Smart Talk

Smart Talk is a daily, live, interactive program featuring conversations with newsmakers and experts in a variety of fields and exploring a wide range of issues and ideas, including the economy, politics, health care, education, culture, and the environment.  Smart Talk airs live every week day at 9 a.m. on WITF’s 89.5 and 93.3.

Listen to Smart Talk live online from 9-10 a.m. weekdays and at 7 p.m. (Repeat of 9 a.m. program)

Host: Scott LaMar

Smart Talk: Open enrollment for health insurance questions

Written by Scott LaMar, Smart Talk Host/Executive Producer | Nov 2, 2015 9:10 AM
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Healthcare.gov photo

What to look for on Smart Talk Monday, November 2, 2015:

There still are many questions about the Affordable Care Act five years after it was signed into law by President Barack Obama.  Americans have even more questions about the complicated law when the healthcare exchanges are open for those without health insurance or are looking to find another plan.

Open enrollment began Sunday for those shopping for a plan.  It will run until January 31, 2016.

Someone who wants health insurance to take effect on January 1 must choose a plan by December 15th.

There still are close to a million people in Pennsylvania who are uninsured.  The state says two-thirds of them are eligible for subsidies to help pay their premiums or Medicaid.

Fines increase to $325 for adults and $162.50 for children in 2015 for those who go without health insurance.  Next year, the fine goes up to $695 per adult.

To answer the many questions about Obamacare and enrolling for health insurance on Monday's Smart Talk are Pennsylvania Insurance Commissioner Teresa Miller and navigators Lynn Keltz, Executive Director of the Pennsylvania Mental Health Consumers Association and Sue Walther, Executive Director of the Mental Health Association.

Pennsylvania health insurance exchange links

HealthCare.gov
800-318-2596

Transforming Health's Getting Covered
The Affordable Care Act in Pennsylvania

PA Insurance Department

Click on health under top issues for more information

State Exchange Profile: Pennsylvania
The Henry J. Kaiser Family Foundation overview of Pennsylvania's progress toward creating a state health insurance exchange.

PAHealthOptions
Operated by the Pennsylvania Health Department

Health Care Section, Office of the Attorney General
Serves Pennsylvania consumers with health-related problems.
(717) 705-6938 / Toll-free: 1-877-888-4877 (only in Pennsylvania)

Pennsylvania Consumer Assistance Program
Assists people with private insurance, Medicaid, or other insurance with resolving problems pertaining to their health coverage; assists uninsured residents with access to care.
(877) 881-6388 / ra-in-consumer@state.pa.us

Get help with your application to the Health Insurance Marketplace or Pennsylvania Medicaid/HealthChoices from Pennsylvania Mental Health Consumers Association Navigators. Call 1-855-274-5626.

To find a Federally Qualified Health Center in your Community, call 717-761-6443 or Toll Free at 866-944-CARE, or go to the PACHC website at: www.pachc.org, click on Health Centers, then " Find a Health Center" (left-hand side of page), then search by County (click on drop down menu for the County nearest to you).

For more on Open Enrollment plus a deeper look at the changing tide of healthcare, check out WITF's Transforming Health. From policy to personal choices we're taking a comprehensive look at today's health system. A partnership of WITF, WellSpan Health and Penn State Hershey Medical Center.

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Teresa Miller, Lynn Keltz & Sue Walther

Published in News, Smart Talk

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  • Radio Smart Talk img 2015-11-02 10:30

    Cindia emails:

    Before buying insurance, be sure to check if your providers are in network!

    I live in Lancaster County. I discovered (after some digging) that nearly a third of my offers on healthcare.gov are for insurance with NO in-network providers in Lancaster County!

    These were the Capital Blue Cross HMO plans. These HMO plans were the cheapest on-line but they are essentially worthless since they don't have any in-network providers in Lancaster County!!

    BTW, I couldn't believe this was true so I called Capital Blue Cross and confirmed that they have NO Lancaster Co providers.

  • Radio Smart Talk img 2015-11-02 10:30

    Thomas emails:

    I am a young, healthy, self employed person, and I want to make it very clear that the ACA has really screwed me. My premiums went up 60% (I do not qualify for subsidies) and my benefits went down. Sooooo, Thanks.

  • Radio Smart Talk img 2015-11-02 10:31

    A Listener emails:

    In regards to why premiums went up for people/companies who had health insurance before the ACA was implemented.. the ACA required insurance plans to have no limits on coverage where previously the plans had limits.

    This is one factor that caused private insurance to increase premiums and also to introduce deductibles and copays for things that they are allowed to charge copays. There are other factors but the unlimited coverage was one cause of premium increase.

