Health Care Coverage Help Lines: Helping People Enroll Is Just the Start

By Guest Blogger

The following blog was written by Brian Rosman and Kate Bicego of Health Care For All (HCFA). Brian is Research Director and Kate is Consumer Education and Enrollment Manager.

When open enrollment for health coverage through exchanges or expanded Medicaid begins in October 2013, millions of people will be applying for new coverage. Many of them will need help navigating the enrollment process, and toll-free telephone help lines are going to be a critical source of assistance. Help lines have already been put to good use in some states, like Massachusetts, where the Health Care for All (HCFA) HelpLine has served a vital role in enrolling more than 300,000 uninsured residents in state health reform coverage that began in 2006. The HCFA HelpLine has also been instrumental in helping the state identify and fix enrollment problems. 

Health Care for All (HCFA), a nonprofit consumer-based organization, had been operating its multi-lingual HelpLine for several years before the Massachusetts health reform law was enacted. It was a relatively small operation that fielded a few thousand general health care coverage inquiries per year. After the law was passed, call volume spiked to 32,746 inquiries in 2007.

The HCFA HelpLine now fields around 40,000 calls per year and serves as an indispensible resource for callers. Using custom software that is connected to a database, counselors can fill out complicated health coverage applications for callers. This usually takes less than five minutes, while the task would take significantly longer for consumers to do on their own. Because the counselors know the ins and outs of all the programs, their advice is tailored to the needs of the caller instead of to any particular program. Counselors also pass on tips that they’ve picked up, such as which days are best to fax in supporting documents.

More Than Enrollment

The HelpLine doesn’t just help consumers who are seeking coverage options. Policy makers and program administrators also rely on it as an “ear to the ground.” The HelpLine collects crucial data about the types of problems people experience. It then shares that information in order to improve health reform. Here’s one example:

HelpLine counselors once noticed that many of the people they had helped enroll in a state coverage option were getting termination notices. The counselors quickly informed state officials, who discovered a computer glitch that was sending termination notices to people for not returning a form they had never received. The computer glitch was fixed, people stopped receiving the notices, and coverage was reinstated for those who had lost it.

This is just one example of the invaluable role that health care consumer assistance programs like the HCFA HelpLine can play in health reform implementation. As the Affordable Care Act goes into effect, it will be imperative that consumers throughout the nation receive ongoing one-on-one assistance with health coverage and enrollment from well-trained counselors who offer culturally and linguistically competent assistance. In many cases, local or state-based non-profits organizations may be the best resources to offer such assistance to the uninsured and to the most vulnerable populations. In addition, help lines can provide real-time information about how well the law is working for real people, generating improvements along the way. 


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