Classes provide help with health care enrollment process

  • By Rashah McChesney
  • Saturday, November 15, 2014 7:51pm
  • News

With the second open enrollment period for the Affordable Health Care Act underway, Alaskans will have another opportunity to sign up for insurance through Alaska’s online marketplace.

But, navigating the world of copays, doctors, hospitals, coinsurance and deductibles can be confusing for some and Soldotna-based Peninsula Community Health Services of Alaska is offering classes for those who are interested, mandated to sign up or uncertain about the available health insurance options.

During the bi-weekly Tuesday meetings, PCHS Certified Application Counselors Tina Wegener and Kelly Whitmore are available for an open-house style class from 7-9 p.m. at the Soldotna Prep (formerly Soldotna Middle School), 426 W. Redoubt Ave., in Soldotna, to discuss health care options and guide applicants through the process of finding access to health insurance in Alaska.

In addition to the Affordable Care Act marketplace, Wegener said the two also guide people through Denali Care, Medicare and Veterans Administration benefits that may be available.

“There’s a fear factor that’s a part of insurance and especially for people who haven’t had insurance before, there’s a huge fear factor,” Wegener said. “Even people who already have insurance, they’re wondering, ‘How is this going to affect me with the insurance that I have, or the insurance that I’m losing or the insurance I might be changing?’”

PCHS offered the same classes during the 2013 enrollment period, and while attendance was steady, people didn’t seem ready to commit to signing up through the exchange, Wegener said.

PCHS counselors assisted more than 2,000 people during the first open-enrollment period, according to Wegener’s data. Of that, about 500 used PCHA to help enroll in an insurance plan.

“The response was there, but there was not a lot of follow-up,” she said. “This year, there’s a lot of follow-up. There are people coming into class and I’m answering their questions and they’re following up with me by calling or emailing.”

Some people who attend the classes don’t qualify for coverage under the health insurance marketplace or other state and federal aid programs in Alaska, either because they make less than the $14,580 cutoff or because they do not meet the age requirements for Medicaid and Medicare.

Another common problem on the Kenai Peninsula, Wegener said, is people who have not filed taxes regularly. Under the ACA, there are penalties, or individual mandate fees, for those who do not carry health insurance.

“It’s a common roadblock,” she said. “They’re living off of the grid. If they don’t file taxes … they’re not going to be paying the penalty fees because — as of this point — the IRS wouldn’t know they exist.”

For those who decide to sign up for health insurance, being off-the-grid can present a problem.

“They need to have proof that you exist,” Wegener said.

The IRS is also tasked with keeping track of the fees assessed to those who have not signed up for health insurance.

For those who did not sign up in 2014, the fee is 1 percent of a person’s yearly household income, or $95 per person for the year — half that for a child under 18. The maximum penalty per family is $285.

But, those penalties increase. In 2015 the fine will be 2 percent of the yearly household income or $325 per person — whichever is larger. The maximum penalty for a family increases to $975.

The fees have come as a rude shock for some who were waiting to see if the law would be overturned or changed before signing up for health insurance.

“People are starting to understand, ‘Wait a minute, this is going to hurt me,’” Wegener said.

Other problems that Peninsula residents seem to have regularly are that they lack the proper paperwork, have language barriers, or live in hyper-rural areas that make it difficult for insurance counselors to find and educate them.

“I hiked to a little Russian village last year and met with the townspeople there and helped as many as I could,” Wegener said. “A few of them signed up. We just don’t have access to towns or to communities the way the Lower 48 does.”

Despite all of the complications, Wegener said she is happy to help and carries around a set of six binders to refer to when people present her with their insurance problems.

“I refer to them every day and if I can’t find the answer to your question, Google can,” she said.

She said the people who signed up for insurance last year seemed to be mostly pleased with the results.

“There’s a thankfulness there with the people who haven’t had insurance before. Now they have access to health care and they’re not going to have those huge overwhelming bills that can happen when they go to the emergency room,” Wegener said. “Now they can go to the doctor, they can have their mammograms done, they can have their preventative services done. They’re grateful.”

 

Reach Rashah McChesney at rashah.mcchesney@peninsulaclarion.com.

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