Cooperative Ministry, said most people who come in and discover they qualify for a substantial tax credit go ahead and sign up for a policy. Those who earn enough pay to qualify only for a small tax credit or no tax credit often walk away, saying they can’t afford coverage. And the really sad cases are the ones who don’t make enough to qualify for tax credits, she said. Those people would have been covered by Medicaid if state leaders hadn’t rejected expansion of the federal health program.

Sullivan said it’s interesting to watch the transformation. “People come in thinking they can’t afford insurance,” said Sullivan, who handled six enrollments, totaling 10 people, in a recent four-hour shift at Palmetto Health Richland’s emergency room. “Then once they get the number (for their tax credit), now it’s a possibility. They get excited. It catches people off guard when they qualify for a tax credit.”

The tax credits are based on income. Individuals making up to nearly $46,000 and a family of four making nearly $94,000 qualify, but the tax credits shrink as income rises. Families at the high end of the income limits will get small tax credits, which are deducted directly from monthly insurance premiums.

The Affordable Care Act requires almost everyone to have health insurance in 2014 or face a penalty. (Those making less than about $11,500 in states that turned down Medicaid expansion are exempt from the penalty.) Originally, the deadline to have insurance coverage on Jan. 1 was Dec. 15. The Obama administration pushed that back to Dec. 23 because of the glitches with healthcare.gov in October and November. And a rush of online traffic on Monday prompted the administration to push it back another day.

In Columbia, the Community Relations Council and the Cooperative Ministry didn’t plan to have navigators on duty on Christmas Eve, but the Progressive Network planned to staff its office at 2025 Marion St.

Missing that deadline Tuesday means you won’t have coverage for a portion of the year. Insurance companies say they usually can process a new policy in two to three weeks. So if somebody signs up next week, they likely will have coverage before the end of January.

The final deadline is March 31. Anyone who signs up by then won’t face the penalty for not having coverage — 1 percent of income or $95, whichever is greater.

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