This past week I attended a useful and interesting meeting, NHF’s Social Worker Insurance Marketplace Workshop (funded by Baxter Healthcare and Pfizer Inc; thanks guys!).
Together with about 80 social workers from HTCs around the country, and some
chapter leaders, we listened to various consultants and government
representatives speak primarily about the “Marketplace,” the website of the Affordable
Care Act that allows people to choose a healthcare plan.

We’ve all heard about the difficulties in dealing with this website— healthcare.gov—such as the
crash, and various other glitches. The good news is that many of these glitches have been fixed; and now it’s time to get our bleeding disorder community on board. Healthcare insurance is mandatory now; all US citizens (with notable exceptions) must have insurance. The website is created to help people find the lowest cost insurance that also provides all their essential healthcare needs.

There is plenty of assistance in navigating the website. We actually tried the website live,
and it was pretty interesting, and yes, we even got stuck once or twice! For
us, we were stuck trying to find out if our HTC hematologist was in-network.

Each website will have on-line or Internet guides, to help you live. They are called various
names: Assisters, navigators, certified application counselors, in-person assistance, marketplace call center, agents and brokers. Most people are used to calling them “Navigators.” (I can’t help but think of “Engineers,” a la Ridley Scott’s Prometheus)

Jim Romano, from Patient Services Inc (PSI), gave a
presentation about how PSI has been chosen to train qualified applicants to
become  Certified Application Counselors (CAC), to
help people navigate the Marketplace. This is truly a great coup for PSI, and I
can’t think of any other group better qualified to train. PSI will train CACs
in different states, and pay their fees (yes, you have to pay for the pleasure to become a CAC to help people navigate their state Marketplace! One point from an audience member who underwent the training: the training wasn’t very hemophilia-focused, and needs to be more focused.

Different healthcare plans are designated by “metal.” The more precious the metal, the
higher priced the plan, but also the more coverage. Enrollment by Metal?

                  60%
are choosing Silver plans

20% Bronze

13% gold

7% Platinum

1% catastrophic plans

There are still consumer problems using the Marketplace:
An inability to complete application on line

Applications get “stuck” (freeze) or lost

Info is not transmitted after the plan is submitted

If not sure you’re insured, call insurance company (not the website) to check

If you don’t pay 1st month premium by certain date, you will not get insurance!

Don’t despair! I found it actually fun to hop on Colorado’s state Marketplace and select a plan.

Another useful website is Marketplace.cms.gov, which has FAQs, tip sheets, paper application, and materials in Spanish. And Healthcare.gov, which does premium estimate, on line application. When you log on, you will see this banner!

Enroll by February 15 for coverage starting March 1

So contact your social worker for help if you are not yet enrolled; don’t miss the deadline!