Daily Sitka Sentinel

Health Care Help at Hand; Deadline Nears

By SHANNON HAUGLAND
Sentinel Staff Writer
    The deadline for signing up for health insurance under the federal Affordable Care Act is Friday, but there’s still enough time and plenty of opportunities to sign up before then – and to get the help you need, says Andrea Thomas, SEARHC outreach and enrollment manager.
    Thomas, two other outreach and enrollment specialists at SEARHC here and one in Juneau, are answering questions on the phone and meeting with Sitkans in one-on-one appointments to answer insurance questions, enroll uninsured people, update information of those covered, and also to enroll people in Medicaid.
    The federally certified health care specialists in Thomas’ office here, as well as in Juneau, have taken hundreds of calls in the past few months helping people get coverage.

Health care specialist Andrea Thomas answers questions, today. (Sentinel Photo)

    Last week was particularly busy, she said.
    “People are feeling the pinch, at long last,” Thomas said.
    Uninsured people will not be able to sign up for 2018 health care coverage after the Dec. 15 deadline.
    “If you’re over-income for Medicaid, or aren’t insured, and not offered insurance at your place of work, this is the one and only window of time to get health insurance from the marketplace, or directly from an insurance company,” Thomas said. “If you miss it, you are uninsured for all of 2018. December 15th is it.”
    Thomas said that although she and her fellow enrollment specialists are busy, appointments are still available this week to walk through the sign-up process. “If we start getting a lot of calls we can extend our hours,” she said.
    The uninsured are generally in three categories, she said: those eligible for Medicaid; those who are eligible for the ACA Marketplace, most of whom can get some federal help paying premiums; and those who are “over-income” and ineligible for federal help with premiums. They may purchase insurance directly from a private company or use an unregulated health care sharing ministry, which is a co-op.
    “It’s unregulated, but better than nothing,” Thomas said, of the health care sharing ministries.
    Several plans are available through the health insurance marketplace, which in Alaska consists of only one participating company, Blue Cross Blue Shield.
    Monthly premiums are set based on the type of coverage the enrollee wants, age, family size, income and location.
    Thomas noted that the full cost of health insurance went down by 26 percent in Alaska for next year, in part through a state reinsurance plan, so even those without insurance or using a health co-op may want to call her for help before Dec. 15 to re-evaluate their situation.
    “It (the cost) may have dropped enough to be affordable,” Thomas said.   
    Preventative health care is covered under all plans. The two catastrophic insurance options have higher deductibles, and more out-of-pocket expenses. Two “silver” category plans have a lower deductible and out-of-pocket expenses. Those with more health care needs opt for the most expensive “gold” plan.
    Thomas said it’s important that people covered under the ACA to update income information every year, since those making more than they expected will be hit with a penalty at tax time.
    “It’s every important to renew every year because the subsidies you get are based on your 2018 income,” she said. “If you make more, you get less assistance. ... You need to keep your insurance up-to-date, and we help people do that. People come in year-round and we can help them update their information.”
    Those who are not available for a daytime appointment with a local specialist have other options – the healthcare.gov website, or the toll free number 800-318-2596. The disadvantage of those options is that they may not provide information on plans specific to Alaska, Thomas noted. She also cautioned that people should beware of fraudulent health care websites.
    Those who want to sign up for health care coverage during an appointment at SEARHC can do so, and the confidential process takes about an hour, Thomas said.
    “We go through the whole process,” she said. “Our job is to explain things, get an account set up, put in the income, explain the different choices and help people enroll in the plan that works best.”
    Enrollees go home with a packet of information to help them understand how to use their coverage, how to pay the first premium and how to work with the insurance company.
    “After enrollment we’re here to help with people running into difficulties,” Thomas said.
    Medicaid enrollment takes less time, she added. Enrollment in Medicaid is open year-round, but now is a good time to make an appointment with the SEARHC specialists, who can complete an enrollment during the visit.
    There are exceptions to the Dec. 15 deadline for a number of special enrollment situations, such as cases where a person loses coverage or becomes newly eligible for coverage.
    The office at SEARHC is a certified application counseling organization, funded by the federal Health Resources and Services Administration and a federal Connecting Kids to Coverage grant.
    The outreach and enrollment specialists can be reached at the following numbers. If you get an answering machine leave your number and your call will be returned.
    Andrea Thomas 966-8883
    Susan Briles 966-8662
    Michaela Dunlap 966-8920
    Mariah Enloe (in Juneau) (907) 364-4589
    “We’re here to help people figure things out,” Thomas said. The service is free.