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.
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.
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.
There are many marketplaces, as each state as their own. All the marketplaces have different funding sources, based on what type of marketplace it is:
FFM: Federally facilitated marketplace
SPM: State partnered marketplace. The federal government has some role in this.
SBM: State based marketplace and the fed has no role in it.
higher priced the plan, but also the more coverage. Enrollment by Metal?
are choosing Silver plans
There are still consumer problems using the Marketplace:
An inability to complete application on line
Applications get “stuck” (freeze) or lost