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Tuesday, July 15, 2014

Ask a Navigator: Who needs you?

Dear Navigator:
Now that is working better, why do people need your help?

A re-occurring Health Matters series
As a child I learned that you should “Never criticize a person until you've walked a mile in his moccasins.”
Most of us don’t wear moccasins anymore, but the saying still counts.

For instance, what is it like to be uninsured in Utah?
Because I’m a navigator, I meet uninsured Utahns every working day (and some weekends).
Many of the Utahns who seek help from Navigators and Certified Application Counselors (CACs) have been uninsured for many years. Some for decades. Most of them worked, but they didn’t get insurance from their employers. Some were students working on their degrees. Many were parents with small children. Many were retirees waiting for Medicare to start. Plus, a significant minority of the people who visited our offices didn’t have email addresses, let alone access to the Internet. I frequently began an enrollment appointment by saying, “Okay, let’s get you set up with an email address.” While lacking email might seem impossible in today’s world of smartphones that track your cholesterol and BMI, it’s a reality for thousands of Utahns.

Let’s face it: Signing up for health insurance is not easy. And it’s especially true if you are an immigrant, have children, are divorced, lack a credit history, or speak English as your second or third language. Not all Utahns can slip on a fitted tee-shirt and faded jeans and recline on a comfy beige couch to sign up for insurance (you know the stock photos I’m referring to).

This week the Kaiser Family Foundation released an amazing report about our work. The “Survey of Health Insurance Marketplace Assister Programs” is a must-read for anyone curious about why the U.S. uninsured rate in the U.S. has dropped 25% in the last 9 months. While the survey results are national, they ring true with Navigators and CACs who work here in Utah. For instance, 64% of assistors reported they spent an average of 1-2 hours working with each client.

So even if is working better (and it is), many Utahns still need assistance—from a single question to a four-hour appointment—to sign up for health insurance.
That’s the role of Navigators and CACs.
We are the glitch-fixers.
We are the trouble-shooters.
We are the question-answers.
And we don’t stop until you are satisfied with your choices.

What can we fix?
Lots of things.
First, incorrectly told many Utahns they qualified for Medicaid when they absolutely didn’t. This created a backlog of application transfers at Utah’s Department of Workforce Services (which wasn’t Utah’s fault). Navigators and Certified Application Counselors (CACs) could easily tell a person if they qualified for Medicaid, and get their applications unstuck (by calling’s 1-800 number) and moving again.

Second, many consumers wanted to keep their doctors. Enrollment specialists could confirm their providers would accept their new insurance. Unfortunately, too many people signed up for insurance without double-checking this important detail. Plus, some insurers published inaccurate provider lists.  As a navigator, I always made sure a client’s providers were included in their new insurance plan by calling both the providers and the insurers.

Third, I heard from several Utah consumers who signed up for insurance without being told they qualified for premium subsidies. One Summit County resident left $1,500 on the table before we were able to help him. Our goal as Navigators and CACs is to deliver the best advice to Utah consumers, which includes making them aware of all their options (like subsidies).

Will navigators be around for the next open enrollment period that beings on November 15th?
We hope so. In mid-June the federal government announced that Utah is eligible for $665,000 in grants to fund the assistance program for the 2015 enrollment. Last year Utah navigators received $806,000 distributed among three groups (including UHPP/Take Care Utah, where I work). The Take Care Utah hub is currently applying for this new round of grants for 2015. If we receive it, then Utah’s navigators and CACs will continue to be the glitch-fixers and question-answerers for thousands of Utahns who need a little extra help.

Find Out More:

Take Care Utah website
(recently re-launched)

Survey of Health Insurance Marketplace Assister Programs
Kaiser Family Foundation
July 15, 2014

2013/2014 Utah Open Enrollment Results

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