Geter said the information she had to present might be beneficial to the Bradley Health Council members’ clients.
Key components of ACA shared by Geter with the community include: young adults may remain on their parents’ insurance until age 26; pre-existing conditions will not bar an individual from insurance; and there are no lifetime caps.
She touched on misconceptions throughout the presentation.
The individual mandate to purchase insurance or face a fine is one of the most hotly debated topics. She said it applies to most people, but not everyone. Individuals who have minimum essential health coverage most likely will not need to get insurance through the marketplace.
However, if a person does not have insurance, they must look at coverage through the ACA Marketplace. According to healthcare.gov, the Marketplace allows customers to see insurance price cuts as determined by income, compare coverage options side-by-side and enroll in the program.
Geter said the Tennessee ACA Marketplace is federally facilitated. This means the state does not have its hand in the maintenance of the site. The Volunteer State is one of about 26 that have chosen the federal option. Additional options included a state-federal partnership and exclusive control by the state.
The end of the current enrollment period is March 31. The next enrollment period opens Nov. 15.
A “special enrollment period” only allows individuals with a qualified life event to sign up between the enrollment periods. These include but are not limited to pregnancy, death in the family, marriage or promotion on a job. Geter explained the life events must significantly change the makeup of the family.
Questions can be directed to ACA Navigators, managers like Geter or by calling the Tennessee ACA hotline 1-800-318-2596.
Geter said the state initially thought it would receive significant financial aid from the federal government to run the program. The money would then be used to pay assisters in an effort to answer the questions of people at every level. The money was less than anticipated.
There are about 18 ACA Navigators spread across the state. Geter said the individual who serves the Bradley County area also serves nine other counties. Additional medical centers and hospitals hired assisters to address the issues.
Geter said Erlanger wanted to be up to date with ACA as the largest health center in the region.
“This is truly near and dear to our hearts. Not only how it affects us business-wise, but also our patients,” Geter said. “It matters for the clients and people who walk through the clinic’s doors. We want people to have access to health care that is going to be affordable, but also helps us in turn.”