If you’re in need of healthcare for the 2015 year, you have less than two months to sign up through the insurance marketplace.
If you’re feeling a little nervous, don’t be. So far 2.5 million new individuals have signed up since enrollment opened again in November.
Since the rollout of the Affordable Care Act—or Obamacare as it commonly called—last year, the number of Americans without health insurance declined by 10.3 million, according to a report from the Department of Health and Human Services.
Some of those millions have been without health insurance for some time because of various circumstances. Some never had a health plan in their life.
“I was without insurance for 10 years,” said Carly Stone, who enrolled just a few weeks ago. “It was never a huge priority in the past for me to have it. However, as I’ve gotten older and have settled down more, all I can think about is how one uninsured ER visit could put me in debt for years.”
A lot of men and women in their 20s and 30s have had the same cavalier attitude toward healthcare, which is why President Obama has tried to reach out to young adults via “The Tonight Show with Jimmy Fallon” and the Zach Galifianakis web series, “Between Two Ferns” to remind them of the importance of healthcare.
In the past, most college-aged adults age out of their parents’ insurance plan, which means they’re uninsured until they find a job that offers medical benefits. Now through the ACA, children can remain on their parent’s plan until the age of 26, even if they’re married.
Lacey Berry, 26, was an early adopter to the marketplace after she was no longer eligible on her parents’ plan. She pays just $17 a month for insurance, which she said is “pretty incredible.”
Berry was not immune to the reported issues of the first enrollment period.
“The first year I applied, I had so much trouble with the website that I ended up calling the marketplace,” she said.
More than a year later, Stone reported having similar issues.
“The website is exhaustively dysfunctional,” she said. “The first snags were with actually trying to navigate through the site. Then it informed me that I wasn’t eligible for any subsidies, which made no sense.”
In the end, she found a plan for $43. It’s the first time she’s been able to afford health insurance since she was on her parents’ plan.
“I make too much money to be approved for Medicaid, but not enough to afford health insurance. It has been a struggle indeed,” she said of the decade without a healthcare plan.
Berry suggests signing up over the phone, which can take about 30 minutes.
“I was very happy with the ease of the transaction that I did it again this year,” she said. “The customer service reps are friendly and make the process pretty painless.”
Navigating the system
Both Stone and Berry agree that a little help goes a long way. From the marketplace helpline, to healthcare representatives that visit your work, there’s someone available to answer your questions.
You could also go the route of a navigator.
Cory Brown, program manager of stability services and benefits at 90Works, helps families and individuals enroll for high-quality plans as a licensed navigator.
“Customers we have assisted range from households with no income and households that have income. We also assist small businesses with their employees’ health insurance needs,” Brown said.
Assistance can be done at the 90Works office or offsite. And better yet, the service is free.
90Works is a non-profit that works with families to overcome homelessness, poverty and family violence and have always assisted its clients with enrolling for Florida KidCare and Medicaid before assisting people with enrolling through the ACA last year.
“Making a choice for an insurance plan can be very overwhelming to someone who is unfamiliar with health insurance,” Brown said. “Navigators are able to answer many of their questions and concerns and explain their options.”
The navigators can also help with the application process, explaining eligibility results and offer advice in choosing a plan that best fits their client’s healthcare needs. The whole process takes about an hour—just one lunch break.
The kind of clients who come in to the 90Works office are from all walks of life, and most end up leaving the office pleased with their results, Brown said.
The caution sign
Of the clients seen at 90Works, several have lost health insurance after reduced work hours. Some fall below the federal poverty level, but still do not meet the qualifications for Medicaid.
“These individuals fall into the ‘Medicaid gap’ because of Florida not expanding Medicaid,” Brown explained.
In the United States, about 4 million uninsured adults remain so without the expansion. In Florida, about 800,000 individuals are in that gray area.
Under the ACA, Florida could offer Medicaid to Florida residents with incomes up to 138 percent of the federal poverty level—$27,310 for a family of three. Instead the annual income eligibility is set for a maximum of $6,930 for a family of three.
Despite the numbers, Florida leaders have voted not to expand Medicaid for the past two years. These uninsured people are left to visit free clinics, pay high out-of-pocket costs or leave their medical bills delinquent. In the last 90 days, the Florida Department of Health in Escambia County, which offers clinical services to women and children as well as dental services, had more than 1,300 visits.
Oftentimes people just ignore their health needs.
The marketplace plans do provide peace of mind for the relatively healthy, but for individuals like Sarah Humlie, it didn’t quite meet all needs.
Humlie does not have medical benefits through her job at a local non-profit, which doesn’t have the funds to support healthcare. If same-sex marriage were legal in the state of Florida, she could join her wife’s insurance plan.
Humlie took to the healthcare marketplace in search for a plan when enrollment first opened up.
“I had to have some kind of coverage,” she said.
As a healthy 32-year-old woman, Humlie was not prepared for the issues she started facing this year. Earlier this month, she was diagnosed with endometrial cancer. Even with her insurance, she has spent thousands of dollars in doctor visits and surgeries.
When she signs up for 2015 coverage, she said she’ll be looking at plans that cover more, but they may come with a higher price tag.
When it comes to enrolling yourself or your family, healthcare veterans Berry and Stone advise to do your research and don’t procrastinate.
“Take a look at plans you’ve had in the past and figure out what your preferences are in terms of deductible, out-of-pocket expenses and copay,” Berry said.
And don’t forget of the lifeline available at 90Works.
“90Works has a long history of helping the medically uninsured get insured and have access to quality health care,” said Cate Jordan, the organization’s executive director in a recent press release. “We are looking forward to functioning as the expert for advocacy and education for the community’s health insurance needs in Northwest Florida.”
Contact 90Works at 855-909-6757 ext. 5 to get connected with a health insurance navigator. Think you can go it alone? Sign up today at healthcare.gov. The deadline is Feb. 15.
As seen in Independent News