“What makes the ACA special in particular, is the fact that you can receive a subsidy to help pay for your monthly premium,” said Amir Jones, a certified Affordable Care Act application counselor.
“If we think about the spirit of the law and what Obama at the time was looking to do, he was trying to make health insurance accessible, and to demystify, if you will, the actual process of purchasing health insurance,” Jones added.
The comments came during a special Tuesday edition of Q Conversations (watch below), a live virtual event with Project Q Founder Matt Hennie. Social worker Angel Robinson also joined the discussion.
AbsoluteCare partnered with Project Q for the event. Both guests are among its staff helping patients navigate the insurance exchange’s current Open Enrollment period, which closes on Dec. 15.
“We’re down to the wire,” Robinson said. “I’m definitely working long hours just trying to make sure they anybody that calls that we’re able to connect with those people, we’re able to get those consultations and those estimates together.”
As the deadline looms, navigators are busy with questions about the system. People seeking insurance are not limited to the online exchange — applications are available via phone or by mail — but the website does have its advantages, Jones said.
“You can compare in real time what your options would be upon the completion of an application,” he said. “There’s what’s called an estimator tool that gives you the ability to see based on a couple of criteria — among them income, family household size and age — whether you’re eligible for a subsidy before you even complete the application.”
LGBTQ ‘respect and dignity’
For LGBTQ people and people with HIV, the ACA offers protections that prohibit discrimination based on sexual orientation, gender identity and medical history, Jones said.
“You are going to be able to receive fair, impartial and respectful care,” Jones said. “The essential health benefits that are available, they’re available to everyone that purchases that plan or looks at that health insurance coverage.”
“For people that are queer and trans, or living with or impacted by HIV, they’re able to see and know what the cost of their medications are, if their doctors are in network or not,” he added. “As well as an application counselor or navigator to walk them through the process and be given all the respect and dignity that they deserve.”
Making sure applicants with HIV find coverage of their specialty medications is one of the common challenges when considering plans, Robinson said.
“We’re going to be making sure that whatever your current med list is, that that’s going to be covered through the prospective carrier that we’re looking at,” she said. “We know that antiviral medications could be on the higher tier of meds, so we will be able to have the discussion.”
Jones said the ACA addresses concerns specific to transgender applicants.
“They may or may not be at a point of doing the medical transition, or that may not be the best fit for them,” Jones said. “For folks that are on HRT, or for the folks that are looking to add surgery to their gender-affirming care, you can look up providers on the exchange.”
Robinson agreed that every case varies.
“Where you are as a person, what things you’re looking forward to doing, we can have a deeper discussion,” she said. “It can vary from person to person.”
Individual concerns for every applicant are exactly why certified navigators and counselors are there, the guests said. For AbsoluteCare, that extends to anyone who is not a patient of their medical practice.
“We absolutely will still speak with you, we will still talk to you, we will still navigate you the route,” Robinson said.
Jones, who previously worked with the LGBTQ clients of the Health Initiative, seconded that sentiment.
“If I don’t have the answer, I can refer you to someone else that can,” he said. “There are sets of colleagues that I have that are more than happy to assist.”