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Ormond Beach Observer Monday, Oct. 7, 2013 4 years ago

Affordable Care Act functionality expected to get smoother with time

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With open enrollment for"Obamacare" open until March 31, local officials recommend waiting awhile before seeking out a plan.

BY WAYNE GRANT | STAFF WRITER

There’s no need to rush in finding an insurance plan under the Affordable Care Act (also known as "Obamacare"), according to David Weiss, director of marketing and communications for the Health Planning Council of Northeast Florida.

“They are not going to run out of plans,” he said. “There’s no advantage to signing up today rather than a few weeks from now.”

Coverage starts Jan. 1, and to be covered by then, a person would need to enroll by Dec. 15. After Dec. 15, applicants would be covered the following month. Open enrollment runs until March 31.

But according to Bob Decker, president and CEO of the local navigator office, Mental Health America of East Central Florida, in Daytona Beach: Waiting might be the best bet for many residents.

His company, which received a federal grant to help residents in Volusia, Flagler, Putnam, St. Johns, Orange and Brevard counties find their way through the application process, has been busy, he says. Decker has four navigators on staff, and because the marketplace is still so new, he says, many of them have gotten complaints from people reporting having trouble with the website, or not being able to get through by phone.

But he expects that to get better.

“It’ll take a little time to get the glitches out,” he said.

Mark Cunningham, a Mitchell Noel Insurance Agency salesman certified to navigate the "marketplace" (the platform for all qualifying health policies), also touts the benefits of going through a private firm.

“The difference is you’re talking to a licensed insurance agent who is knowledgeable,” he said. “The navigators are only trained in helping people get through the website.”

He said the enrollment is just getting started, but he has “seen some people.”

Those already covered by insurance, he added, can also take out a policy, if qualified. So he expects the new health care law to be good for his business.

“You’re going to have more people buying insurance,” he said.

Weiss encourages people to take their time figuring out what policy is be best for them or their family.

“A navigator may not be available when you call, but if you leave a message, they will get back to you,” he said.

Get covered: click or call

Users can apply for the Affordable Care Act online, at healthcare.gov. Or, call 800-318-2596 for recorded answers to frequently asked questions (855-889-4325 for the hearing-impaired). Lines are open 24/7.

For further assistance, call the Health Planning Council of Northeast Florida, at 866-295-5955, or visit nefloridacounts.org,

Make an appointment with a local navigator by calling Mental Health America of East Central Florida, at 531 S. Ridgewood Ave., in Daytona Beach, at 252-5785. The office will assist anyone but specializes in users with mental illness. "“We’ll reach out to individuals with mental illness,” President and CEO David Weiss said. “That’s our target market.”

Affordable Care Act quick facts

Here are some quick facts about the Affordable Care Act, paraphrased from the healthcare.gov website:

• Health care exchanges for the Affordable Care Act opened Tuesday, Oct. 1. Most people must have coverage in 2014 or pay a fee: $95 per adult, $47.50 per child or 1% of income, whichever is higher. Some people might qualify for a fee exemption.

• Under the Affordable Care Act, insurance plans can’t refuse to cover people who have a pre-existing condition, or charge sick people higher rates than healthy people. They also can’t refuse to cover treatments for pre-existing conditions. Many preventive services, like routine checkups, must be covered with no out-of-pocket cost to the patient.

• All insurance plans offered through the marketplace must cover emergency services, hospitalization, maternity and newborn care, outpatient care, mental health and substance-abuse services, prescriptions, laboratory services, pediatric services, rehabilitative services and devices, chronic disease management and preventive/wellness services.

• People eligible for insurance through their employer could switch to a marketplace plan, but they wouldn’t qualify for lower costs based on income unless the job-based insurance is unaffordable or doesn’t meet Affordable Care Act requirements.

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