When it comes to health insurance, certainty can seem scarce.
Meet Quentella Perry, whose job at the nonprofit Covering Wisconsin is helping people plow through complexity. Just as accountants have their busy season during tax time, people like Perry have their hands full helping people navigate the choices presented during the tax season. Open Enrollment Period from November 1 to January 15.
The open enrollment period is a time when people can change or sign up for health insurance — through their employer or the federal health insurance marketplace, if they qualify for those subsidies.
Outside of this period, people can only enroll in plans under certain circumstances, such as getting a new job, getting married, or having a child. If someone meets the criteria, state-run Medicaid programs, such as Wisconsin’s Badger Care Pluscan be enrolled all year round.
Regardless of the health insurance source, however, virtually everyone is confused about it on some level.
This is where Perry and people like her come in.
Perry will clear up that confusion.
She will answer your questions.
She will guide you through the steps.
You will come out of your meeting with an insurance plan that meets your needs.
Perry is a licensed health insurance navigator with Covering Wisconsin, a nonprofit at the University of Wisconsin-Madison that educates people about health insurance and helps them choose a plan. It operates throughout the state, including Milwaukee.
Covering Wisconsin is part of a coalition of organizations and agencies working to increase enrollment among all residents, but especially those who are uninsured.
There are 55,000 uninsured people in Milwaukee County, and nearly 35,000 of them live in the city, according to data from the Milwaukee Health Care Partnership. The nonprofit works with healthcare providers, government agencies and community organizations to serve vulnerable residents.
More than a job
Perry, 40, was born and raised in Milwaukee. She has been a navigator for four years, but many years before that she was a qualified application consultant or CAC.
A CAC is a staffed position within a medical setting, such as a hospital, to assist patients in applying for health insurance. CACs often transition into navigators. Navigators are more experienced and can assist CACs when they encounter particularly complex or challenging cases.
“This is my passion. I believe education is key. Educating individuals within the community is key. This is something I enjoy doing and that is why I will continue to do this work,” said Perry.
“We don’t receive commissions; all information we provide is impartial. Our services are free for individuals,” she said. “Many brokers – they work without commission – and individuals struggle to figure out if they have their best interests at heart.”
Education should always be a navigator’s first goal, said Cheryl Isabell, Milwaukee community engagement lead at Covering Wisconsin.
“To understand what a bounty is…. To explain to them what a copay is. If you’ve never had insurance or had to pay for health insurance, you don’t know,” Isabell said.
It can be difficult to keep track of all the information and documentation, even for those who are fluent in the process.
“It’s very confusing,” says Winona Grieger, a navigator at the Gerald L. Ignace Indian Health Center. “Each person you work with – it’s never the same. Everything is always different.”
After the client understands all these moving parts, “we discuss different plans,” Isabell said.
Officials are urging you to register
The Wisconsin Department of Health Services has issued a “call to action” to organizations such as Covering Wisconsin.
The mandate is simple: subscribe, subscribe, subscribe.
The reason for the call to action, in addition to the number of uninsured, is that there is additional financial aid for health coverage that has not been available in recent years.
If people “have looked before and just chose not to have health insurance because it wasn’t affordable for them, they need to look again,” Isabell said.
Another major change is resolving what insurance professionals call the “family breakdown.”
“If you’re salaried, your employer may offer health insurance, but it’s only affordable to the employee — the family plan can be prohibitively expensive,” says Isabell. Until now, those family members were not eligible for alternative help via the marketplace, so that the choice to insure the family members was between a scheme that was unaffordable via the employer or a scheme without financial aid via the marketplace.
“Now that the breakdown in the family has been resolved, the family members have the option to get those tax credits (through the marketplace), so now the whole family can be insured,” said Isabell.
Another concern of particular urgency for navigators is the possible end of the federal public health emergency, allowing people covered by BadgerCare Plus to maintain coverage regardless of changes in their income or household size. BadgerCare Plus recipients are also not required to update their information, which is normally required every 12 months.
When the public health emergency finally comes to an end, recipients will need to update their information and be reassessed to determine if they can maintain their coverage.
While the public health emergency has been extended 11 times since its original proclamation in January 2020 and is currently being extended until January 11, many health professionals expect it to end within the next year.
“A lot of people are used to getting help through the state program, and with everyone going back to work and everyone going back to work, some people may lose coverage, because they’re crossing the income line,” Perry said.
For more information
You can use this to make an appointment with a navigator at one of a number of agencies online resource hosted by Covering Wisconsin.