Informed and educated: Health insurance navigators making coverage more accessible in Florida

By

Nicole Pasia

|

An increasing number of Floridians are seeking health insurance as a result of the pandemic. A report from the Centers for Medicare and Medicaid Services (CMS) shows over 487,000 people in Florida gained health coverage by the end 2021 Special Enrollment Period (SEP) last week. 

However, some individuals are paying high deductibles or copayments for services that other plans may cover for less — making them underinsured, according to Jodi Ray, the program director of Florida Covering Kids & Families, an insurance navigator coalition. 

 

Stay one step ahead. Join our email list for the latest news.

Subscribe

 

Ray said the benefits of the SEP — which was an advanced premium tax credit (APTC) — translated into plans that cost as little as $10 for new enrollees, reduced premiums by half, and completely eliminated co-pays in some cases. Ray said: 

“These are the kinds of things that make health coverage affordable, so that people can access health care … I think there’s still that level of confusion out there. ‘What is covered in terms of vaccines?,’ especially with COVID vaccines and treatment. [We’re] really getting the word out that, particularly if you’re insured, that treatment is covered. You won’t get hit with some massive bill, and they can get the vaccine.”

Taking advantage of these benefits is particularly beneficial to young adults, who might not be familiar with navigating the health care and coverage landscape. Zuriel Galey-Ocasio, a young adult who now works as a navigator with Ray, advocated for providing these resources: 

“I’ve seen firsthand the lack of knowledge that I had before I entered this field of work, and how many people I know that don’t have this knowledge now. I also see the desire for it, because believe it or not … a lot more people in the young, invincible demographic want to learn more about [coverage].”

Young adults aren’t the only demographic that needs help finding coverage. Ray said she once had a client in his 50s who hadn’t seen a doctor in 10 years. Ray encouraged people to not only use insurance for emergency services, but primary and preventative care as well. 

That’s where health insurance navigators step in. Their job, according to Ray, is to find the best plans for consumers that will cover the types of services they desire, for the amount they are willing to pay:

“In [Hillsborough] county alone, there’s 105 plans. Especially if you’re doing virtual or phone appointments, that’s a lot to work through [as a navigator] and there’s no reason to go through all 105 plans when you are able to work with the person and just get some idea of what they can handle what works for them, what they feel like they need in terms of coverage.”

Open enrollment begins later this year on November 1, but Ray and Galey-Ocasio say helping people navigate the state’s coverage landscape happens year-round. Galey-Ocasio laid out the plans for an after-school program that will help students become more health-literate. This includes education on scheduling doctor’s appointments, finding and contacting therapists, and more. Galey-Ocasio outlined the program’s vision: 

“It’s very jarring for a lot of young adults out there, because one moment, they’re being taken care of by their parents. The next moment they’re on their own, and they have no idea what to do or where to go … 

I hope we can change this, or at least give a few young adults the tools to be able to take their health into their own hands.  And maybe even, to further that point, educate them to the point where they can in fact give the tools to other people as well.”