Local health-care navigators begin offering assistance

Initial one-on-one sessions guide people to insurance

Elizabeth Macino, a CareNet navigator, helps John Thomas of Toledo sign up for Obamacare during an initial session held on Wednesday at the United Way offices in downtown Toledo.

Toledo resident Kathy Kusz said she is skeptical by nature and that's the attitude she brought to a meeting with one of the Affordable Care Act health-care “navigators” on Wednesday.

Ms. Kusz is one of 47 people who participated in the first official event held locally to help the nearly 44,000 uninsured county residents enroll in the federal health-care exchange.

About 10 navigators met with people one-on-one at the United Way headquarters downtown, guiding them through the healthcare.gov Web site and answering questions. By the end of her meeting, Ms. Kusz, a 54-year-old West Toledo resident, said the Web site was working well and the navigator was very helpful.

She is planning to enroll in a silver-level plan that will cost about $260 a month after tax credits and subsidies are applied.

The marketplace offers four coverage levels. The platinum and gold plans generally have higher premiums but smaller co-pays and deductibles, whereas silver and bronze plans will have lower premiums with higher co-pays and deductibles.

Now Ms. Kusz wants to consult her doctor and talk to representatives from the two insurance companies she is choosing between before making a decision.

South Toledo resident Judith Zuniga, 54, is a part-time cashier at Kroger. She has been on the job for a year but has to wait six more months before being eligible for the company-sponsored health plan.

She met with a navigator in the hope of finding private health coverage to fill the gap, but discovered her income qualifies her for Ohio's Medicaid program. Some 275,000 adults in Ohio are expected to qualify for Medicaid now that the state is accepting federal funds to expand the program to more low-income, uninsured Ohioans.

The Medicaid enrollment period begins Dec. 9 for Ohioans.

“I don't plan on staying on Medicaid. I work for a living and I will use the benefits that are available to me because I don't have the income to pay for it. But once I get the income and get better employment and things are looking better for me, then I plan on kicking off all this stuff and doing what I have to do,” she said.

Jan Ruma, executive director of CareNet, one of the two agencies overseeing the navigators in northwest Ohio, said there will be many people like Ms. Zuniga who will find they can get health-care coverage at little to no cost through the Medicaid expansion.

“What we are finding is that people in Ohio who are up to 138 percent of the federal poverty level, which is about $15,000 a year in income for an individual, are now going to be eligible for Medicaid and so that takes them out of the marketplace,” Ms. Ruma said.

Ms. Ruma, however, is concerned because many doctors refuse to treat patients with Medicaid out of concern over reimbursement rates, which can be 30 to 35 percent less than private insurance reimbursement rates.

More information and appointments with navigators in Lucas, Erie, Sandusky, and Wood counties are available by calling 419-214-0043 weekdays from 9 a.m. tol 5 p.m. In other northwest Ohio counties, the number is 1-800-648-1176.

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