February 29, 2024

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Nancy Vaughan column: Navigators essential to understanding health insurance options | Columns

Amid the avalanche of Medicare enrollment messages, one could easily miss the other major health care enrollment season: marketplace health insurance.

From Nov. 1 to Jan. 15, people who are not eligible for Medicare, Medicaid or employer insurance can shop health care plans at Healthcare.gov. However, there is a lot more to just logging onto the site to understand the most affordable options. That’s why free assistance is available through a network of licensed navigators supported by Covering Kids and Families of Indiana (CKF).

This year, marketplace plans have been made more affordable through cost sharing that includes lower deductibles and extra savings options, and increased tax credits that offset premium costs. Most people will qualify for some type of assistance.

Navigators can help people determine their final cost of plans. They can also help ensure that plans are accepted by the medical providers that people choose.

Finally, navigators can enroll those who are income eligible in an appropriate public plan, such as the Healthy Indiana Plan (HIP), Medicaid, or the Children’s Health Insurance Program (CHIP).

Since the passage of the Affordable Care Act (ACA) in 2010, marketplace enrollment has been a key focus of CKF, along with ongoing efforts to reach out to uninsured persons who qualify for one of the public options. Some additional considerations of the Federal Marketplace:

Coverage begins on the first day of the month following application.

More Hoosiers than ever qualify for a free plan.

Current Marketplace customers may find a lower cost plan this year as plans have been made even more affordable.

Consumers should beware of solicitations that appear to be marketplace-compliant plans, but do not offer the essential ACA elements.

Key elements of ACA-compliant plans include free wellness checks, out-of-pocket maximums, no lifetime limits, and no exclusion of preexisting conditions.

After January 15, the marketplace will be an option only for those with a change in circumstance such as loss of employment-sponsored coverage. Public option enrollment is open year-round for qualified applicants.

Heart of Indiana United Way in Madison County has sponsored the local CKF coalition since 2009. CKF Coalition Director Julie Barton facilitates outreach opportunities and information sharing among the many navigators employed by hospitals and health centers in Madison County. Navigators are also partnering with the Madison County Health Department to offer information and enrollment opportunities at its mobile unit stops.

Wherever one lives in Indiana, CKF navigators can help with health insurance information and enrollment. Appointments, including virtual options, can be made at www.ckfindiana.org or by calling 1-888-975-4CKF. Information is also available by calling 211 or calling Heart of Indiana United Way at 765-643-7493.

Nancy Vaughan is chief operating officer of Heart of Indiana United Way. She can be reached at [email protected] or 765-608-3061.