Navigators 'swamped' by St. Lawrence County residents signing up for health insurance on state exchange
Sunday, January 5, 2014 - 8:38 am

By JIMMY LAWTON

Nearly 241,000 New Yorkers have purchased insurance on the New York Health Exchange and while local figures are not currently available, an insurance navigator at the St. Lawrence Health Initiative says her office has been swamped.

“We’ve seen about 400 unduplicated appointments,” said Ann Marie Snell at the Health Initiative. “We’ve had about 650 appointments total if you count the people who came in for duplicate appointments,” she said.

Snell said the schedule at the Health Initiative is pretty full, but other agencies serving as navigators aren’t seeing the same traffic.

Sheryl Evans at ACR Health in Canton said the ACR has signed up well over 1,000 people across nine counties in Northern New York, but has had less than 100 appointments here in St. Lawrence County. She encouraged anyone seeking help with the state’s health exchange to contact her office and make an appointment.

“My schedule is flexible and we can take appointments. For people with travel limitations we can even come out to meet them,” she said.

Not Too Late

Although the deadline for health insurance effective Jan. 1 was Dec. 24, Snell says there is still plenty of time to sign up.

She said individuals, families and small businesses have extended open enrollment this year into March of 2014. She said anyone who enrolls now will have insurance about thirty days later, with insurance going into effective Feb. 1, March 1, or April 1, depending on when the person enrolls.

Snell said there are also exceptions that will allow enrollment anytime of the year. She said native Americans can sign up for insurance at anytime. She said “qualifying life events” such as a pregnancy, losing a job or insurance coverage and other exceptions will also allow people to enroll outside of the open dates.

People signing up for Medicaid can do so at any time.

Snell said signing up for insurance is fairly easy, she said the trickiest part is choosing a plan.

“Everyone’s situation is different so it can be tricky for them to decide. It’s something you need to think on,” she said.

Keep Earnings Current

Snell said an important thing to remember when filling out an application is to make sure to accurately guess your projected income.

She said people should be diligent in reporting changes in income as it affects the amount of government subsidies one would receive.

She said overestimating income could mean losing on tax credits, while underestimating could result in a payment due when the Internal Revenue Service compares the true income with the projected income during tax season.

“The federal government is going to reconcile what (applicants) said they would make with their actual income,” she said. “The government is basically giving people an advance on a tax credit. If the numbers aren’t right they are going to ask for it back.”

Snell said customers who have signed up for insurance can simply log into their accounts and report additional earnings on the NY Health Exchange website.

“It’s very easy to do,” she said.

Preventative Care, Pre-existing Conditions

Snell said an aspect people may have overlooked in the Affordable Care Act is a provision that forces insurance companies to cover preventative care. She said everyone should be aware that preventative coverage will be covered even if the deductible has not been met.

“That means people should be afraid get mammograms or colonoscopies because their deductibles aren’t met,” she said. “Those costs are covered separate from the deductible.”

Evans said the Affordable Care Act also bars insurance companies from denying coverage or charging people with pre-existing health conditions higher rates.

She said people who once paid exorbitant amounts for their plans are now charged equally by insurance providers.

Evans and Snell said the vast majority of people they have worked with were surprised at the affordability of insurance, but acknowledged every case is different.

“People are finding that it is very affordable with the tax premiums. Most people are paying less than what they were paying.”

Help Available

Anyone in need of assistance is urged to contact one of the agencies that have professionals trained to help guide people through the process.

In St. Lawrence County professional help can be found at:

• ACR in Canton, 101 Main Street, Canton, 13617, 386-4493

• Community Health Center in Canton, 4 Commerce Lane, Canton, 13617, 386 – 8191

• St. Lawrence County Chamber of Commerce, 101 Main Street Canton, 13617, 386-4000.

• Health Initiative, 439 New York 56, Potsdam, 13676, 261-4760

Additional assistance is available online at http://www.nystateofhealth.ny.gov/