ACA partners’ goals: Outreach, education and enrollment

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“All our navigators have gone through training and background checks,” said McCluan.

Line, whose agency is responsible for ACA enrollment throughout 10 Pennsylvania counties said no one’s personal information has been compromised.

“We don’t keep anyone’s information, and neither do our navigators,” she said. “And we do not divulge any information to other agencies.”

Both recommended that when people enroll make sure they see the healthcare.gov url at the top of the screen, as hackers have created links to fake home pages they created for state-run ACA sites like the one for Washington, D.C. There are no reports of the federal site, which Pennsylvanians must use, being copied.

But McGee said customers still have to be wary.

“And another thing to remember is we don’t solicit,” she said. “So, if someone contacts you to say they are calling to sign you up for an ACA, it’s not us. It’s a scam.”

As to reports of people paying two or three times as much as before, some are true, but so is the reverse. Some people who never had insurance before are paying very little—and some of them could not have gotten insurance before the ACA passed due to pre-existing medical conditions.

“One of the pitfalls is people don’t understand how the ACA can benefit them,” said Line. “I recently enrolled a 21-year-old, part-time worker who makes $13,000 per year into a Silver plan for 12 cents a month. It’s not a Medicaid plan, it’s an Independence Blue Cross policy.

That particular plan is not available in Allegheny County, but McGee said she enrolled a 21-year-old, locally, for $20 a month. In total, there are three approved policy providers in Allegheny County: UPMC, Highmark and HealthAmerica. Between them they offer eight Bronze plans, 13 Silver plans, 13 Gold plans and one Platinum plan.

Consumers need to know two things about these plans: the lowest level (Bronze) plans have the least expensive monthly premiums, but also the highest deductible, covering only 60 percent of services—and only after the client has paid their portion.

Subsidies available for individuals and families up to 400 percent of the federal poverty level do not apply to Bronze plans. They can be applied to reduce the cost of premiums and, in some cases, out-of-pocket expenses on Silver-level plans and above.

Silver policies cover 70 percent of the back end costs, Gold policies cover 80 percent, and Platinum policies cover 90 percent. Consumers need to weigh their expected usage of services against their coverage level.

People who need frequent hospital, testing and lab services will want a plan that covers more of the back-end costs. Those who do not anticipate using much beyond an annual physical and routine office visits will probably want the lower deductable, but everyone is different. And that’s where AIU and its partner organizations can help.

Those partners providing outreach, information and enrollment include:

• the Consumer Health Coalition, 412-456-1877 ext. 200;

• Enroll America, 718-483-4986;

• the Pennsylvania Health Access Network, 412-512-9225;

• Planned Parenthood of Western Pennsylvania, 412-258-9539; and

• The Squirrel Hill Health Center, 412-904-5285.

Outreach and information coordination services are also being provided by

• the Carnegie Presbyterian Church, 412-225-7550, and

• the Jewish Healthcare Foundation, 412-594-2559.

Right now, McGee said, their focus is on outreach because a lot of people who need help getting through the enrollment process don’t know that the AIU and its partners are here to do just that, or how to reach them.

The AIU is conducting education and outreach sessions throughout the county, most recently at its headquarters in the Waterfront in Homestead. For those who do not have a computer, McGee said she or one of her fellow navigators will take them to a convenient library or community center and walk them through the process.

McGee can be reached directly at 412-576-3297.

(Send comments to cmorrow@new­pitts­burgh­courier.com.)

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