Partners will help navigate insurance options

YOURCOUNTY
Jim Baumgart  Sheboygan County Supervisor

The Affordable Care Act has been the law of the land for a while. Present benefits include allowing your children to be on your policy longer (age 26), you no longer can be turned down by an insurance company for an existing medical condition, insurance coverage amount is no longer an issue, it requires preventive care coverage, it requires insurance companies to spend a minimum of their income on those they insure or you will get a partial rebate, along with a variety of other rules that are presently in place helping individuals and families.

Now comes the next step. Starting October 1st begins the process of signing up some 40 million people (nationwide) not presently insured or underinsured so they can be covered starting January of 2014.

In Sheboygan County, four insurance companies (Exchanges) will available in choosing coverage.

All of Wisconsin will be covered by at least two insurance Exchanges and at least 68 percent of the state will have at least four insurance Exchange options available.

To help educate citizens on the new insurance exchanges, six organizations in Wisconsin have been provided federal financial grants. Partners for Community Development, Inc., located in the Sheboygan area, obtained one of the grants. They will be involved in what is called an Exchange Navigator Program, Once staffed, they will perform outreach functions to support consumers in accessing the expanded subsidized health insurance program that best fits them and/or their family.

Partners goal is to facilitate the enrollment of the uninsured and underinsured in the Federally -facilitated Exchange. While reaching out to everyone, they will provide special emphasis on reaching out to Hispanic and Hmong families and other hard to reach consumers in Door, Kewaunee, Manitowoc, Ozaukee and Sheboygan Counties.

Navigators will serve as an in-person resource for Americans who want additional assistance in shopping for and enrolling in plans in the Health Insurance Marketplace starting in October.

A goal of the Navigators, through a variety of outreach and enrollment efforts in their service area, is to help hard to reach consumers and families with limited English proficiency, by utilizing community connections and partnerships.

Partners’ Navigators will provide accurate, unbiased information to help individuals and families gain coverage and enroll in an appropriate health plan. Navigators are intended to play a critical role in helping Wisconsin realize the federal vision of a customer-friendly “one-stop shopping” approach that will allow consumers to enroll in health coverage as seamlessly as possible.

Partners, during the grant period, will be hiring two full-time and three part-time Navigators to enroll some 7,000 eligible consumers and their families in qualified health plans through the Federallyfacilitated (insurance) Exchange.

This new sign-up insurance exchange program is for the uninsured and underinsured. People with existing health insurance coverage through their employer will not be affected. People who are on and continue to stay on the state’s Badger Care program will not be affected.

It should be noted, insurance coverage for low income families is based on a sliding-scale. And, this column will follow up with information when the Exchange Navigator Program is up and running (October 1st) as well as where people can get help for understanding the program and to get their insurance questions answered.


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