By Jenny Neyman
The clock is ticking on the open enrollment period to sign up for heath insurance under the Affordable Care Act, but navigating the acronym-laden options, deciphering plan benefits and the pressure of making the best decision for your health and your wallet can be a real headache. Peninsula Community Health Services is there to help.
Tina Minster is a health insurance “navigator” with PCHS, specializing in outreach and enrollment. Friday, she set up shop for three hours in the Soldotna Public Library, and had 20 people come visit with her, and takes her services much farther afield, as well.
“I host events, I do follow-up appointments, I go to people’s homes that may not be able to get out. I’ll go to coffee shops, I’ve been down to the beach while people are dip-netting,” she said. “I’ve been on the boat with people, fishing captains that are going to need help. I’ll take my pocket full of business cards, and wherever I go I’ll be standing in a grocery line, ‘Hey, do you need help understanding what your responsibilities are? Do you have insurance? Do you know anyone that needs insurance?’ I’m kind of outgoing, so that really helps a lot.”
She fields a lot of questions about Medicaid and Medicare and can walk people through the enrollment process online on healthcare.gov to see if they qualify for subsidies under the Affordable Care Act. If Minster can’t answer a question, she can refer to someone who can, such as a private insurance broker, Native health services or veterans health services.
Her last client of the day, Betty, and her husband are trying to figure out heath care coverage now that they’re retired. She’s covered under Indian Health Services, but isn’t sure how to integrate that with the Affordable Care Act — or “Obamacare” — while her husband is trying to decide how much coverage he needs under Medicare.
“Which way do you go? When can you get signed up? So we’re trying to get that in order, and he wants to be completely covered, like Medicare A, B and C and supplemental,” Betty said.
They want to take care of their health, but don’t want to spend any more than they have to.
“And then with me, I have Indian Heath Services, so have the exemption with that with Obamacare,” she said. “And I’m on Social Security. So you’re retired, this is what you get — you get Part A, and there’s certain things it covers, then Part B covers something else, but I want to know the advantages of why should I get Part B,” Betty said.
It gets pretty complicated.
“I don’t know which way to go,” she said. “And then, am I taking a chance if I travel? How do I get to them (IHS) if I need to go to a hospital? How do I check ahead? What if something happens to me? If I’m knocked out, does my husband call and say, ‘OK, you need to cover this?’”
After a discussion, Betty left with a clearer idea of her options and a contact phone number with IHS.
“That’s where having somebody like me here locally that knows the other resources out there and the other points of contact to talk to makes it easier for her,” Minster said. “Where before she was just like, ‘I don’t know where to turn, I don’t know what to do,’ and now she knows.”
Adding to the confusion is a recent change to Medicaid in Alaska. The income level at which people qualify for the program was raised as of Sept. 1, so now more people are eligible for coverage, but they might not know it.
“‘Oh, I applied two years ago and I was denied.’ Well, no, Sept. 1st, everything changed. So if you think you qualify, call us,” she said.
The cost of health insurance in Alaska is another stumbling block for people. Cost went up another 37 percent this year, after 30 percent the year before.
Minster can’t do anything about that, but she can at least try to explain it to people.
“Staying educated and being aware of what’s going on politically and locally is a big part of this,” she said. “The simplest way I can explain it (rising health insurance costs in Alaska) is a lot more people have health insurance that are not as healthy and they’re now having their health needs met, versus healthy people to offset those costs.”
As complex as the system can be, Minster said she enjoys the opportunity to help people.
“I’ve seen people’s lives dramatically change — people that have stage 4 cancer now can get the services that they need. Young people that are healthy and doing totally great get minimal coverage and then, boom, they get into some kind of an accident. And now instead of facing astronomical costs they’re facing part of the costs. So, it’s been a good thing,” she said.
Open enrollment for health insurance under the Affordable Care Act ends Jan. 31, but anyone wanting coverage to begin Jan. 1 needs to sign up by Dec. 15. Under the law, anyone without health care coverage could be assessed a fine.
Minster says she lets everyone know their rights and responsibilities under the law and explains the options they have, but doesn’t make any decisions for them.
“Any situation — insured, uninsured — we’re just here to help people understand what the law is, what their rights and responsibilities are, and if they want the individual help, we can certainly give that to them, as well,” she said.
To speak to a navigator on the central peninsula, call PCHS at 260-3119. Similar services exist throughout the state. To find help near you, visit localhelp.healthcare.gov and search by your zip code.