From coverage to care: Federal navigators ready to help with marketplace

Published 12:00 am Tuesday, November 8, 2022

By Mary Schuermann Kuhlman

Ohio News Connection

Dozens of navigators are available to help Ohioans shopping for health care plans through the federal insurance marketplace. Open enrollment is underway and runs through Dec. 15 for coverage beginning Jan. 1.

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Nearly 260,000 Ohioans enrolled in coverage for 2022, a 24 percent increase from the year before.

Federal leaders provided an additional $99 million in funding for navigators to provide assistance with enrollment.

Kathryn Bamberger, outreach and enrollment coordinator for Southeast Healthcare, explained navigators help consumers compare plans to figure out the right cost and coverage for them.

“I can’t emphasize how much it’s very helpful to contact a navigator because you wanna make sure you’re getting the assistance that you have a right to,” Bamberger stressed. “We’re totally unbiased, and a big part of what we do is educate, from coverage to care.”

Congress also extended subsidies for health-insurance premiums, so customers will pay no more than 8.5 percent of their household income on health coverage through the federal exchange through 2025. To schedule an appointment, people can visit getcoveredohio.org.

Bamberger pointed out another change this year is families who have access to coverage from their employer can now also qualify for plans through the marketplace with subsidies.

“Before we had to look at whether the insurance for the employee was affordable,” Bamberger recounted. “If it was affordable for the employee, then that family could not access marketplace insurance. But they didn’t look at whether the premium was affordable for the spouse or the children.”

Bamberger suggested those already covered through the marketplace also review their coverage, because there are a lot of low-cost options.

“For people whose income is low, there’s even assistance for paying the out-of-pocket costs,” Bamberger emphasized. “That isn’t available for everybody who gets assistance with the premiums, but it’s available to a lot of people.”

An estimated four in five customers will be able to find plans for $10 or less per month.

Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.