testimonials – R&R – Reachout and Rebuild

Tears for Liz

David Posnett — Thu, 20 Mar 2014 04:30:40 +0000

My friend Liz was an intense supporter of the ACA. There was a good reason. She had her health insurance canceled back in 2005 when she was stricken with a nasty cancer. Chemotherapy nearly bankrupted her. But she survived. She became a cancer survivor and started a national support group for patients like herself, a group counting a membership of over 5000. She was very well informed and attended medical conferences to keep up with the latest advances.

However, she still had no medical insurance. So a few weeks ago she signed up on-line for the ACA and she was waiting for her insurance card. She wasn’t feeling well. Fully aware of the costs, she did not want to see a specialist in NY City until her insurance card was in hand. However, on Monday she went to an emergency room because of shortness of breath. A few hours later she was dead!

Its not clear what happened. BUT it is very clear that

Health insurance is not a “joke” – in fact, lacking health insurance dissuades us from consulting a physician when we know that we should. Lacking insurance really costs lives.
Treatment for cancer and other disorders can be extremely expensive and often leads to personal bankruptcy, specially when you are uninsured.

Many people were touched by Liz and I know they are mourning. I know she would want us all to fight for the ACA (Obamacare) in her name. RIP Liz.

How to sign up for ACA Healthcare Insurance WITHOUT problems on the Southfork

David Posnett — Thu, 30 Jan 2014 18:59:07 +0000

Millions of Americans and documented residents
now have the chance to get quality care that they
can afford.
1. If you need help, financial assistance is available.
2. You can’t be denied coverage, regardless of your health
3. You choose the plan that’s right for you.
4. Sign up through March 2014

This is for those that are frustrated and found it difficult to get good health insurance at a good rate.

I went to visit Sheila Rogers (the head of East Hampton Health Care Foundation).
Forget using state paid navigators in Suffolk county she says. There are only about 3 of them. They show up very infrequently (e.g. once a month for 3 hours at Southampton Hosp. for example).

There are 8 companies that are NYS approved to sell insurance through the ACA individual market place in Suffolk county. But only 3 are providers of Medicaid Managed Care.

Affinity Health Plan (provider of Medicaid Managed Care)
Fidelis Care (provider of Medicaid Managed Care) – no local doctors accept this companies plans! Closest doctors in Riverhead! FAVORITE CHOICE BECAUSE CHEAPEST
United (provider of Medicaid Managed Care) – very expensive if you are not eligible for Medicaid Managed Care!
Emblem Health
Empire Blue Cross Blue Shield
Health Republic (Freelancers) – no local doctors accept this companies plans!
North Shore LIJ – doctors are mostly up island
Oscar

Small Business Marketplace:

Health Republic
North Shore LIJ
United

Probably better to use an insurance broker if you are a business.

Here is the exciting part: Sheila has “enrollers” that come to her clinic 4 days a week for 3 hours. They see and sign up about 10-12 families at each session. People have to make an appointment and the wait is usually about 1 week. These enrollers are fluent in Spanish. They do NOT try to overtly sell/push their own company… (most of them come from Affinity and United).

You can call for an appointment:

MAKE AN APPOINTMENT WITH A
FACILITATED ENROLLER
AT THE EAST HAMPTON
HEALTHCARE CENTER

MON & FRI:
UNITEDHEALTHCARE
JULIA FUENTES: 631-294-2921

TUES & THURS
AFFINITY HEALTHPLAN
VICKY DURAN: 516-315-1021

Insurance Brokers can also sell plans, including plans from other companies like Aetna, these plans are supposed to be in line with the ACA market place.

Sheila organizes a monthly Health Care Fair at our local Most Holy Trinity Catholic Church on Buell Lane, where families get free screening (BP, Diabetes, Cholesterol, etc) and free advice on how to sign up for the ACA. The next such event is Friday, Feb 7th (11AM to 1:30 PM).

Republican Converts to Obamacare

David Posnett — Thu, 23 Jan 2014 21:02:33 +0000

It is strange how I have been hearing about right wing oponents of Obamacare. When they get really ill, and the situation is life threatening, some of them convert to Obamacare supporters. Its interesting to read these stories (I think). Here is a story about a young Republican operative with testicular cancer!

And meet Butch Matthews from Arkansas too.

Another Testimonial: Take your time – don’t do it all in one session

David Posnett — Mon, 06 Jan 2014 06:02:24 +0000

(I posted this for my friend J)

My wife and I went through the NY State Health website https://nystateofhealth.ny.gov/

There are a few tricks you learn along the way….first register. You don’t have to do it all at once, you can come back.

