LGBTQ advocacy groups in New York are scrambling to help people choose appropriate Obamacare healthcare plans for the new year before the December 15 deadline.
Gay Men’s Health Crisis (GMHC), New York’s LGBT Community Center, and others have deployed navigators and certified application counselors — trained experts who help people sign up for healthcare — to meet with potential enrollees to discuss the different plans available on the exchange. These experts serve as important resources for LGBTQ folks who might have specific questions about finding a plan that caters to their needs. Some people are searching for general coverage, while others are looking for plans with LGBTQ-friendly doctors or coverage of HIV medications and PrEP.
The healthcare plans, which are subsidized by the government based on income, have been under attack from the Trump administration, which has employed various tactics to cripple the Affordable Care Act. To that end, advertising dollars have been slashed, leaving vulnerable populations without proper notice that they need to sign up in the coming weeks in order to be covered on January 1.
Alexandra Remmel, who serves as GMHC’s director of advocacy and is a certified application counselor, told Gay City News that she and her colleagues work around the clock to meet with those who are looking for healthcare plans.
“We see people as a walk-in if they happen to come in or we can make appointments,” she said. “We need to be flexible. If they’re working individuals, there is a commute attached.”
Remmel stressed that there are important distinctions to consider for people who are HIV-positive compared to those who are negative. The AIDS Drug Assistance Program (ADAP) can help cover medication costs for HIV-positive individuals in need.
“From ADAP’s perspective, platinum is perfect,” Remmel said, referring to the highest “medal” level of coverage. Platinum plans have the most expensive premium, but other expenses are usually covered — and ADAP recipients can get assistance. Bronze plans offer the cheapest coverage, followed by silver, gold, and platinum options. Plans with lower premiums have higher deductibles and more out-of-pocket costs.
ADAP does not cover the cost of PrEP since it only serves those who are HIV-positive. Prescription drug coverage can, therefore, also be a key consideration for those who are HIV-negative.
For people making $24,280 or less annually, Remmel touted the Essential Plan, which costs $20 or less per month and provides coverage for doctor visits, prescription drugs, and more. But regardless of income, she said, it’s important to explore all options to stay covered and remain healthy.
“If you’re living a life that is at all risky, the center here can help you figure out how to get PrEP and to get it covered,” she added. “But individuals need access to care for everything, too.”
The enrollment period started on November 1 and extends to January 31, but individuals must sign up by December 15 in order to be enrolled on January 1. Those who apply by January 31 can still be covered for the remainder of 2019.
Anyone currently enrolled in existing plans for 2018 still must sign up for plans for 2019.
To enroll directly on the State of Health website, click here.