Residents face shorter health insurance enrollment period

Central Montana Medical Center’s Business Office Manager Andrea Martin overseas staff who submit claims to insurance, as well as bills to patients, making her all too aware of the true costs of medical care.

Photo by Jenny Gessaman

By: 
JENNY GESSAMAN
Reporter
Central Montanans using the Health Insurance Marketplace have a tight deadline this year: The Marketplace opens Nov. 1, but will close on Dec. 15, cutting the enrollment period from three months to 45 days.

As a case manager for the Central Montana Community Health Center, Cherie Errecart is familiar with the Marketplace. She’s also acquainted with people’s general attitude towards health insurance.

“People are unhappy they have to buy health insurance,” she said. “They say, ‘I’m healthy, why do I need to buy this?’”

Errecart’s also seen dislike spring from the complexity of figuring out which plan to choose on the Marketplace. As a certified application counselor, part of her job is helping clients understand how the site works, and how insurance plans work.

With a little work, though, Errecart believes people can understand how to enroll, and compare options to find the best plan for them. It may not be the simplest, or most entertaining experience, but Errecart labeled it essential.

“Take a basic scenario,” she said. “We had a man come in who could not walk. He needed two hip replacements and worked full time.”

Errecart worked with the patient to find health insurance, and he later had not only his hips replaced, but several other health issues treated as well.

“He would have been unable to do that without health insurance,” she said.

Health insurance is not only helpful for big medical issues, according to Errecart. She estimated a general comprehensive visit at the Health Center, whether a follow-up or a check-up, cost roughly $200 before insurance or sliding scales.

The cost could increase based on the length of the visit, or testing needed.

Andrea Martin, business office manager at Central Montana Medical Center, pointed out even recurring anticipated medical costs could be unaffordable without insurance.

“My husband has rheumatoid arthritis, which is a chronic condition,” she said. “If he didn’t have insurance, his medicine would be beyond our ability.”

For Martin, that would be tens of thousands of dollars beyond. She pointed out the same is true for those with diabetes, asthma and other chronic conditions.

Martin has heard several reasons for not getting health insurance, from car insurance covering accidents to the size of after-insurance costs. She said car insurance policies normally have a cap for medical costs, and after-insurance costs are usually small compared to initial charges.

“People don’t realize that yes, you owe $2,500, but before insurance, it was $250,000,” she said. “I think we know healthcare is expensive, but we’re unrealistic about how expensive it really is.”

Those numbers are not impractical, either, according to Martin. She estimated it was a minimum of $500 before insurance just to set foot in the ER.

The government has provided an additional incentive to enroll, imposing a fee for those without health insurance. According to HealthCare.gov, this year’s fee was calculated two ways, as an income percentage and per person.

The final fee was whichever number was higher. The per person maximum was $2,085, while the percentage income maximum was the total yearly premium, nationally averaged, of a bronze-level Marketplace plan.

Martin encourages Central Montana residents to find a health insurance plan.

“We just need to be conscience of open enrollment if you don’t currently have insurance, or if you already go through [the Marketplace],” she said.



Starting is simple

• Open enrollment dates: Nov. 1 – Dec. 15

• What you need: Everything on the one-page checklist at https://marketplace.cms.gov/outreach-and-education/marketplace-application-checklist.pdf

• Where: Online at www.healthcare.gov, over the phone at 1-800-318-2596, or through the mail

• For more information: Schedule an appointment with Cherie at 535-6545, or look through the Marketplace Quick Guide at https://www.healthcare.gov/quick-guide/

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