You will be asked to estimate next years income and based on that you will be provided with a deduction that is taken off the published premium…..don’t freak out because that premium doesn’t show the applied premium deduction. It will show only after you complete the application.

You will be asked to submit some document numbers (for instance my wife is a naturalized citizen, so she needed to provide that info) plus SS#’s.

Each time you look at the plans, until you actually choose one, you have to restart. After a few revisits it becomes easy. We found the most frustrating part was determining a plan, so you really have to figure out what you want based on past history, such as prescription use or child care etc. Try to determine what you spend on the most and what you need medically. Balance that against deductible versus premium.

Looking for a plan that includes your current physician is also a little weird. Our Physician’s office was not all that up to speed as to what plans they accept because there have been so many changes…ask if they accept the insurance company first, if they do, they will most likely accept the specific plan you choose….some physician offices are not aware of some of the different company relationships (like United Health and OSCAR) because they are so new…..we had to educate them…..it took a few calls to straighten that out. The Physician look up function works, but make sure the address is correct and choose the right specialty: General Medicine, etc

The best advice I can give is to not try and do it all at once…..when it gets annoying, stop and come back. Keep a good password record.

The suggestion of finding a navigator is a good one.

We are still waiting for new cards and were told that some companies are behind but will honor the application if you get a confirmation letter which is sent to you in your application account mailbox. Call the insurance company you choose for information. We had to overcome our desire of getting it all done at once. Now, we feel pretty good about our plan. J

More Testimonials Regarding Signing up for ACA (Obamacare)

David Posnett — Wed, 01 Jan 2014 01:41:52 +0000

I spoke to Alice who told me of the existence of “navigators”, live people who are available throughout the country to talk or meet with subscribers. I found one in my area (Suffolk county), who walked me through the various options and gave me some real advice and suggestions. So I signed up for a multi-state PPO with only a $1,500 deductible for $70 a month after my credits! The plan pays at least 50% of medications and doctors visits before the deductible is met. Of course, without knowing about these navigators I would still be floundering – I was originally looking at a $6,000 deductible plan for $50 per month. So for an additional $20, I got a much lower deductible and pretty much the same benefits and for a 26 year old that is perfect!

We need to get the word out about navigators. They really can make all the difference to a successful sign-up or not.

Sam

Testimonials from Suffolk county: It is not all bad!

David Posnett — Sun, 29 Dec 2013 05:10:23 +0000

I signed up through the NY state website. It was the easiest thing I’ve ever done in this realm. Particularly, as an independent contractor — In the past, I’d tried several times to navigate their labyrinthian website — finally giving up as I was asked to produce more and more paperwork. In this new incarnation, as a self employed person — I went to the Individuals section, and then it asked me to fill in what my expected income was, my deductions and it did the calculations for me. The site immediately told me what I was eligible for and then asked me to choose a plan — I was able to see which plan my doctor accepted (by going to my doctor’s site)….you also have the option to change the plan within 90 days or if not within that time frame then after a year you can opt for another plan. It was so easy and stress free I couldn’t believe it. I am so pleased, I am encouraging others to follow suit. Caterina.

I signed up by PHONE and it was easy and painless, though I think the “hold time” to talk to someone may have increased. I got what I believe is a good plan at an amazingly good rate as my income is low enough to qualify for the subsidy. It took about a half hour. They are available 24/7. Marketplace 800 318-2596. Robin.

I did finally get a BC/BS policy for a few dollars more than my old lousy Oxford policy. This one now has no deductible and covers a lot more services. An agent (paid by the state) helped me sort through it, since finding participating providers is the huge time consuming part. I have a confirmation number for the new policy but I have not yet been contacted by BC/BS to pay, so…come January 1st I do not think any doctors will see me without insurance verification or policy number… I will call them on Monday and see what needs to be done. By the way, the agent I used was Steven Schiller, Financial Representative, Group Sales
Tel 516-677-5031 • Fax 516-677-6894 Woodbury , New York 11797.
sschiller@glic.com. He gets one set up and confirmed but then payments and activation is between the insurance company and the insured. Jim

The story of Adam (an uninsured young Texan)

David Posnett — Mon, 30 Jul 2012 21:19:22 +0000

This is your typical story about an uninsured motorcycle rider. A must read.

Adam, the uninsured motorcycle rider