The NCLR Affiliate educates our community on obtaining and using health insurance
What is the main concern Hispanic Unity of Florida hears from your community members regarding the Affordable Care Act?
Hispanic Unity counselors and navigators have heard a variety of concerns regarding the Affordable Care Act. Most of the time, the concern is about the tax penalty for not having health insurance. Consumers know that if they do not enroll for coverage they may have to pay a fee when they file their taxes. The per-person charge in 2016 will jump to $695 per adult and $347.50 per child, topping out at $2,085 per family. The income-based penalty rises to 2.5 percent of the annual income.
Another concern we have heard in the community regarding the Affordable Care Act is the lack of knowledge of the health insurance system. Most people have difficulty understanding complex terms like deductible, coinsurance, or tax credits. It is fairly understandable because this program is new for almost everybody. But, thanks to our trained navigators and certified application counselors, we can help clarify these terms to make them more understandable to our clients.
Lastly, a concern particularly true in Florida is the lack of eligibility due to low income. We hear from consumers who earn less than 100 percent of the federal poverty level that they do not understand how it is that they do not qualify for tax credits if their income is low.
How do navigators and others in your organization talk to people in your community about the value of health insurance, even for those who consider themselves healthy?
We emphasize that there are many options available no matter what their health situation is. There are plans for the healthier population while there are also plans for those who use health care services more often.
The best thing about this program is that it is not allowed to refuse coverage to anyone based on pre-existing conditions. Sick or not, these plans can work for anybody.
We also like to remind them that these plans can help people save money on out-of-pocket costs in case of a dire emergency. Our navigators inform consumers about the importance of health insurance by explaining different scenarios that could happen unexpectedly, such as getting sick or getting into an accident. We also explain the difference in costs between having insurance and not having insurance when going to the emergency room. It is important to make them understand that prevention is key. The same way they cover their cars and their homes in case of an accident and or a natural disaster, they must make their health coverage a priority. We help them understand that staying healthy to enjoy their other assets makes more sense.
Is cost a concern? Do people understand that they most likely qualify for financial assistance to enroll in a health plan? How do you help them with this concern?
Yes, premium cost is a top concern for health insurance shoppers. We help consumers understand that financial assistance is available for those who qualify. We make sure they understand that the amount of financial assistance they receive depends on income, household size, and many other factors. When we help consumers apply for coverage in the Health Insurance Marketplace, we help them find out whether they qualify for a “premium tax credit” that lowers the premium, which is the monthly amount they will have to pay to their insurance carrier.
However, we know that not everybody will qualify and some might fall into what is called the “coverage gap.” This is one of the most disconcerting barriers some of our clients ultimately face.
Are you still seeing most people come in to get covered for the first time, or are more coming in for help to re-enroll?
There is a mix of those who want to enroll for the first time and people who want to renew their current plan. There are also others who had one plan but want to switch to another plan for a variety of reasons. Also, there are people who enroll for the first time because they had a situation change such as increased income or a change in their family configuration. Most people do come to re-enroll in the program. We would say it is about 60 percent of people are re-enrolling, while 40 percent are enrolling for the first time.
The current open enrollment period ends on January 31. Find out how you can get covered!
Does Hispanic Unity of Florida offer assistance to people on how to utilize their ACA insurance once they have it?
Hispanic Unity of Florida understands people may be overwhelmed by their choices in the Marketplace. After our counselors have helped clients choose a plan that meets their specific family needs, we also help understand how to use their coverage to get the care they need. Hispanic Unity of Florida offers all sorts of assistance regarding health plans. We have knowledge of how to use the insurance plans, how to look for doctors and prescription drugs that are covered in their plan, and other inquiries about their designated health insurance company.
After their application, we help consumers understand key terms, such as copayments, deductibles, and out-of-pocket limits. Consumers always leave better informed about the Marketplace and the insurance company they applied with. If consumers have any concerns or questions regarding their health coverage, they know that they can come back to see an assister to help them get the coverage that is right for them and help them move from coverage to care.
Florida still has one of the highest rates of uninsured children in the United States. Are you seeing more community members coming in to get their children covered? Do parents understand that even if they do not qualify, they can still enroll their citizen children in coverage?
We always explain the importance of having all the family covered. No one should be left behind. We make sure our participants understand that even when they are not qualified for coverage, we can submit the application and let the Marketplace send the information to Florida KidCare (CHIP) or Medicaid to confirm their eligibility and help them.
We also explain that when it comes to enrolling children in health plans, once an application is submitted, the Health Insurance Marketplace will send their information to a designated health company (Medicaid or CHIP) so they can make a final determination. We also explain to our clients that children who do not qualify for either Medicaid or CHIP can enroll in a plan with their parents until the age of 26.