CompleteCare Health Network Becomes Local Resource for ACA

COURT HOUSE – In July, CompleteCare Health Network received a grant from the Health Resources and Services Administration to hire staff members who have the sole duty of helping consumers, both CompleteCare patients and non-CompleteCare patients apply for coverage poising them as a the resource in Cape May Cumberland and Gloucester Counties for Affordable Care Act questions and help.
The enrollment team consisting of John Fuqua, Jill Harris and Anthony Morales are called Certified Application Counselors, a designation they were given by completing training and testing. The counselors will be available at different CompleteCare locations daily throughout the six-month open enrollment period. CompleteCare also hopes to have more staff trained in and available in almost all of their sites by the end of the month.
“We are happy to help anyone who needs it,” said Anthony Morales, a Certified Application Counselor who also speaks Spanish. “We are available to answer simple questions or to walk people through each stage of the process – whatever level of help customers’ need we can offer.”
Although those covered by job-based health insurance and those already on Medicaid, Medicare or VA benefits do not have to make any changes to their care plans, there are over 900,000 people in the state of New Jersey that currently do not have insurance. These individuals will be required to carry health insurance coverage by March 31, 2014 or face penalties.
Starting on Oct. 1, the new online system to sign up for health insurance, called the Health Insurance Marketplace launched with millions of Americans flocking to the site to see what the new plan was all about.
“Initially there was a lot of traffic on the site and this caused some slowness and error messages,” said John Fuqua, Certified Application Counselor and Bridgeton resident. “Right now, we can see improvements in the site every day, so we just go with the flow. We help people in whatever way they feel most comfortable. If they want to mail a paper application we can do that. If they want to make an online attempt, we can also try that.”
In New Jersey, consumers who do sign up will have options based on income and family size, but can rest assured knowing that all plans are required to have essential elements. These are items that must be covered at every level and in every plan, including prenatal care, prescription drugs, lab tests, pediatric services and more.
For those who make up to 133% of the federal poverty level, $15,415 per year for a single person, Governor Chris Christie approved expanded Medicaid coverage in New Jersey. Even those who have been previously denied Medicaid are encouraged to reapply as the qualifying parameters have changed.
For those individuals or families who earn more than 133% of the federal poverty level, there is the option to purchase insurance. Insurance can be purchased through the Health Insurance Marketplace, where consumers can shop for coverage that varies in cost and coverage level.
To help pay for the monthly premiums many Americans will qualify for premium tax credits or cost sharing plans. Tax credits are given to consumers before they pay their costs, making health insurance premiums more affordable. Cost sharing plans lower the amount of out-of-pocket costs for deductibles, coinsurance and copayments. Both credits and cost sharing are available based on income level.
Exemptions to the health insurance law will be given for certain groups, those who qualify for religious exemptions, members of Indian tribes, undocumented immigrants, people who are incarcerated and those who have an income level below the threshold required for filing taxes or would have to pay more than 8% of their income for health insurance.
The Affordable Care Act may provide some pleasant surprises for individuals who are already covered by an insurance plan, as well as those new to insurance coverage. “The Affordable Care Act attempts to shift consumers’ mindsets from treating illness and disease once it happens to preventing illness and disease before it happens,” said Jill Harris, Certified Application Counselor and Millville resident. “By making many preventative services under all health plans free of charge, the idea is that more people will seek testing and treatment early and not wait until they are already sick.” Things like obesity screening and counseling, HIV screenings, immunization vaccines, tobacco cessation help and many preventative health services for women will be covered.
Another huge change will come for people with pre-existing health conditions. Starting in January 2014, health insurance companies will no longer be able to block people from coverage if they have pre-existing health condition like diabetes, arthritis, high blood pressure or pregnancy.
If you have questions about the Affordable Care Act or would like to set up an appointment with one of CompleteCare’s Certified Application Counselors or have more questions about the Affordable Care Act, visit www.CompleteCareNJ.org/ACA and click on the Contact Us link or call 856-391-4815.