En español | You can get more than a banana split at the Ye Ole Fashioned Ice Cream and Sandwich Cafe in Summerville, S.C. You can get health insurance.
That’s because Shelli Quenga and her band of navigators go wherever they can to make sure that South Carolinians get the help they need to enroll in the Affordable Care Act (ACA) Health Insurance Marketplace.
ACA open enrollment begins Nov. 1 and ends Dec. 15. The sign-up period was cut in half this year, leaving consumers with less time to review their options and fill out the marketplace application.
"Navigator" is the name the ACA gives to people throughout the country who assist individuals with the enrollment process. They review the basics of health insurance, help people fill out the online application, and explain how the federal subsidies — which lower the monthly premium and defray the cost of deductibles and copays — work.
Quenga works for the Palmetto Project, a nonprofit social services organization in South Carolina. Most navigators around the country are based at community health centers, nonprofits or other social services groups.
Palmetto’s navigators usually spend a minimum of 45 minutes with each client. Applicants can schedule appointments by phone or via Palmetto’s website. Before their appointment, clients are briefed on the pertinent documents they need to bring with them.
Quenga’s team members not only go where the people are, they work when it’s most convenient for their clients. “We don’t want people to lose a day’s pay to sign up for health insurance,” she says, so her team works on weekends and evenings.
That’s where Ye Ole Fashioned comes in.
Palmetto navigators first went to the ice cream shop in 2015 because its employees asked for help. Friends and acquaintances of the employees also came by. Then the word spread: You could go to Ye Ole Fashioned and get health insurance assistance while enjoying an ice cream cone or sundae.
“We started setting up in a corner booth,” Quenga says. “We just hang out there and help.” Anna Cardenas, Ye Ole’s manager, says she and her fellow workers appreciate the assistance because they found the website complicated. Her customers also like the guidance.
“I think it’s really awesome,” Cardenas says. “People can come in and get ice cream and a sandwich and eat while they’re signing up for insurance.” Palmetto’s team also goes to libraries and community centers by day and fast-food restaurants and coffee shops at night.
Often navigators have to deal with other issues. For example, you can’t sign up for a health marketplace plan without an email address, and it’s not unusual for a navigator to help a client set up an email account.
A navigator also reviews a client’s list of doctors and medications to help find a plan with a network that includes those doctors and that covers the applicant’s drugs with reasonable copays.
“The great thing about having an in-person appointment or calling and speaking with someone in our office is that we’re not operating off a script. We have time to walk through a person’s individual situation,” Quenga says.
This year Quenga and her team have their hands full. She had 62 navigators last year but has only 30 to deploy this year because the amount of the federal grant that paid for their services was cut. “It’s going to be crazy,” Quenga says.
Consumers who want in-person assistance with open enrollment can go to localhelp.healthcare.gov, enter their zip code and find a list of nearby navigators.