#Ready4OE2: Assisters Should Help Connect Consumers to All Potential Coverage Options and Benefits

By Guest Blogger

As we count down to the start of the second open enrollment period (OE2) on November 15, Enroll America’s #Ready4OE2 blog series will feature a new entry every weekday in October sharing lessons learned from OE1 and strategies for OE2. For more tips and tools, check out the #Ready4OE2 webinar series!

This post was written by Lisa Stein, Vice President for Work and Family Supports, Seedco.

Strategy for OE2: Equip Navigators with information so that they can effectively and efficiently connect consumers that fall into the Medicaid gap to the full range of free or low-cost coverage options in their community, and screen consumers for other public benefit programs.

Where and when it was used during OE1: Georgia and Tennessee

Notable metrics from OE1:

  • 23 percent of the people that Seedco Navigators screened in Georgia did not qualify for Medicaid or financial help through the marketplace. All of these individuals were provided a referral to a free or low-cost health clinic if they indicated they wanted or needed it.
  • Of the folks Seedco screened for other public benefit programs, all were found eligible for at least one other benefit, and 65 percent received assistance to submit an application for other programs.

How it worked:

Seedco operated across four states (New York, Maryland, Georgia, and Tennessee) during OE1 as in-person assisters to help raise awareness among consumers about the new coverage options and financial help available through the marketplace, Medicaid, and the Children’s Health Insurance Program (CHIP), as well as to help consumers complete the application and enrollment process. This work required a detailed understanding of the different coverage options available to consumers in a given state.

For enrollment assisters working in states that have not yet expanded Medicaid (such as Georgia and Tennessee), it is not always possible to help consumers find an affordable coverage option. For example, in Georgia, there are approximately 409,350 individuals who fall into the Medicaid gap, equaling 31 percent of the state’s uninsured non-elderly population. Because of this, Seedco knew it needed to develop a resource for its Navigators to ensure that consumers in the Medicaid gap were efficiently and effectively connected to low-cost health care resources in the community.

To do this in Georgia, Seedco merged two referral lists: the statewide network of community health centers and the Charitable Care Network, an association of free health clinics throughout the state.

Seedco sorted the referrals by ZIP code, and created a binder for all of its assisters to use when conducting outreach and enrollment activities. If an in-person assister encountered an individual who was not eligible for marketplace coverage with financial help, they were given a referral to a nearby free or no-cost health clinic. This approach helped our assisters do their job effectively, and consumers greatly appreciated this assistance. We will use this approach again in OE2.

Furthermore, whenever possible, our in-person assisters used a technology tool we developed, Earn Benefits Online (EBO), to screen consumers for other public benefit programs, including the Supplemental Nutrition Assistance Program (SNAP, formerly known as food stamps), the Earned Income Tax Credit, home energy assistance, and many more. If a consumer wished to complete an application on the spot, they could. If not, there would be a follow up. This helped ensure consumers left meetings with our in-person assisters with the satisfaction that they knew about all available coverage options and resources available to them and their families.

Best practices to replicate for OE2:

  • Understand the specific dynamics in your state and region and tailor your enrollment efforts to best fit the needs of your community.
  • Develop a referral list of community health centers and free health clinics across the state and be prepared to share nearby options with consumers that don’t qualify for other forms of financial help to pay for health coverage.
  • Leverage online tools or other mechanisms to inform consumers about other types of benefits that they may be eligible to receive in addition to their coverage options.
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