SYRACUSE — HealtheConnections Health Planning is spearheading the navigator program for Onondaga County to help consumers as they pursue the purchase of health-care coverage through NY State of Health, the state’s health-insurance exchange. The New York State Department of Health and NY State of Health chose the Syracuse–based organization to lead the local navigator program, […]
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The New York State Department of Health and NY State of Health chose the Syracuse–based organization to lead the local navigator program, the organization announced Sept. 10.
NY State of Health is New York’s health-plan marketplace for purchasing health-care coverage under the Patient Protection and Affordable Care Act, the federal health-care reform law.
NY State of Health on Oct. 8 announced that over 40,000 New Yorkers had signed up for health insurance in the exchange’s first week of operation, “more than any other state reporting thus far,” according to a news release on the NY State of Health website.
The HealtheConnections navigator program is designed to reach individuals, sole proprietors and employers, and its target audience is uninsured and underinsured individuals, the organization said.
Nearly 40,000 individuals in Onondaga County, amounting to about 8 percent of the population of the county, are uninsured, according to HealtheConnections.
Of those, more than half (54 percent) are employed, the organization said.
New York’s navigator program requires each county to designate individuals at select organizations to facilitate access to health insurance.
HealtheConnections Health Planning is partnering with four community agencies to provide navigators who are located near and “culturally engaged” with their respective neighborhoods, the organization said in a news release.
The partner agencies include Benefit Specialists of NY, Northside Urban Partnership, the Salvation Army, and the South Side Innovation Center, according to HealtheConnections.
Each agency will have one navigator available to provide services that include educating potential enrollees about the health-plan marketplace, the types of available health-insurance plans, and opportunities for tax credits and cost-sharing.
In addition, the agencies will provide facilitated enrollment into plans available through the marketplace, which include Medicaid and Child Health Plus. They’ll also assist with plan renewals and appeals, according to HealtheConnections.
The role of the navigator is to assist individuals in person, says Sara Wall Bollinger, executive director for health planning at HealtheConnections.
“So, the focus is on people who find, for whatever reason, that enrolling through the 800 number or the website didn’t work for them,” Bollinger says.
The website for NY State of Health (https://nystateofhealth.ny.gov) lists the number at 1-855-355-5777.
Those needing help locally can also call (315) 470-1847 to set up an appointment with a local navigator, Bollinger says.
“Essentially, we will meet people wherever they need [to meet],” says Bollinger, noting they can meet with applicants in libraries, community centers, and the Onondaga Nation Health Center, if need be.
The process to get consumers signed up for coverage involves two parts, which includes determining an individual’s premium support and choosing the plan that’s right for the person and his or her family, Bollinger says.
The process starts with an assessment of a consumer’s personal-income situation, which is based on a person’s 2012 New York state tax return.
“So, if you a have a 2012 tax return in New York state, pretty much all the information you’ll need is going to be there,” Bollinger says.
Once the navigator helps the applicant determine the amount of the subsidy credit for which he or she is eligible, the consumer then chooses coverage from the bronze, silver, gold, and platinum levels and the companies that offer coverage in the area.
“You might have a choice of 10 or 12 different insurance coverage [options] to look at and so you have to think about that and take your time,” Bollinger says.
“We’ll go through doctors. We’ll go through prescriptions and just try and make the process as easy as we can for each person,” says Stacy Sturdevant, a navigator who’s based at the Salvation Army of the Syracuse area at 677 South Salina St.
Armed with a laptop computer, Sturdevant also offers her services at other sites, including the Onondaga Nation Health Center on the third Friday of every month to help people enroll, she says.
Sturdevant trained a total of 24 hours over a three-day period and had to pass a certification exam, she says.
But the training is ongoing. “The training’s not done yet,” Sturdevant adds.
The navigators will also participate in webinars to keep themselves up to date on what they need to know.
HealtheConnections Health Planning is a service of HealtheConnections, a regional health-information organization which provides health-information exchange and electronic-health record adoption services to the medical community in Central New York, according to its website.
Contact Reinhardt at ereinhardt@cnybj.com