Megan Jeffords was overwhelmed when she got her first job at a local hospital in 2010 and had to sign up for employee health insurance.
She had four plans to choose from, one decision to make and what felt like a thousand questions.
“I had to get someone to choose it for me,” said Jeffords, 26, now a first-year student in the physician assistant program at Georgia Regents University.
Four years later, it’s still difficult to navigate a complicated web of copays, deductibles, out-of-pocket expenses and knowing which procedures may not be covered by insurance.
“I still need help and I’m not always sure what it all means,” she said.
To get some insight on how to properly use her insurance, Jeffords on Tuesday attended a forum hosted by Christ Community Health Services Augusta, where three panelists answered common questions about coverage and how to make the most of office visits. The forum looked to help those who may have acquired insurance for the first time under the Affordable Care Act and those whose plans may still seem daunting.
Ronald Skenes, Christ Community’s director of communications and development, said since enrollment for the Affordable Care Act began in October, the Center has seen many first-time insurance holders discouraged by the system.
“For folks getting covered for the first time, a lot of the terminology is almost like a foreign language,” Skenes said. “We want to make sure if someone’s getting covered, they’re getting the best of what they pay for and not skipping something because they can’t pay for it.”
The forum covered the basics of what’s behind copays, deductibles, who is eligible for Medicaid and Medicare, the differences between an HMO (Health Maintenance Organization) and a POS (Point of Service), as well as what kinds of health needs are best suited for a primary care physician or the emergency room.
Skenes said Christ Community has seen a huge need for people who were left slighted by the state’s decision to not expand Medicaid – low income patients in their 50s and 60s who now do not qualify for Medicaid but can not afford the premiums of insurance plans in the Health Insurance Marketplace.
“They need all the help they can get,” he said.
Skenes said Christ Community will continue to work on outreach to those who need help navigating the health care system or signing up for the first time. Two health care navigators hired to help people enroll for the 2014 cycle will also be reaching out this year to help with awareness before the 2015 enrollment cycle begins in November.
Tuesday’s forum at Heritage Academy was sparsely attended, by only a handful of people, and Skenes said spreading the word is part of the battle.
“It’s a long process,” Skenes said. “It’s sometimes hard to put ourselves in the shoes of somebody just now eligible. It can make a huge difference in their life.”