The Herald Bulletin

October 9, 2013

Marketplace options provide 'narrow network'

Officials urge people to check with providers and insurance companies about coverage

By Traci L. Moyer
The Herald Bulletin

---- — ANDERSON — As the problems keeping people from enrolling in the Indiana Marketplace are worked out at the federal and state levels, local officials encourage people to do their research.

“The online system is currently not working well,” said Georgiana Reynal, director of public policy and government relations for St. Vincent Health.

Reynal said the Marketplace products can be confusing for people to understand and they operate differently from insurance plans people may already have or had previously. She said it is important for people who plan to use the Marketplace to talk with their provider, their hospital of choice and health insurance companies to make sure they choose the insurance carrier with the services they want.

“The design of the Marketplace products is ‘narrow network,’ which means that if your doctor or hospital is not contracted with the insurance carrier you choose, you will not be covered,” Reynal said. “However, it is also important to note that there are a multitude of insurance products available outside the Marketplace. For example, if you are currently covered by Anthem outside the Marketplace you will still receive services at St. Vincent Health.”

Reynal explained that General Motor retirees with insurance provided through Anthem are covered by the St. Vincent facilities. She said that Medicare is also not a part of the Marketplace.

“Medicare beneficiaries can enroll in the program’s traditional drug coverage or in a Medicare Advantage plan as usual during the Medicare open season, which begins Oct. 15,” Reynal said.

Both St. Vincent and Community Hospital Anderson are offering enrollment assistance and are available to answer questions regarding the Marketplace.

"We want to be accessible to answer questions,” said Tom VanOsdol, president of St. Vincent Anderson Regional Hospital, in a press release. “Our staff can help individuals prepare to make their final decisions.

“To meet the personal needs of individuals, we are offering a variety of ways to receive assistance: walk-in education and enrollment sessions, personalized one-on-one meetings with trained counselors, as well as assistance by phone," he added.

Reynal said people can complete paper applications to get an idea if they qualify for Marketplace plans. She said until the Marketplace is fully functional online, people will not be able to officially choose an insurance plan, but the paper application will give them an idea of their cost and coverage.

For personalized appointments regarding help with the Marketplace, St. Vincent can be contacted at 646-8240. Community Hospital is offering individual enrollment appointments by calling 298-1775 and leaving a message.

Educational and enrollment sessions at St. Vincent Anderson Regional Hospital, 2015 Jackson St., will be on Monday, Oct. 21, from 8 a.m. to 5 p.m. and Monday, Dec. 2, from 9 a.m. to 7 p.m. Sessions will also be offered at The Impact Center, 630 Nichol Ave., on Wednesday, Oct. 30, from 1 to 7 p.m. and Wednesday, Dec. 11, from 1 to 7 p.m.

Like Traci L. Moyer on Facebook and follow her @moyyer on Twitter, or call 648-4250

Marketplace dates to remember Oct., 1 - open enrollment began Jan. 1 - Health coverage can start March 31 - open enrollment closes