Consumers New To Health Insurance Face Learning Curve

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Healthcare navigator Jessica May (right) goes over different plans with Shelby Conrad, 60, of Clintonville.(Photo: Thomas Bradley, WOSU Public Media)
Healthcare navigator Jessica May (right) goes over different plans with Shelby Conrad, 60, of Clintonville.(Photo: Thomas Bradley, WOSU Public Media)

Monday is the deadline to sign up through the federal healthcare exchange to get coverage by January First. The process was frustrating until the website improved, but people who have never had insurance faced a steep learning curve. WOSU met with one woman who received a crash course in private insurance.

By all accounts, Shelby Conrad, of Clintonville, is an informed consumer. She’s even worked in the medical industry. But she has not had health insurance in a long time.

So as she shopped for an insurance plan on healthcare.gov, she received an education.

“How the heck do the deductibles work?”

Conrad isn’t alone. For many people who’ve never had insurance – or haven’t had it in some time – they’re quickly learning about premiums, co-pays and deductibles.

In Conrad’s case, the teaching fell to her healthcare navigator who helped guide her through the process.

Lisa Hamler-Fugitt leads a team of navigators at the Ohio Association of Foodbanks.

“It’s elementary education for folks who haven’t had the experience,” she said.

Hamler-Fugitt said if you’ve never had insurance or relied on a company plan there’s a new language to learn.

“This is private health insurance, meaning that you are going to have to pay a premium even if you do receive the premium tax credit. There are going to be co-pays, out-of-pocket expenses and deductibles,” she said. “So, again, this is terminology that many of us are familiar with. But for many new to the system of private health insurance it is, it’s all new.”

On this day, Conrad is at the Foodbanks Association, for a second time, working with her healthcare navigator, Jessica May.

“That’s actually a little bit more [expensive] because remember you qualified for some additional help on that silver level,” May said after tallying up the cost of the deductible and monthly premiums.

May is helping Conrad compare costs between insurance providers.

Using the on-line tools, Conrad narrowed her choice to plans with monthly premiums she could afford. Then she learned about deductibles, and suddenly that affordable plan had a $6,000 deductible. She’d have to pay six grand out of pocket before her benefits kicked in.

“Right now, it looks like I would have to go into savings to do this, that I couldn’t do it on current income,” Conrad said.

We asked her if her federal subsidy wasn’t what she had expected.

“No,” Conrad replied. “It’s the concept of working with the deductibles.”

It did not help that the on-line calculator that told Conrad what plans she could afford failed to include the deductible cost.

Hamler-Fugitt said seen “sticker shock” for those new to the system.

“Private health insurance is pretty mystifying for most of us that even have it. So for those who don’t have it this is new to them. And it, you know, it’s about managing expectations,” she said.

Hamler-Fugitt encourages people discouraged with the process to find a navigator to help explain the convoluted system.

“We recognize that while we talk about everybody being connected there are a lot of folks that aren’t connected. Certainly, lower-income folks can’t afford $100 a month on high-speed internet. They don’t have smart phones. Help is available in your community. Don’t give up.”

Conrad left the Foodbanks Association without signing up with a provider, though she had plans to return another day to go over the coverage one more time.

Comments
  • disqus_Rrj1iJCDh1

    If the Gov’t is going to force you to purchase (over-priced) insurance, you’d think they’d make it super-easy to acquire. But as the disasters of the past decade have illustrated, everything they attempt is a failure.