  • Mark img 2015-11-02 10:32

    I currently pay $230/month (Capital Blue Cross – name company at your discretion…), for a bare-bones "catastrophic" plan, not through the exchange, paid directly to the company. The cheapest policy on the exchange for my age, etc., is $424. I don’t make enough money to qualify for a subsidy in Pennsylvania. Can you offer any other ways to “shop around” other than the exchange?

    • Lynn PMHCA img 2015-11-02 16:34

      Please feel free to give us a call at 1-855-274-5626 so we can talk with you about your unique needs. Thanks for listening and emailing! You can also email pmhca@pmhca.org so that we can be in touch.

  • Mark img 2015-11-02 10:32

    I currently pay $230/month (Capital Blue Cross – name company at your discretion…), for a bare-bones "catastrophic" plan, not through the exchange, paid directly to the company. The cheapest policy on the exchange for my age, etc., is $424. I don’t make enough money to qualify for a subsidy in Pennsylvania. Can you offer any other ways to “shop around” other than the exchange?

  • Radio Smart Talk img 2015-11-02 10:36

    Mike emails:

    Wouldn't it be better to finally implement socialized, single payer healthcare, such as that promoted by Bernie Sanders? Great topic today. Thanks!

  • Radio Smart Talk img 2015-11-02 10:38

    Ben emails:

    Every time I hear a complaint about how much my insurance premiums went up because of the ACA, I never hear about the insurance insurance details. Almost everyone who had large increases in premiums ended up with a plan covering much more. Having insurance is not the same as having insurance that will cover serious illness. Please help to dispel the illusion.

  • Radio Smart Talk img 2015-11-02 10:40

    A listener emails:

    Again regarding insurance rates, adding coverage for young adults to a parents plan until they are 26, mental health requirements, no copays for preventative services, and trying to rate groups of people with no previous rate experience and taking into consideration the possibility that people signing up will be people who are sick and have needed insurances are all factors that insurance companies had to consider when trying to come up with rates for insurance.

  • Radio Smart Talk img 2015-11-02 11:07

    A listener emails:

    CHIP was mentioned by a guest. CHIP is a really rich benefit and is available to all kids. Please ask Teresa for a comment on the future of CHIP.

  • Radio Smart Talk img 2015-11-02 11:08

    Laura emails:

    Does the state expansion plan for Medicaid have asset limits? I have good retirement assets and don't want to have to exhaust them before receiving Medicaid benefits? I lost my job 2 1/2 years ago. Also, do all physicians take patients who are on Medicaid plans? I would hate to have to change from my long-time physician.

  • Scott LaMar img 2015-11-02 12:56

    Mark ask...
    How many people are losing coverage because highMark is canceling plans?

  • Scott LaMar img 2015-11-02 12:57

    A question about navigators...
    Please tell us where the phone #s for navigators are listed on your website. I’ve been all over it and still cannot find the list you say is posted.

    • Lynn PMHCA img 2015-11-02 16:36

      Please feel free to give us a call at 1-855-274-5626 so we can talk with you about your unique needs. Thanks for listening and emailing! You can also email pmhca@pmhca.org so that we can be in touch.

  • Scott LaMar img 2015-11-02 12:58

    Mary wants to know...
    My husband, toddler son and I live in Lancaster county. I work part-time and am not eligible for health insurance. My husband works for a small business who stopped providing health insurance last year. We make too much money to qualify for any tax credits or subsidies. Last year we chose a plan on the market place with a $515 monthly premium. That plan is no longer available in 2016 and we have to find a new one. I looked at our options last night and the closet comparable plan will now cost us over $650 a month and we will now have a higher deductible and no copays! What are people in our situation supposed to do in order to have health care and be able to survive and pay our other bills!

    • Lynn PMHCA img 2015-11-02 16:41

      Please feel free to call us. It is possible that with plan costs increasing, tax credits will be different for you this year. CHIP (Children's Health Insurance Program) is likely available for your child. The cost for CHIP is dependent upon parents' income and is different than costs on the Marketplace. 1-855-274-5626. We have a navigator who can meet with you in Lancaster County.

  • Lynn PMHCA img 2015-11-02 16:38

    Sue Walther of Mental Health Association in PA and I were on Smart Talk this a.m. Several people asked for our telephone number. For assistance from a certified health insurance navigator, please call 1-855-274-5626. You will hear options for western, central and eastern PA. You should chose your region (Central PA is 3). If lines are busy, please leave a message and we will get back to you in 24 to 48 hours. Thank you all for listening and commenting.