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Health deadline March 31

'Navigators' can help people pick plan

The March 31 deadline for people to enroll for health insurance for 2014 using the federal Health Insurance Marketplace is here in a week.

And that means a growing workload for the health care navigators, who help people use the marketplace.

The Allegheny Intermediate Unit, based in Homestead, hired two new navigators in February to assist people in Butler and Beaver counties.

Tom Franz, one of the new navigators, focuses primarily on Butler County.

“We are all working hard to make sure that those who want to sit with a navigator ... have that service available to them,” said Franz of Muddy Creek Township.

He is helping people sign up from 8 a.m. to 4 p.m. today and next Monday at the Community Health Clinic of Butler County, 103 Bonnie Drive, Summit Township, and from 8 a.m. to 4 p.m. Friday at the Center for Community Resources, 212-214 S. Main St., Suite 625. He also is available by appointment.

He noted that he and the other navigator use a secure Wi-Fi, no public Wi-Fi networks, to help people sign up.

Franz said he generally allots two hours per person.

Since the beginning of February, he has helped 35 people. He also has taken numerous calls from those who have quick questions.

He said people mainly are buying silver level plans, which require patients pay 30 percent of their costs. However, he also said that some are going for bronze plans, which have a low premium but require patients to pay 40 percent of their costs.

He said the people he has helped have come from all ages, levels of employment and income ranges.

“It’s really been across the spectrum,” Franz said.

After the March 31 deadline, he said work will slow, but not stop.

“There’s still going to be people in need,” Franz said.

He also tries to direct people to the main marketplace website, www.healthcare.gov, and to the 24/7 federal help line, 800-318-2596.

To sign up for a plan, call 724-290-8256 or send an e-mail to thomas.franz@aiu3.net.

The Hospital Council of Western Pennsylvania, based in Warrendale, has had a part-time enrollment counselor since early February.

Pat Raffaele, council vice president for professional services, said members of the council board were interested in offering an enrollment counselor when they knew that the marketplace was opening. She said Allegheny County has many navigators and counselors, but more rural counties have few.

Katie Montgomery, certified enrollment counselor at the council, said she has helped sign up about 50 people since she started.

“It’s been pretty steady,” Montgomery said.

Raffaele said business has picked up since March 1, due to the deadline.

“They kind of waited until the last minute,” Raffaele said.

Montgomery said the Highmark Community Blue plan, which is among the most affordable available, has been the most commonly selected. However, if the applicants have a UPMC doctor, they have been choosing UPMC plans.

When the marketplace opened last year, the website had problems. But the kinks seems to have been worked out.

“The website seems to be working smoothly,” Montgomery said.

For the most part, she said the people signing up have been from Butler, Beaver and northern Allegheny counties. She said she has seen a variety of people signing up, with no typical customer.

“I’ve had just about everything,” Montgomery said.

To sign up at the council, call Raffaele at 724-772-7202 or e-mail Montgomery at montgomk@hcwp.org.

Jennifer Grybosky, western region marketplace navigator with Mental Health America of Westmoreland County, has been helping people in the western part of the state sign up for insurance since October.

“I’m getting probably about a hundred calls a day,” Grybosky said.

She has been meeting with about 20 people per week, and she has signed up about a dozen people from Butler County.

She said that the most common plans people have signed up for are Highmark Community Blue offerings. Generally, people are looking for low premiums and affordable deductibles.

“People are looking for the most affordable plans,” Grybosky said.

To sign up, send an e-mail to westernPAnav@mhawc.org or call 855-274-5626.

The Community Health Clinic has heard a lot of questions about insurance.

Beth Foringer, clinic director of case management, said it has been getting about five calls a day about the marketplace, especially with the deadline approaching.

“Definitely within the past month,” Foringer said.

She said that the regular hours on Mondays by Allegheny Intermediate Unit navigators have been successful.

The clinic sees about 1,000 patients per year. She said the goal is to have half of them be able to afford insurance through the ACA, but she said that likely is not possible.

Individuals, as well as families, with no insurance between the ages of 19 and 64 meeting certain income requirements are eligible to use the clinic’s services.

She said there is a concern that, with so many people getting insurance, that there will not be enough primary care physicians to handle all of the new patients. She said the clinic may modify its eligibility requirements in the future to help those with insurance who are unable to find a doctor.

Foringer said some people have asked what the clinic will do if a significant number sign up for insurance. She noted that the clinic still exists for people in transition, such as those who lose their job and cannot immediately sign up in the marketplace.

“We’re really a safety net for our community,” Foringer said.

The federal Health Insurance Marketplace, which opened Oct. 1, was established by the Affordable Care Act.

To find navigators, computer users can go to www.healthcare.gov and click on “Find Local Help.” Users will be directed to enter their ZIP code and find the closest agencies offering help.

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