KVHC navigators make health plan sign up easy

By Gloria Austin
Staff Writer
By the end of March, every American — regardless of age — will have to be covered by health insurance or pay a penalty for not having any coverage.
The Affordable Care Act, initiated in January, will allow for enrollment until March 31 before penalties are applied. People can visit what is called the “Marketplace,” opened Oct. 1, 2013, as a way for individuals, families or small businesses to shop for coverage in one place.    “The open enrollment is coming to an end soon,” said Megan Day, Katahdin Valley Health Care eligibility coordinator. “We are trying to get the word out.”
KVHC in Patten will be the site of an insurance information forum on March 6 at 5 p.m. Similar forums will be held in Houlton and Millinocket at later dates.
“People do not have to wait for the forum,” said Day. “They can call and set up an appointment anytime.”
The whole Affordable Care Act or “Obamacare” has caused much concern and controversy, sending people into a tailspin.
KVHC professionals want to help people sort through all the confusion to find a plan that is right for them. KVHC staff will aid people in navigating through the Marketplace to understand coverage at four levels — Bronze, Silver, Gold or Platinum — and insurance plans are offered by two companies.
“There are no requirements that say if someone comes in, they have to enroll in a plan that day,” said Day. “We are available to answer questions. We can go through the Marketplace application with people and review the plans.”
“A person can go all the way through the process and see the prices and decide not to choose one,” added Tina McNinch, eligibility assistant.
The decision is still left to the individual as to what plan works for a household’s or business’ coverage needs. There are also exemptions that can be made.
“Every person is going to get a monthly premium under different plans based on their own information,” Day explained. “We are not going to make recommendations to people because we may not necessarily know what their needs are. We will, however, go over each plan with them, dissecting each plan to help them choose what is best for them.”
“The way the Marketplace works, the plans can be put up side by side for comparison,” said McNinch. “The coverage is listed and it makes it easier for the consumer.”
“We do not want to lead anyone, we just want them to make the best decision for themselves,” added Day.
All the plans in the Marketplace are required to cover certain wellness basics such as preventative/wellness; prescriptions; emergency room care and maternity.
“There are a lot of people who are not comfortable getting on the website,” said Day. “They find it overwhelming. They can set up an appointment with us and we will go through the process with them.”
When coming in to review the Marketplace, people should bring the following with them: Social Security numbers for household members; proof of income and email passwords if they have one set up.
“We can open a free email for them or the application can be done over the telephone,” said Day.
KVHC encompasses Island Falls, Patten, Millinocket, Ashland and Houlton areas.
“Anything that is said when they meet with us is confidential,” Day said. “We shred all documents that are left,” added McNinch. “We try to send them out the door with everything they brought in. We want people to know the security of their personal information is our number one priority.”
The waiting period before a person is covered varies.
“If people fill out the application online, they immediately get their prices,” explained Day. “If they enroll that day and pay their premium, a guideline shows the date of coverage.”
If someone chooses not to purchase coverage, the penalty for 2014 is $95 per adult or 1 percent of taxable income and $47.50 for children. The largest penalty that can be charged is up to $285 for a family. However, in 2015, 2 percent of a person’s taxable income or $325 per person. In 2016 and later years, it is 2.5 percent of your taxable income or $695 per person.
“If someone is uninsured for part of the year, one twelfth of the yearly penalty is applied each month they are uninsured,” Day said. “If it is less than three months then there is no penalty.”
McNinch noted that they have seen some happy people, who have gone years without health insurance and never thought they could afford it. It all depends on income and where someone falls within the poverty line.”
“We go over the positives of the Act,” said Day. “We encourage people to check it out to see if it is affordable. In the end, they have to make the decision for themselves.”
“To check it out is free,” McNinch added. “The goal is for the uninsured to have a chance to be insured.”
To find out more visit healthcare.gov or www.kvhc.org. To set up an appointment or for more information, call KVHC at 1-866-366-5842.