Navigating Your Health Insurance Options

Under the ACA, states had the option to apply for a number of federal grants to help implement federal health care reform. One such grant was for a customer assistance program, to help states field questions and concerns from individual consumers in the market for private health insurance (i.e. excluding Medicare, Medicaid, and CHIP coverage).

21 states and D.C. chose to apply for this grant, and their residents will likely have an easier time navigating the new system as private insurance companies meet new standards for coverage and costs.

 

Residents of the many states that did not apply for a grant will still have somewhere to turn for help.  First, individuals may contact their state insurance department or ombudsman's office.  Second, some community organizations have stepped up to the plate to take on the task of educating the public  Finally, consumers and small businesses will receive assistance if they choose to enroll in a plan on their state's online insurance exchange, or by calling the exchange's toll-free help center.

This morning, an NPR's health blog gave an example of how one New York woman has already benefitted greatly from N.Y.'s customer assistance program:

Maryanne Rice called Community Health Advocates, New York's Consumer Assistance Program, when she got hit with a $50 copayment for a bone density scan she had in January to check for osteoporosis. Under the ACA, preventive screenings recommended by the U.S. Preventive Services Task Force are covered without any out-of-pocket cost to the patient.

Rice, who lives in Canastota, N.Y., was just a few months shy of her 65th birthday when she had the test, which is recommended for women age 65 or older. Her CAP advocate argued successfully on her behalf that she should receive the preventive screening without shouldering any of the cost.

Although N.Y. and other states have already received portions of an initial $30M grant, additional funding for these programs remains unsettled.