When it comes to insurance and paying for health care, much of the public has been suffering from a nearly chronic case of confusion.
“It’s befuddling and it’s not like we have classes that teach us about our health-care system,” said Janis Rich, a volunteer coordinator for the Statewide Health Insurance Benefits Advisors program, or SHIBA.
Officials in Washington recognized that it can be a challenge for residents to untangle their health-coverage options, so 28 years ago they started the SHIBA program — one of the first of its kind in the nation.
Volunteers with SHIBA answer phone calls and meet with people who need help finding health-care coverage and understanding their insurance options and rights. Today, there are 400 advisers with SHIBA statewide and the program, part of Washington’s Office of the Insurance Commissioner, has been replicated elsewhere.
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Now the state is trying to create a similar support system of “navigators” or “in-person assisters” to help residents shopping for and enrolling in insurance programs through the Washington Healthplanfinder online insurance exchange. The exchange, run by the Washington Health Benefit Exchange, is being created as part of the Affordable Care Act overhaul of the U.S. health-care system.
SHIBA mostly advises older people eligible for Medicare but will answer all kinds of health-insurance questions.
“Every once in a while we get stumped,” said Rich, who works in Olympia and has been with SHIBA for nearly four years.
Some of the harder calls are from younger people who don’t have insurance through their jobs. They ask how to find a cheap, individual insurance plan, said Rich, but up to this point, “there really isn’t such a thing.”
Soon Rich will be able to direct callers to the new insurance exchange, where they can look for a plan that fits their budget. In her time at SHIBA, Rich has helped a number of people who have never had health insurance and are getting it for the first time when they qualify for Medicare.
For some people, she said, health coverage “is almost a luxury.”
Need help exploring your health-coverage options?
Washington Healthplanfinder: This site allows you to compare the cost of insurance policies and determine if you qualify for financial assistance. http://www.wahealthplanfinder.org/
Washington Health Benefit Exchange: The agency provides big picture information on health-care reform in the state. http://www.wahbexchange.org/
Support by email: Questions can also be sent by email to firstname.lastname@example.org
Office of the Insurance Commissioner: This state office reviewed and approved plans in the insurance exchange, and has information on what the plans cover. http://www.insurance.wa.gov/current-issues-reform/health-care-reform/individual-families/whats-covered/
Federal government: The federal government has a comprehensive health-care marketplace site. https://www.healthcare.gov/
IRS: The Internal Revenue Service provides information on the law. http://www.irs.gov/pub/irs-pdf/p5093.pdf
AARP’s Health Law Tool: The American Association of Retired People has an interactive tool to help users figure out the law’s effect on their family. http://www.healthlawanswers.org
Kaiser Family Foundation: The foundation, which focuses on health-care issues, provides information and analysis of health reform and ACA issues. http://kff.org/health-reform
Consumer Union: The organization has a tool to help calculate tax credits. http://consumersunion.org/wp-content/uploads/2013/05/Tax_Credit_Worksheet_2014.pdf.
Help by phone
Call center: Staff members at the state’s toll-free customer-support center can answer questions, walk people through the enrollment process or suggest other resources. Open weekdays from 7:30 a.m. to 8 p.m. with help available in up to 175 different languages. Call 1-855-WAFINDER (1-855-923-4633) or TTY/TTD 1-855-627-9604.
Help face to face
Navigators: Every county is partnering with community centers, health facilities, libraries and other organizations to provide in-person help through so-called “navigators” or “in-person assisters.” Call the state’s toll-free number or go online to Washington Healthplanfinderto locate the closest location of someone who can help.