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Sat, Jul 12, 2014

COMMUNITY MATTERS: Help available for insurance enrollment

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MURFREESBORO, Tenn. -- The Patient Protection and Affordable Care Act marketplace is now open and many people have questions about how this new law will affect them.

The terminology alone can make anyone uncomfortable when trying to navigate the websites and applications that are involved.

With the help of Kathleen Kennedy and Terri Woodmore at the Tennessee Primary Care Association and Beth Uselton at the Baptist Healing Trust, I have pulled together a brief overview to answer many of your questions.

In Rutherford County, there are two federally qualified health centers.

Each location has certified assistance counselors who can answer questions and help individuals enroll: the Primary Care and Hope Clinic, located at 1435 Hope Way in Murfreesboro, and the Matthew Walker Comprehensive Health Center, located at 739 President Place, Suite 100, in Smyrna.

For residents wishing to go to the Murfreesboro clinic, Cindy Rhea is the person who can help. She can be reached at 615-893-9390, ext. 208.

Julie Warner-Morris, who works at the Smyrna clinic, is also available to help residents. She can be contacted at 615-327-9400.

What information will you need?

In order to enroll, residents will need the following information for every household member whether in person, online, or by phone: Social Security number or document number for lawfully present immigrants, employer and income information like pay stubs, W-2 forms and tax statements, and policy numbers for any current health insurance plans.

You will also need a completed “Employer Coverage Tool” worksheet for every job-based plan anyone in the household is eligible for. The worksheet can be found online at

When is the enrollment deadline?

Individuals must have enrolled in an insurance plan and paid their first premium by Monday, Dec. 23, to be covered on Jan. 1, 2014.

Open enrollment in the marketplace is scheduled to close on March 31, 2014.

After that date, individuals may only enroll if they have a qualifying event, such as loss of job, change in marital or family status.

Following enrollment, individuals may contact their carrier after 48 hours to determine their status or find out how to make a payment if they did not pay online.

The process for enrolling in the marketplace is the same for everyone, whether you are a student, retired, a part-time employee or a small-business owner.

For a variety of reasons, there will be individuals who, after completing the process, will not qualify for an insurance plan through the marketplace.

Navigators and certified assistance counselors may be able to help these individuals explore other options.

How does the program help you?

First of all, it’s an easier way to shop for health insurance because the federally funded marketplace  has all your options in one place.

With one application, you can compare plans and explore any free or low-cost programs you may qualify for.

Secondly, most people can reduce the cost of their monthly premium and out-of-pocket expenses, though some have had to pay more due to the new regulations.

And finally, the marketplace is designed to give consumers more control by allowing them to compare plans based on what is important to you and letting you choose the combination of price and coverage that fits your needs and your budget.

You have most likely heard the key features of the Affordable Care Act, but here are several changes that protect consumers: There are no discriminations based on pre-existing conditions, children will be able to stay on their parent’s plan until they are 26 years old, improved preventative care health coverage, and there are prescription discounts for seniors

The law also bans insurance companies from imposing lifetime dollar limits on health benefits, which is designed to free cancer patients and individuals suffering from other chronic diseases from having to worry about going without treatment.

For more information, call Kathleen Kennedy at the Tennessee Primary Care Association at 615-425-5904 or the national hotline at 800-318-2596.

Call the marketplace consumer assistance line at 1-800-318-2596.

Tagged under  Baptist Healing Trust, Community Matters, Health Care, Insurance, Obamacare, Tennessee Primary Care Association

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