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Linn County Leader - Brookfield, MO
  • Health Care Marketplace Has Local Gatekeeper

  • Doornob: “You’re much too big [to enter through my door]. Simply impassible.”
    Alice: “You mean impossible.”
    Doornob: “No, impassible. Nothing’s impossible.”
    — from: Alice In Wonderland
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  • Some have reasoned that there’s no use enrolling in the Health Insurance Marketplace by phone or in person because everyone’s information has to go through a single doorway in cyberspace, and that door is hopelessly closed. Advocates and citizens who just want to comply with the law  push on nonetheless, confident in their belief that nothing is impossible.
    With all of the attention being directed toward problems associated with trying to use the Health Insurance Marketplace website, consumers might be left with the impression that there is no way to comply with the law requiring most to have healthcare insurance by January 1, 2014. That is simply not the case. First, the President has announced that the deadline for securing health insurance without a penalty, if you don’t already have insurance, has been pushed up to March 31, 2014. That is when the Marketplace will stop enrolling applicants.
    While the ‘bugs’ in the website are being corrected, you can still call the Marketplace toll-free at 1-800-318-2596, 24 hours a day, seven days a week. The hearing-impaired should call 1-855-889-4325. As more staff have been added to answer these phone calls, it’s estimated that on average someone will answer your call in less than one minute. The application process by telephone should take about 25 minutes for individuals and 45 minutes for those seeking coverage for an entire family.
    And here’s another very local alternative for those who, like myself, prefer to be helped face-to-face, in person.
    Jane Spencer is a retired RN who has 25 years of experience at University [of Missouri] Hospital and its clinics; some of that time was spent working with insurance companies to get patients more days of covered care. “I have also seen folks who suffered from a lack of sufficient coverage and providers refusing coverage as a result of pre-existing conditions, as well as young people who are now already benefitting from the Affordable Care Act (ACA),” explains Spencer. The ACA now prohibits insurers from denying coverage because of pre-existing conditions and allows individuals to be covered under their parent’s policies up to age 26.
    Spencer is stationed in the Marceline Business Complex (old St. Francis Hospital) during regular business hours every Tuesday, and you can drop in without an appointment. Just enter the upper level of the Business Complex (north side of the building) at 225 West Hayden in Marceline as if you were paying a visit to Dr. Betty Noll and go left after you go through the steel door instead of down the hall. Spencer is in Suite 100. If you work and can’t see Spencer until after 5 p.m., just call her at (573) 823-9518, and she will arrange to see you at a time that is more convenient for you. “I am available to speak to entire groups as well,” says Spencer. So, if your church, civic or other organization wants an informational presentation about the ACA, just call Jane and she will arrange a time to come to you.  
    Page 2 of 2 - As a Certified Application Specialist/Counselor, Spencer’s primary duty is to help the uninsured get enrolled in the Health Insurance Marketplace, otherwise referred to as the insurance exchange. She has taken as much as 30 hours of required training and passed a test to become certified and licensed as a Marketplace Enrollment Specialist.   
    Spencer explains that the health insurance policies must now, as a part of the ACA, meet the following basic standards: They must cover both outpatient (ambulatory) care and hospitalization. They must cover maternity care, mental health and substance abuse care, emergency services, laboratory services, rehabilitative and habilitative services and devices, pediatric services, and preventive and wellness services, as well as chronic disease management.

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