Tonawanda News

January 26, 2014

Program helps with insurance

'Navigators' assisting Niagarans' search for affordable health insurance

BY JOE OLENICK joe.olenick@lockportjournal.com
The Tonawanda News

Tonawanda News — Universal healthcare, Obamacare. The whole healthcare thing can be confusing and overwhelming. Some may not even know the federal law’s official name is the Affordable Care Act.

Some probably have questions. What plans are available? What’s covered? How do I sign up?

The good news, for those seeking health insurance coverage, is they don’t have to figure it all out on their own.

The new healthcare law provides for healthcare “in-person assisters/navigators” – real, live people who can explain how to sign up, point out the differences in the health insurance plans available and guide people and small businesses in setting up coverage.

For Niagara County, Niagara Falls Memorial Medical Center was awarded a grant last summer by the state Department of Health to fund a navigator agency that helps consumers apply for health insurance through NY State of Health, the state’s official health plan marketplace.

The marketplace also offers financial assistance, provided by the federal government, to lower the cost of health insurance coverage. Individuals and families may also qualify for free or low-cost coverage from Medicaid or Child Health Plus. Anyone who needs health coverage can apply.

Navigator agency Director Christin LoFaso said people who seek help from the Niagara County navigators don’t have to be Niagara County residents. Local navigators can assist any New York state resident.

”We have no boundaries. Just because we’re specific to Niagara County, that does not mean we can’t serve somebody from Erie County, Orleans County, Genesee County,” LoFaso said. “We have a great working relationship with the other counties.”

Individuals, families and small businesses can get information and enroll in a plan either online at nystateofhealth.ny.gov, by calling the toll-free number 1-855-355-5777.

Or they can set up an in-person meeting with a navigator by calling 278-4264 or emailing navigator@nfmmc.org. It’s free, but appointments are required.

Navigators are based throughout the county; sites include Niagara Falls Memorial, Lewiston Town Hall, Wheatfield Community Center, United Way of Greater Niagara on Inducon Drive West in Sanborn, the Doris W. Jones Family Resource Center in the Falls, the YWCA and Dale Association locations in North Tonawanda.

Joy Richter is the Lockport-based navigator, working typically at the Dale Association on Ontario Street. She usually handles people from Lockport and eastern Niagara County, but they come from all over.

Navigators have met with folks from Newfane and Youngstown, Buffalo and Clarence, Depew and Lancaster, Medina and Middleport, LoFaso said.

Word of mouth has certainly been a major referral source for the Memorial navigators, both Richter and LoFaso said, especially by those who have already worked with a navigator.

“I think we have such a strong focus on customer service and getting back to people,” Richter said. “I meet people who come with people who met with Christin; because they had such a good experience with her, they’re coming to meet with me and vice-versa. We’re really focused on helping the individual.”

A typical appointment takes 60 to 90 minutes. The hope is the application is started, finished and a plan chosen in one appointment, Richter said. But it’s different for each applicant, because each situation is different. 

And the session doesn’t end until the person’s health plan covers everything it needs to and it’s accepted by their healthcare providers, Richter said. Issues with coverage are rare, so far, she said.

Most of those who come to the navigators don’t have a computer or just need a little help with the application. Almost all are actively looking for insurance and are ready to go, Richter said.

And there is a significant lack of health coverage out there. According to a study by Univera, about 6.8 percent of people in Western New York are uninsured. In Niagara County, that number rises to 7.6 percent. The study was based on information through Dec. 31, 2012.

However, both the county and the Western New York region are better off than the state as a whole, which Univera determined has about 11 percent of its residents going without insurance. Nationwide, the percentage of uninsured jumps to 14.8 percent.

Those who work with the navigators have been thankful for the service, according to LoFaso.

“They’re very appreciative,” she said.

According to the state Department of Health, as of Jan. 20, 328,796 New Yorkers had successfully enrolled in coverage through the New York State of Health marketplace. More than 587,000 applied for health insurance since the marketplace opened Oct. 1, nearly 100,000 of them since Dec. 24.

The State of Health open enrollment period runs through March 31 and New York is on track to meet or exceed its enrollment goal of 1.1 million people by the end of 2016, the health department said.

ENROLLMENT FIGURES As of Monday, 587,486 New Yorkers have applied for health insurance through New York State of Health Marketplace with 328,796 successfully enrolled AVAILABLE PLANS IN NIAGARA COUNTY Individual • Fidelis Care • Health Republic • Blue Cross Blue Shield of Western New York • Independent Health • Today's Options (American Progressive) • Univera Small business • Health Republic • Independent Health • Univera

Contact reporter Joe Olenick at 439-9222, ext. 6241, or follow him on Twitter @joeolenick.