Navigating health care — Dec. 15 deadline looms for ACA enrollment

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December 1, 2017 - 12:00 AM

Kelli Frazell’s days can be a roller coaster of emotions.

One encounter may bring high-fives. Another, an apology and a wish the circumstances were different.

Frazell is a Navigator with Thrive Allen County. It’s her job to help people find health insurance through the Affordable Care Act.

“For some, they say ‘Wow! I’ve never had health insurance before,” she said. “They can’t believe they can see a doctor for little to nothing.”

For others, there’s no way to sugarcoat it. Their incomes simply are not enough to put them above the Federal Poverty Level, and because Kansas has not expanded Medicaid, they fall into the “Medicaid Gap,” where they make too much to qualify for Medicaid and too little for assistance through the ACA.

“Those are heart-breakers,” Frazell said.

For individuals, they must make above $12,060 to qualify for assistance with their health insurance, for a family of two, at least $16,240, three, $20,042 and four, $24,600.

For those who qualify, the tax credits are paid directly to the insurance provider to help cover their premiums.

Of the 158 applicants seen across November, 28 individuals or families live below the Federal Poverty Level, and almost half live between 100 percent and 200 percent of it.

If Kansas were to expand Medicaid, another 460 among the community would be eligible for health insurance, said Lisse Regehr, who helps oversee Thrive’s insurance enrollment program. About 10 percent of Allen Countians do not have health insurance of any sort.

The next two weeks are a crucial period for area Navigators such as Frazell. The sign-up period for insurance through the Marketplace closes Dec. 15 — a full four weeks shorter than previous years.

That narrow six-week window is worrisome to Navigators because though the numbers of enrollees exceeds those of previous years, time is running short.

 

A SECOND message they want to broadcast is that even though some consumers think there’s no need to apply because their incomes are too low, they should register anyway, because if their circumstances change — say they take on at G&W Foods — then they will be “in the system” and can receive benefits within 60 days.

“There are several ways consumers can become eligible for insurance,” said Regehr.  

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