Searching For Health Insurance? You May Need A Navigator

Nov 6, 2017

Inside a conference center in Cranston, Robert Collington tried to find out what he’ll have to pay for his health plan come January. He’d come to the state’s open enrollment fair to meet with a health insurance navigator, who was helping him sign up for coverage under the Affordable Care Act.

“OK, so here’s my adjusted gross income from last year….”

Robert Collington and Deborah Cote of North Kingstown talk with a health insurance navigator at a HealthSource RI enrollment fair in Cranston.
Credit Lynn Arditi / RIPR

Kay Kos, the navigator, sat at a computer, tapping numbers into the agency’s new online “savings tool.”  She pointed to Collington’s current health plan and explained what it would cost for the same plan next year.

“And then you see that all the monthly premiums are the same,” she said, “but what differs is the deductibles.”

Collington works as a carpenter and his income fluctuates with the season. And Kos said his earnings will determine how much he’ll get in federal subsidies to lower his insurance costs.

“It’s just going to be very different than what you’re doing now with your insurance,’’ she said, “and what you’ve been paying.”

Different this year because the Trump Administration cut federal subsidies for health insurers sold on state exchanges. Collington is one of roughly 16,500 Rhode Islanders who qualify for those subsidies. Insurers still have to offer those customers discounts. But to recoup the expense, they’re raising premiums an average of 18- to 20-percent on their most popular plans.

Karen Pollitz, a senior fellow at the nonprofit Kaiser Family Foundation in Washington, said rate changes mean customers who are re-enrolling may need to switch plans – or even look outside their state exchange -- to find the best deal.  

“It really will be important to shop around because the premiums are increasing in an unusual pattern for 2018,’’ Pollitz said. “People aren’t used to that. And it really will matter to look and see what plans are available to you in your area and what they would cost you, particularly if you are eligible for subsides.”

At last week’s open enrollment fair in Cranston, Collington, the carpenter, sat alongside his live-in companion, Deborah Cote. As a pharmacist, Cote has more experience than most with health insurance. But even she finds the enrollment process can be daunting.

“It’s very frustrating. It’s confusing,’’ Cote said. “And I’m a health care professional. But I know the importance of being ultra-patient and asking lots of questions and being persistent and waiting for hours on the phone.”

Cote came along to help Collington pick an insurance plan. But he couldn’t recall what he earned this year so it’s hard for the navigator to calculate his subsidies.  She used an estimate based on what he thinks he’ll earn and his age. He just turned 62.

“For someone who is in this income bracket for a 60 year old it’s $610,’’ Kos, the navigator, said. “So I can already tell you right now it did increase from $533 to $610 for a 60 year old.”

So Collington’s premiums will go up for the plan he has now. And his annual deductible will go up by two-hundred and twenty-five dollars.

The couple decided to go home and verify his income before they signed up.

By then, they’d been at it for nearly an hour.

Other enrollments went a lot more quickly. Ronnie Phipps, an outreach specialist, cheered after helping re-enroll a woman she’d signed up for coverage a year ago.

“Oh it took ten minutes,’’ Phipps said. “She re-enrolled. She changed her income. She picked a new plan re-enrolled for next year and it went not a hitch.”

Health policy analysts are concerned that enrollment on the exchanges may dip this year, because of higher premiums and the Trump Administration’s vow to repeal Obamacare. Nearly 30,000 Rhode Islanders currently buy coverage through HealthSource.

Kaiser’s Karen Pollitz said Rhode Island is better positioned than most.

“The state really has stepped up to do everything possible to make this program work as well as it can,’’ Pollitz said. “And you know the residents should be proud to live in a state that did that. And, you know, we’ll just kind of have to see what the future holds.”  

HealthSource will be holding more than a dozen one-day enrollment fairs around Rhode Island between now and December 21st.  The deadline to enroll in coverage for next year is December 31st.