If you buy your own insurance, open enrollment for the Affordable Care Act’s Health Insurance Marketplace is your chance to make sure you get the best plan for your health and your pocketbook. Insurance can feel complicated—but talking with one of these navigators can help make sense of it all.
Many local hospitals have helpers to walk you through the enrollment process. In the Philadelphia area, Temple University Hospital’s Patient Financial Services Department is dedicated to working with individuals, their physicians, and their insurance providers to connect people with the best insurance options.
To learn more about this department and the team of professionals that runs this program, Healthy Me PA sat down with Anita Colon, the director of the Patient Financial Services Department at the hospital.
“Temple has always had a very strong mission to the community and the importance of individuals and patients to be able to access care,” Anita said.
Long before there was an Affordable Care Act, the hospital had a strong financial counseling program and worked hard to assist patients in obtaining insurance coverage.
Because Temple University Hospital is in the heart of Philadelphia, its Patient Financial Services Department serves one of the most underrepresented populations in terms of access to health care coverage. The needs range from everyday illnesses and mishaps to life-threatening conditions requiring intensive medical treatment.
“I honestly can’t think of a serious health condition that we don’t see,” Anita said. “Without having any type of coverage, patients, or individuals who obviously need to be patients in some way, have no way to access care other than through the emergency room and some of the city health centers.”
Without insurance, many people don’t have the means to access preventive care, screenings, and other services that are important for catching health problems early and keeping them from becoming health crises.
“What our counselors do is really spend time with individuals to understand their specific health care needs, and help them understand that a higher premium may in the long run be less expensive,” Anita said.
Anita gave us an example.
“If you are someone with diabetes, you have to regularly go to the doctor and frequently get lab work done, and you know there are cases where you wind up in the emergency room just because of your levels not being adequate. Paying an extra hundred dollars a month for a premium that’s going to result in less out-of-pocket costs when you’re going and doing all of these regular measures can come out a lot cheaper than getting a lower-cost premium that is going to have very high out-of-pocket costs or deductibles.”
Anita said lack of understanding is one of the biggest barriers people face when it comes to obtaining insurance.
“One of the things that we stress is, if you have a medical issue or you know you need to see the physician, that’s stressful enough, so we work so hard to make this process add as little stress to that as possible,” Anita said. “I don’t think you could do this job day in and day out without having such a strong sense of caring, and the team clearly does.”
Anita’s team members are equipped to overcome language barriers, too. Quite a few people on the team speak Spanish, as do many people in the community Temple serves. Other interpreters in the hospital speak other languages common in the community.
“I have seen individuals that we have been able to help, and some of it has been life changing,” Anita said.
If you are looking for more information on insurance options during open enrollment, check out these Pennsylvania navigators. They are eager to help!