A consortium of Pennsylvania behavioral health organizations was awarded a federal grant to continue its Navigator Program. The program places support staff in communities to help local residents understand health insurance and sign up for health plans and subsidies in the Health Insurance Marketplace--the online shopping mall for private health insurance. Open enrollment begins Nov 15, 2014.
Comprised of the Pennsylvania Mental Health Consumers' Association, Mental Health Association in PA, Mental Health America of Westmoreland County, and the Advocacy Alliance, the consortium has trained Navigators to help anyone who needs health insurance, including individuals who are looking specifically at behavioral health coverage. All plans offering policies in the insurance marketplace must include behavioral health benefits.
Last year, the group of Navigators helped approximately 1,400 people enroll and provided thousands of Pennsylvanians with information about using the marketplace to obtain insurance. The state relies on the federally operated healthcare.gov site that had serious technical issues during last year’s open enrollment.
“The biggest challenge was when we assisted consumers who fall into Pennsylvania's Medicaid ’gap,’” says Lynn Keltz, executive director of the Pennsylvania Mental Health Consumers' Association. “Occasionally people who very much needed insurance left here in tears. They were above Medicaid eligibility, yet under the income levels to qualify for tax credits and did not have enough income to purchase insurance without the credits.”
Slightly more than half the country has expanded Medicaid, and Pennsylvania just reached a deal in August to move forward on expansion with a federal waiver that will allow it to create its own model of coverage, rather than what was prescribed in the Affordable Care Act. Some 600,000 people could benefit for the 2015 plan year.
Keltz says it was rewarding when last year’s enrollees ultimately accessed healthcare under their new insurance plans and discovered a necessary health service was covered.
In total, the federal government awarded $60 million to 90 organizations for the 2015 open enrollment season. Navigators must receive grant funding and complete training in order to provide service to those signing up for health plans.
According to the Department of Health and Human Services, Navigators provide unbiased information to consumers about the insurance marketplace and other public programs while recognizing the needs of the communities they serve. Navigators were selected to receive funding through a competitive grant process based on their ties with the communities they will be serving and other standards such as effectiveness and program integrity.
Some other behavioral health Navigator grants include:
· The East Texas Behavioral Health Network, which also served the uninsured, underinsured, and self employed population in 75 counties in Texas as a 2013 Navigator grantee.
· The Alcohol/Drug Council of North Carolina, which served as a 2013 Navigator grantee and established Project Jumpstart, implemented by a consortium formed to provide specialized Navigator services to people in recovery from mental illness and/or substance abuse. This year they plan to target people with addiction, young adults, Latinos and uninsured military veterans.