Kokomo Tribune; Kokomo, Indiana

Local News

October 21, 2013

Navigator answers ACA questions

More education needed to reduce confusion.

Someone recently asked Nemramy D’Agostino if people could be thrown in jail for not having health insurance per the new rules of the Affordable Care Act.

The certified navigator chuckled as she told the story.

“No, you won’t be thrown in jail,” she told that person.

It was an illustration, though, of just how important community outreach is, she said. There are so many questions and misconceptions surrounding the ACA and the new health insurance marketplace, she said.

Her job is to answer those questions and debunk the myths.

D’Agostino tried to do just that during a League of Women Voters forum on the ACA Wednesday night.

She delivered an hour-long presentation showing people what to look for when shopping on the exchange.

She flashed informational slides through a projector as people in the crowd quickly jotted down notes. D’Agostino paused occasionally to answer questions.

She started with some basic information explaining the Affordable Care Act. The navigator quickly delved deeper into the exchange, though.

She explained the tax credits and cost-sharing reductions available to some families to help lower the cost of premiums, copays, coinsurance and deductibles. Eligibility for the tax credits and immediate reductions are based on income and family size, D’Agostino said.

But people who smoke are not eligible for the assistance regardless of how little they make or how big their families are, she explained.

The crowd wanted to know more about the five tiers of insurance plans available on the new marketplace.

They start at the bottom with a catastrophic plan that covers three primary care visits each year until a consumer meets the deductible. That plan is only available to people under the age of 30, D’Agostino said.

The plans go all the way up to the platinum plan. Under that plan, insurance pays 90 percent of medical costs, but premiums are higher. The bronze plans cover 60 percent of costs. The silver plans cover 70 percent, and the gold plans pay 80 percent.

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