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Published: Wednesday, 10/2/2013 - Updated: 11 months ago

Local agencies preparing to ‘navigate’ health plan

BY MARLENE HARRIS-TAYLOR
BLADE STAFF WRITER
Doni Miller, chief executive with the Neighborhood Health Association outlines the new national health insurance program. Behind her is Kim Kensler, who hopes to obtain insurance. Doni Miller, chief executive with the Neighborhood Health Association outlines the new national health insurance program. Behind her is Kim Kensler, who hopes to obtain insurance.
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Oct. 1 was a date that Kim Kensler had anticipated for months.

For 10 years, the 58-year-old Toledo woman has struggled to find a full-time job with benefits and spent many of those years with no health-care coverage for herself or her two sons.

As one of the more than 50,000 people in Lucas County with no health insurance, Ms. Kensler has been looking forward to having an opportunity to get coverage for her family.

“I was trying to get answers about the Affordable Healthcare Act before today from Marcy Kaptur’s office,” Ms. Kensler said. “They basically said it was still being rolled out and I would find out more after Oct. 1. It seemed like people who should know things about it didn’t, and I really didn't know who to ask.”

RELATED ARTICLE: Consumers have variety of health-care plan options

Ms. Kensler lost her job and her health benefits when her employer, Ann Arbor’s Super Sales of America, went out of business in 2004.

She spent several years getting by on freelance work and part-time jobs with no health benefits.

She was just happy that she and her sons were pretty healthy. As the years went by, though, she found it harder and harder to find a full-time job, and eventually she began to worry more about her health as she got older.

Early this year, her fiance found a full-time position with TASC of Northwest Ohio and it seemed her luck had changed. They married in April and she started getting regular checkups, during which her doctor discovered she had a heart murmur.

But before she could get that issue addressed, her husband's employment at the mental-health and substance-abuse agency changed to part-time, and with that the family’s health coverage was lost.

Ms. Kensler hopes her frustration now will end with her exploration of options available in the health care marketplace. She plans to go online to the healthcare.gov Web site, where she can explore options from seven insurance companies.

Insurers offering coverage in Lucas, Williams, Fulton, Defiance, Henry and Wood counties include Anthem, Buckeye Community Health Plan, CareSource, HealthSpan, Medical Mutual of Ohio, Molina, and Paramount. Ms. Kensler also wants to talk to one of the health “navigators” who will guide people through the enrollment and insurance selection process before she makes a decision.

“It may take me a week to really figure out what I want to do,” she said.

Ms. Kensler may have to wait a little longer than a week to speak one-on-one with one of the navigators.

In the Toledo area, the Neighborhood Health Association and CareNet were awarded federal grants to provide navigator services. As of Tuesday, however, only five navigators had qualified through the federally mandated training and certification program.

Doni Miller, Neighborhood Health Association’s chief executive officer, said federal funds to hire and train navigators were very slow in coming and were released just a few weeks ago.

The agency has been advertising the positions for about three weeks and will eventually hire 18 navigators, a marketing person and an outreach coordinator.

Navigators will have to be trained and certified before they can begin assisting people and there were some glitches today in the training process.

“We are having trouble accessing the training Web site right now,” Ms. Miller said. "Everyone is trying to get on. I don't think anyone anticipated the amount of access that would be attempted on this first day. Its just crashed essentially today.”

Ms. Miller feels confident, however, that her agency will be able to hire and train all the navigators in a few weeks.

“We will have boots on the ground by the end of October,” she said.

Navigators will be available to help people enroll in coverage at nine Neighborhood Health Association sites in Toledo, and Ms. Miller is developing an outreach plan that will include navigators going out to speak at church and community events.

The CareNet agency is not as optimistic. It just received official word from the Ohio Association of Foodbanks last week that it would be one of the groups receiving grant money to help implement the health care marketplace in Lucas County.

Executive Director Jan Ruma hopes to hire four to six people as navigators, but said her timetable for getting fully operational is sometime in November.

“We are quickly becoming accustomed to challenges in the implementation of this act,” Ms. Miller said. “It is ever-evolving and ever-changing.”

The Health Insurance Marketplace is now open for enrollment through March 31. Consumers must sign up by Dec. 15 for coverage to begin Jan. 1.

Contact Marlene Harris-Taylor at: mtaylor@theblade.com or 419-724-6091.



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