Mike Jewell didn’t have high hopes when he pulled up to MetroHealth’s insurance enrollment fair in mid-October.
Jewell – a retired teacher – and his wife have been buying health insurance from the federal Affordable Care Act marketplace for the last five years. He typically shops for a new plan each fall to make sure their premium stays low and to keep the services the couple wants. The process, he said, can be “profoundly confusing.”
This year, Jewell’s anxiety grew while watching the news: A set of federal tax credits that offset the cost of health insurance could soon expire while premiums, for the most part, are going up next year. After enrollment opened Nov. 1, he skimmed over his options almost daily. Walking into the MetroHealth fair, he had 194 plans to choose from and expected his premium to shoot up from zero dollars to $400 to $500 a month.
But Jewell left the insurance fair with a plan that would cost $175 a month for him and his wife – a plan he called “too shockingly good to pass up.” He credited the insurance agent at the fair who sold it to him. He’d never used an agent before and was skeptical about whether one would have his best interests at heart. Instead, he found someone who had answers to his questions about health savings accounts and in-network hospitals.
“To get the questions answered, it would take me three or four hours, searching through the internet and still not sure if I have the right answer,” Jewell said. “This is now using a professional that is part of the process at no charge to me.”
Professionals like this across Cuyahoga County and Ohio can help residents navigate the Affordable Care Act Marketplace for free. Some, like the insurance agent Jewell used, receive commissions from insurance companies for the plans they sell. Others, called “assisters” or certified application counselors, provide free guidance on the marketplace without getting paid by insurance. Many are volunteers.
Charlotte Rudolph is the executive director of UHCAN Ohio, a statewide health policy nonprofit that offers free assistance. She advises marketplace enrollees to take advantage of the help, especially as insurance premiums are set to grow increasingly expensive and uncertainty looms around the future of enhanced tax credits. They’re set to expire at the end of the year, but Republican senators have promised a mid-December vote on whether to extend them or not.
“Our advice is to go ahead and look at the plans now,” Rudolph said. “And get a sense of how you will be affected and start thinking about critical decisions that need to be made.”
Free health insurance help available at Ohio nonprofits
Cuyahoga County residents can call on Neighborhood Family Practice, a local non-profit health center, and UHCAN Ohio to get free assistance in navigating the marketplace.
Residents will be connected with certified application counselors, who are trained to help consumers, small businesses and their employees consider marketplace options. The counselors can help find a plan that fits residents’ budgets and medical needs, such as which doctors are in-network and which medications are covered. Counselors are available for followup after residents buy the plan, Rudolph said.
The counselors receive training from the federal government and are required to provide fair, impartial and accurate information about insurance plans. They can also help residents apply for Medicaid.
Earlier this year, the federal government cut 90% of the funding that helps pay for the free healthcare navigation program that UHCAN and Neighborhood Family Practice provide. Now, UHCAN is largely relying on volunteers to serve as certified counselors, Rudolph said. Many former workers have returned as volunteers, but the agency is still looking for more.
To schedule an appointment with UHCAN Ohio, call or text 614-505-9460. UHCAN will respond within 24 to 48 hours. Residents can get assistance in English, Somali, Nepali, Arabic and Spanish, in person or using Zoom. UHCAN is also looking for volunteers to serve as certified counselors. Those interested can apply here.
To schedule an appointment with Neighborhood Family Practice, call 216-237-6120 or 216-281-0872, ext. 2020.
Other free assistants can be found here.
Insurance agents, brokers offer personalized plan recommendations
Residents can also get free insurance advice from licensed insurance agents and brokers. There are hundreds to choose from in northeast Ohio.
Unlike certified application counselors, agents and brokers get paid by insurance companies when they sell a plan to a customer. The difference between the professions is that agents are more likely to work for one insurance company while brokers often represent a wider array.
That’s the case for Elyse Robinson, a Cleveland-area broker with Unquoting Insurance Company. She said she can sell all the plans on Ohio’s marketplace. To find the best plan, she walks residents through questions about their medications, doctor’s office (or offices) and income. Residents often want to find a plan that will cover their long-time doctors and keep prescriptions low-cost.
Insurance agents and brokers can offer personalized health plan recommendations. Certified application counselors can only explain different plan options, wrote Janet Rodriguez, who oversees the marketplace advising program with Neighborhood Family Practice.
“We do not recommend specific plans,” Rodriguez wrote. “…If a patient is primarily seeking guidance on which plan to choose, an agent or broker may be better suited to meet that need.”
To find a certified insurance broker or agent who sells marketplace plans, visit this link.
Avoid getting caught with high-cost health insurance
Even if you don’t go see an expert, Rudolph is warning residents who are currently enrolled in a marketplace plan to take steps to avoid unexpected premium price hikes.
That includes updating contact information with the marketplace and your insurer. Residents should also opt out of auto re-enrollment by December 15, she said.
“We don’t want them auto-re-enrolled until they’ve had the opportunity to look at the plans and the cost and make that decision,” Rudolph said. “So rather than have the decision being made for them, we’re encouraging them to opt out.”
Residents can also cancel auto-pay by Dec. 31 to ensure premiums aren’t taken out of their bank accounts.