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home : local news : local news June 25, 2016

10/29/2013 1:17:00 PM
Local health department offering help in dealing with ACA
The upcoming changes in health care - particularly those concerning health insurance - can be confusing, especially for people not used to dealing with insurance.

Fortunately, the Crawford County Health Department has counselors trained to help people navigate their way through the system.

Under the Affordable Care Act, all Americans must have health insurance by Jan. 1 or face potentially stiff tax penalties. This means many people - including younger people who have never had their own health insurance because they were healthy and didn't believe they needed it - are faced with finding the coverage that is right for them, their families and their bank accounts.

"We're here to help people navigate through the new system," In-Person Counselor Kim Decker said.

"Which is quite a feat," fellow counselor Stephen Rich added, explaining that with anything new there are misunderstandings that need cleared up.

"We want to help people learn about the system and how it works so they can get the right insurance for their exact needs at that exact time," he said.

Decker and Rich have completed about 60 hours of training to be able to work with local residents in need of insurance help. They started last week. They have both now been certified as in-person counselors by the Illinois Department of Insurance.

They explained that during an initial meeting, they provide information that helps a person make an informed decision about eligibility and which plan works best based on his or her financial situation and medical needs. They will go online with the person and help them fill out applications if need be.

They can also refer them if they need additional help. They do not make recommendations on which policy to get. They emphasized that it is not their function to recommend which insurance company a person should go to, but only to present all the options a person might have.

For an appointment, call 544-8798. Most appointments are at the CCHD offices, 202 N. Bline, Robinson. However, Rich and Decker can come to a person's home if they are unable to come to the department for reasons such as disabilities. They can also schedule meetings for evening hours if need be.

"We can work around people's schedules," they said.

Many people are already covered and have no need to worry. People on Medicare or Medicaid are already covered, as are those with insurance through their jobs. Those who have no insurance, however, have two basic options.

One of the biggest changes in health insurance is a massive expansion of Illinois' Medicaid program. People ages 19 to 64 may qualify for its adult care coverage, depending on their incomes.

Under the "marketplace" portion of the new law, a household can earn up to 400 percent of the federal poverty level and still qualify at some level. A family of four with an annual income of up to $94,000, for example, can get tax credits for insurance costs. A family of four with an income of up to $58,000 can qualify for cost sharing to help them with items such as deductibles and co-payments.

The marketplace provides an assortment of private companies offering health insurance. In Illinois, those are Aetna, Coventry Health and Life, Coventry Health Care, Health Alliance Medical Plans, Heath Care Service Corp.(Blue Cross), Humana Health Care, Humana Insurance Co., and Land of Lincoln Health.

People can compare the options offered by the companies and apply for the policies that best suit them. They can apply on line using the state website - - or the federal website - - or by calling a toll-free number - 1-866-311-1119 (state) or 1-800-318-2596 (federal).

Open enrollment for people applying for health insurance is now through March 31. Most years it runs from Oct. 15 to Dec. 7.

Carriers can no longer refuse someone coverage or charge them extra for pre-existing conditions. Also, preventative measures, such as vaccinations, are to be paid for in full. Minimum essential care, such as emergency room and doctor's office visits, will still have co- payments of deductibles.

Rich said they can also help small businesses with 50 employees or less that need to provide coverage. Business owners should contact them.

Other area groups, such as the Embarras River Basin Agency, are also offering health insurance help. Rich and Decker said they hope to organize a community outreach in which they will all come together to provide more information to the public.

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