Staying Fit
With open enrollment for most Affordable Care Act (ACA) health marketplaces ending Dec. 18 2019, consumers are being advised to not wait until the last minute to seek help figuring out which plans are best for their health care needs.
ACA enrollees can get personalized help unraveling the details of health care coverage, which can be complicated and confusing. Consumers can go to healthcare.gov and click on the “Find Local Help” tab to get contact information for trained assisters and local insurance agents and brokers. They can also call the marketplace hotline (800-318-2596), which is available seven days a week, 24 hours a day.
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Both the federal and state marketplaces have trained people — called navigators — who can help consumers review the basics of health insurance, walk them through filling out the online application and explain how federal subsidies for premiums and cost sharing work.
“Don’t wait to the last minute to seek help,” says Karen Pollitz, a senior fellow at the nonpartisan Kaiser Family Foundation. “The lines could be especially long this year because there just aren’t as many assisters who are not paid by insurance companies.”
Pollitz says the navigators, who have gone through the federally paid training, and volunteers, who receive more limited training, provide in-person assistance; telephone assistance is also available through the federal government’s call center. Unlike insurance agents and brokers, the navigators and volunteer assisters have no financial stake in the plans people select.
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Federal funding for ACA open enrollment has been cut in recent years. Jodi Ray, a faculty member at the University of South Florida in Tampa, runs Florida’s navigator program, which has lost 85 percent of its federal funding in recent years. The state had an average of 152 paid navigators throughout the year but now is down to about 50. Navigators not only help marketplace enrollees renew and change coverage, they also help people enrolling for the first time.
“We’ve tried to be real creative in our approach,” Ray says. “One way we’re trying to provide services is offering virtual and phone appointments to anyone in the state.” She’s also been working with community organizations, especially in places with language and cultural barriers. Many health centers also help their patients complete the enrollment process.
“We don’t make a recommendation” for a particular plan, Ray says. “Our job is to make sure you understand enough that you feel you are confident in the decision you make.”
