SANFORD — The first person who signed up for health insurance coverage under the Affordable Care Act with the help of certified “navigators” at York County Community Action Corporation is saving about $280 a month.
The woman, whose name the navigators can’t reveal because of federal medical privacy laws, has been paying $400 a month for a health insurance policy with a hefty, $10,000 deductible, said Robin Hewitt Bibber of YCCAC.
Under the Affordable Care Act, the woman, who qualifies for tax credits and a subsidy, will pay $120 a month for combined health and dental insurance.
Not only is the new plan much less expensive, it provides better coverage, said Bekah Hayes, also of YCCAC.
Bibber, along with Celyn Reed of Nasson Health Center, which is a program of YCCAC, are certified navigators through the Maine Health Marketplace, where folks who don’t have insurance or are looking for a better deal can get information and help with the enrollment process.
As well, those engaged in the lobster industry and their families have another option for information. The Maine Lobstermen’s Association has a navigator, April Gilmore, who has been getting the word out to fishermen and their families along the coast.
She said there’s been a lot of interest and expects that will pick up toward the end of the year.
“We’re letting the fishing community know we’re there,” through newsletters, weekly emails to its 1,200 members and information on the association’s website, Gilmore said.
For those who haven’t had insurance in the past, the enrollment process and all the talk about co-pays and deductibles and formularies can be baffling and overwhelming, said Bibber. That’s why the community action corporation has been hosting forums around the county ”“ with more scheduled.
“We’ve connected with about 700 people” in the past six weeks, estimated Hayes, who supervises the navigators at YCCAC. They’ve have helped enroll 15 to 20 individuals, but that number doesn’t take into consideration folks who gather information from the navigators and then enroll on their own.
“People are looking at their options before they enroll,” said Hayes.
Coverage is aimed at the uninsured, either because they’re self-employed, the company they’re working for doesn’t offer insurance, they’re part-time workers who don’t work enough hours to qualify for their company’s insurance program, or they’re stuck in a high-deductible plan because they can’t afford anything better.
Some, who have been skeptical of the Affordable Care Act, also known as Obamacare, are changing their view after learning more, Bibber said.
“They’re finding it isn’t as horrible as they thought,” she said.
Open enrollment for the new health care system began Oct. 1 and ends March 31. And while there are problems with online enrollment ”“ the website www.healthcare.gov isn’t working properly ”“ Bibber said folks may still sign up by telephone, or with a paper application. People must be signed up by Dec. 15 for coverage that begins Jan. 1.
Tax credits, available for those at up to 400 percent of poverty level, or about $94,000 a year for a family of four, helps with premium costs and can be sent directly from the government to the insurance company, Bibber said. Subsidies help with co-pays, deductibles and out-of-pocket expenses for those under 250 percent of the poverty level; for a family of four, that works out to an household income of about $58,000 a year, she explained.
Those who don’t enroll for coverage face a penalty. For 2014, she said, that is $95 or 1 percent of their income, whichever is greater. That increases to $340 or 2 percent of income, whichever is greater, in 2015, and to $695 or 2.5 percent of income, again, whichever is greater, in 2016.
About 70,000 Mainers who would qualify for coverage under MaineCare ”“ had Gov. Paul LePage not vetoed the expansion ”“ can get an exemption from the penalty, she said. The Legislature is expected to re-address the expansion of MaineCare when it reconvenes in January.
At YCCAC, Bibber said she has been fielding 20 phone calls per day about the health care plan. Reed, her counterpart at Nasson Health Center, has had a similar number of inquiries, and the closer it gets to Dec. 15, the more they expect, Bibber said.
Gilmore, at the Maine Lobstermen’s Association, said the agency is happy to help fishermen and their families, and they to plan give presentations in coastal communities and assistance through individual appointments.
Both Gilmore and Bibber recommend the website www.enroll207.com as a resource.
To reach Gilmore, call 976-4555 or email april@mainelobstermen.org.
For Bibber, call 459-2989 or email her at robin.bibber@yccac.org.
— Senior Staff Writer Tammy Wells can be contacted at 324-4444 (local call in Sanford) or 282-1535, ext. 327 or twells@journaltribune.com.
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