Buying insurance can be a headache, even when the nation’s health care system is not undergoing reforms.
The Affordable Care Act (ACA) has changed eligibility requirements for Medicaid and instated a mandate that almost all U.S. citizens enroll in plans by the end of March. The new law also will cause some state health care programs to expire and clients of these programs may have to enroll in new insurance plans.
Registration for individual and group plans through the New Mexico Health Insurance Exchange (NMHIX) began Tuesday.
This article provides a guide to local resources that can help you sign up for health care through NMHIX Qualified Health Plans (QHP), or plans certified by the exchange. It includes information about how immigration status may impact your options. The article is part of a three-part series about how to navigate the new health care law. Subsequent articles will address the impact of the health care law on clients of different government-sponsored plans, and outreach organizations where you can learn more.
Additional information is included in the online version of this article at rdrnews.com.
Where do I sign up for a Qualified Health Plan or Medicaid?
You can sign up for a QHP by visiting one of NMHIX’s websites, calling NMHIX, sitting down with a insurance broker who is certified to enroll clients in QHPs or seeing a “health care guide” trained by NMHIX to use the exchange to register clients for plans.
Do not accept NMHIX registration services from guides or brokers not listed as certified by NMHIX. Any guide or broker who requests compensation for NMHIX registration services is not certified.
To sign up for plans through NMHIX, you will need the following documentation: social security cards or numbers for everyone in your household whom you wish to enroll, government issued identification card; proof of monthly income, preferably pay stubs; proof of American Indian heritage (if applicable), proof of citizenship or lawful residence (if applicable).
NMHIX has two websites where you can sign up for plans on your own: bewellnm.com (English) and seguroquesinm.com (Spanish). You can also call 1-855-996-6449. This hotline provides assistance in English, Spanish, and other languages as necessary. It will be operate 24 hours a day through at least March, and will later be open 7 a.m. to 7 p.m.
Small businesses, defined by NMHIX as businesses with 50 or fewer employees, are not required to offer insurance to employees. However, they may apply online at shop.nmhix.com/hix/ or contact a broker to register for group plans through the Small businesses Health Options Program (SHOP).
Health care guides are available to help small business owners navigate healthcare options, but may refer small business clients to brokers, said Patti Watson, CEO of Cooney, Watson and Associates, Inc., a marketing agency handling public relations for NMHIX.
Chaves County has two health care guides, Cecilia Cardenas and Alice Palma-Aarmendariz, who work in outreach for non-profit healthcare organization La Casa Family Health Center. Due to an anticipated high load of clients, La Casa is currently offering registration services by appointment only. Appointments can be made by visiting La Casa, 1511 W. Grand St., or calling the organization on its mainline, 575-623-3255, or at its Los Ninos Pediatrics office, 575-622-5956.
Eastern New Mexico Medical Center (ENMMC) is slated to have five health care guides, but is pending as a health care guide location, according to NMHIX.
While ENMMC will accept walk-in registrations, ENMMC Marketing Director Brooke Linthicum said it is best to make an appointment.
You may schedule an appointment with ENMMC now. Appointments are set to begin Oct. 15. To schedule an appointment with ENMMC, you may call any of the following phone numbers: 575-627-4035, 575-624-4559, 575-627-4002, or 575-624-5672. All numbers offer assistance in English and Spanish.
Contact information for certified brokers can be found in the phone book or online at bewellnm.com/find-a-broker/.
A map of health care guide locations in New Mexico can be found at bewellnm.com/were-here-to-help/.
Medicaid will be expanded in 2014 and will be known as Centennial Care. From Jan. 1 on, Medicaid can cover health costs for those who make up to 138 percent of the federal poverty level. Some jail and prison inmates will qualify for Medicaid as part of the expansion.
Human Services Division (HSD) Communications Director Matt Kennicott says 130,000 New Mexicans are expected to be added to Medicaid in 2014. More than 12,000 Chaves County residents are enrolled in Medicaid.
Medicaid enrollment occurs at hospitals, the office of the Income Support Division (ISD), 1701 S. Sunset Ave., in Roswell, through determiners located in public schools, and online with HSD at yes.state.nm.us. You also may call HSD to sign up for Medicaid at 1-855-637-6574.
Applications for Medicaid can be started through the exchange, but cannot be completed unless the applicant visits HSD’s Medicaid enrollment website, calls HSD or visits an ISD office.
Kennicott says that the application process for Medicaid is being streamlined and there will be only one application for Medicaid programs, whereas in the past there were multiple.
How does my immigration status impact my options?
Naturalized citizens have the same access to Medicaid and plans through NMHIX as U.S.-born citizens, and will be fined if they are not enrolled in insurance by the end of March.
Lawfully present immigrants also can sign up for plans through NMHIX, but face restrictions on registration for Medicaid. Among lawfully present immigrants, eligibility for Medicaid is based on visa type, age and length of time spent in the U.S.
Individuals who fall under the category of “qualified immigrant” may apply for Medicaid if they have been in the country five years or more. In New Mexico, there is an exception to this rule for children and pregnant women who are qualified immigrants, who do not need to wait five years.
Undocumented immigrants are not eligible for Medicaid benefits or NMHIX plans. Jenny Rejeske, a health policy analyst for the National Immigration Law Center, said they can purchase private health insurance from outside the exchange, receive emergency services from hospitals and visit community health centers, which sometimes offer services on a sliding fee scale.
Indigent Healthcare Services of Chaves County can partially compensate some healthcare providers for services performed for uninsured individuals, including undocumented immigrants.
Where can I get more information?
To learn more about the Affordable Care Act online, you can visit bewellnm.com, nmhix.com, and healthactionnm.org.
NMHIX is conducting a BeWellNM tour that will stop in 10 cities across the state. As part of the tour, NMHIX will hold an informational session Monday in Artesia. The session will take place from 2:30 p.m. to 4:30 p.m. at Eddy County Fairgrounds, 3402 S. 13th St., in Artesia.
If you are planning on using the exchange to buy insurance, be prepared to wait.
New Mexico’s exchange website for individuals, BeWellNM.com, was marred by slow service when it launched Tuesday.
The website, which will be federally operated through 2014, saw a surge in customers its first day according to the Associated Press.
On Tuesday, Roswell insurance brokers Nicole McWilliams and Renee Swickard were unable to log on to the website.
While the reporter was present, McWilliams tried to log on to the exchange on her office computer. She received a message stating, “We have a lot of visitors on the site right now.”
“Sometimes you get past that to a place where you ask security questions,” said Swickard, who stood behind McWilliams during the attempt.
The website is not the only aspect of the new insurance system in high demand.
La Casa health care guides say they expect a high load of clients seeking health care guide services, which is why they are currently offering guidance for the exchange by appointment only.
La Casa offered similar guidance when SCI was rolled out four years ago. At that time, the health center enrolled 10 to 15 patients a day into the now expiring health plan. They expect a higher load of
clients this time around.
“It is going to be a lot of work,” said La Casa Practice Manager Ana Rangel. “We need to start getting people enrolled because otherwise there are going to be penalty fees for those who don’t.”
McWilliams expressed frustration with the new system.
“We say good luck everybody,” she said.