03/30/14 — Deadline looms on health care sign-up

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Deadline looms on health care sign-up

By Matt Caulder
Published in News on March 30, 2014 1:50 AM

For years after moving back to Goldsboro, Candice Webb did not have any health insurance.

As a self-employed manicurist renting a chair at Nails and More on Spence Avenue, she was responsible for her own insurance.

"I spent a lot of sleepless nights worrying about it. Worrying about what could happen," Ms. Webb said. "When you are single and self-employed, affording insurance in my line of work is just .... I can't afford $500 a month."

When she first moved back to Goldsboro five years ago, Ms. Webb had to start her business all over again and build up a clientele before she could even think about insurance.

When she last paid for her own insurance, the bill was $300 a month.

Now, she pays $55.

"Now I have health and life and dental and eye," she said. "I also have a pharmacy card. Someone my age needs insurance."

In January, Ms. Webb cut her hand badly.

She said she needed stitches but didn't go to the doctor for fear of the medical bills.

"If I had had my insurance then, I could have gone to the doctor," she said.

Ms. Webb now has Blue Cross and Blue Shield, the only provider on the health care marketplace in North Carolina.

She is going for preventive care and getting to know her own personal care physician.

"I used WATCH before and they were great, but there was a waiting list, and it was someone different every time," Ms. Webb said. "Now I can just call up and set my appointment. The first thing they ask is whether I have insurance, that's always the first thing they ask, and now I do."

Last year the Wayne Action Team Community Health program, or WATCH, provided through Wayne Memorial Hospital, saw more than 7,000 uninsured patients, Wayne Memorial Chief Financial Officer Becky Craig said.

The mobile unit serves as a free primary care service to uninsured in the county.

According to U.S. census data, one in five people in Wayne County under the age of 65 is uninsured.

"We are interested to see how those numbers change after this year," Ms. Craig said.

Each year, the hospital writes off more than $20 million in care for the uninsured.

Mrs. Craig said 11 percent of all charges at Wayne Memorial last year were for uninsured patients.

Ms. Webb signed up for health care through a local broker, but there is also free assistance available from certified assistance counselors through Goshen Medical Center.

Carmen Hargrove is a counselor for Goshen, working in Faison to help sign up as many people as she can ahead of the deadline Monday.

Anyone not in the process of signing up under the Affordable Care Act by Monday will be assessed a penalty if they do not qualify for an exemption.

The way the deadline is set up, anyone without coverage in 2014 for at least nine months will be subject to a penalty.

For the 2014 tax year, if an otherwise qualified person does not carry insurance, he or she would have to pay one percent of their annual pay or $95, whichever is higher.

Ms. Hargrove said signing up takes about an hour for an individual, but added that it can take longer for families.

"You have to enter each person's information individually, so it takes longer with more people," she said. "When people come to sign up, they need to bring documentation with them such as a Social Security card, birth certificate and tax information."

The tax information is to assess if the household's income qualifies the insured for one of several subsidies.

During the special enrollment period, anyone working on an application will be able to continue to work toward coverage, penalty-free for 2014, Ms. Hargrove said.

"It's the law, giving them the option to still enroll in health care," she said. "You still have an opportunity to get health care and, surprisingly, get a great plan."

Ms. Hargrove said her understanding was that the period would be extended until November when enrollment opens back up.

To make an appointment with a Goshen counselor, call 1-844-467-4361.

A counselor will be able to meet at one of Goshen's five locations in Wayne County.

Goshen has two locations in Goldsboro and Mount Olive as well as one in Fremont.

Packages with sign-up information are also available at other locations throughout the county.

Those locations include Wayne County public libraries in Goldsboro, Mount Olive and Fremont, Wayne Memorial Hospital, the WATCH van, Goldsboro Family Y, the Wayne County Health Department, the Wayne County Social Services Department and the Wayne County Senior Center.

For those who do not need an in-person counselor, there are four ways to sign up, using the health care exchange at www.healthcare.gov, calling the federal exchange at 1-800-318-2596, calling Blue Cross and Blue Shield at 1-800-324-4973 or getting an estimate from www.bcbsnc.com/shopping.

For those not eligible for coverage under the Affordable Care Act, there are exemptions to avoid the penalty.

Wider reaching exemptions, released by the White House in March, based on a person's hardships could keep most people from paying the penalty for another year.

The new exemptions continue allowances for if someone was homeless or facing foreclosure or bankruptcy but also include exemptions for other "hardships."

Other exemptions include if a utility has sent a shut-off notice or the person has been the victim of domestic violence.

Also included on the excuse list are if a family member has died, if you reside in a state which did not expand Medicaid or your individual plan was canceled due to the ACA.

One of the easiest exemptions to qualify for is an exemption if the person signing up "experienced another hardship in obtaining health insurance."

To apply for an exemption wait to claim the exemption on a 2014 tax return in 2015 or fill out a form on the ACA site at www.healthcare.gov.