When it comes to health insurance, security can seem lacking.
Meet Quentella Perry, whose work at the nonprofit organization Covering Wisconsin involves helping people deal with complexity. Just as accountants have their busy season at tax time, people like Perry have a full-time job helping people navigate the choices offered during the Nov. 1-Jan. 15 Open Enrollment Period.
The open enrollment period is a time when people can change or sign up for a health insurance plan—either through their employer or through the federal health insurance marketplace if they qualify for those subsidies.
Outside this period, people can only enroll in plans under certain circumstances, including finding a new job, getting married or having a child. If a person meets the criteria, state Medicaid programs, such as Wisconsin’s BadgerCare Plus, can enroll year-round.
However, regardless of the source of health insurance, almost everyone is confused about it on some level.
This is where Perry and people like her come in.
Perry will clear up that confusion.
She will answer your questions.
She will guide you through the steps.
You will leave your appointment with an insurance plan that fits your needs.
Perry is a licensed health insurance navigator at Covering Wisconsin, a nonprofit organization based at the University of Wisconsin-Madison that educates people about health insurance and helps them choose a plan. Works all over the state, including Milwaukee.
Covering Wisconsin is part of a coalition of organizations and agencies working to increase enrollment among all residents, but especially those who are uninsured.
There are 55,000 uninsured people in Milwaukee County, and nearly 35,000 of them live in the city, according to data provided by the Milwaukee Health Care Partnership. The nonprofit organization partners with health care providers, government agencies and community organizations to serve vulnerable residents.
Other organizations that employ navigators helping Milwaukee residents include the Gerald L. Ignace Native American Health Center, Progressive Community Health Centers and Feeding America.
More than work
Perry, 40, was born and raised in Milwaukee. She has been a navigator for four years, but before that she was a Certified Application Counselor, or CAC, for many years.
A CAC is a staff position in a medical facility, such as a hospital, to assist patients when they apply for health insurance. CACs often transition into navigators. Navigators have more experience and can assist the CAC when they encounter particularly complex or challenging cases.
“This is my passion. I believe education is key. Educating people in the community is key. It’s something I love to do and that’s why I keep doing this job,” Perry said.
“We do not receive commissions; all information we provide is unbiased. Our services are free for individuals,” she said. “A lot of the brokers — they work on commission — and people struggle to figure out if they have their best interest in mind.”
Education should always be a navigator’s first goal, said Cheryl Isabelle, Milwaukee community manager at Covering Wisconsin.
“To understand what a premium is … . To explain to them what a surcharge is. If you’ve never had insurance or had to pay for health insurance, you don’t know,” Isabelle said.
All the information and documentation can be difficult to keep track of – even for those who are fluent in the process.
“It’s very confusing,” said Winona Grieger, a navigator at the Gerald L. Ignace Indian Health Center. “Every person you work with is never the same. Everything is always different.”
Once the client understands all those moving parts, “then we discuss different plans,” Isabelle said.
The staff urges you to sign up
The Wisconsin Department of Health has sent a “call to action” to organizations like Covering Wisconsin.
The mandate is simple: enroll, enroll, enroll.
The reason for the call for action, in addition to the number of uninsured people, is that there is additional financial assistance for health coverage that has not been available in recent years.
If people “have looked before and just chose not to have health insurance coverage because it wasn’t affordable for them, they need to look again,” Isabelle said.
Another big change is fixing what insurance professionals call the “family problem.”
“If you’re employed, your employer may offer health insurance, but it’s only available to the employee — a family plan may not be available,” Isabelle said. Until now, these family members were ineligible for alternative assistance through the marketplace, which meant that the insurance options for family members were between a plan that was prohibitively expensive from the employer or a plan without financial assistance through the marketplace.
“Now that the family issue is fixed, family members have the ability to get these tax credits (through the marketplace), so now the whole family can be insured,” Isabelle said.
Another concern of particular urgency to Navigators is the potential end of the federal public health emergency that allowed people covered by BadgerCare Plus to keep their coverage regardless of changes in their income or household size. BadgerCare Plus recipients are also not required to update their information, which is required every 12 months under normal circumstances.
When the public health emergency is finally over, recipients will need to update their information and be reevaluated to determine if they can keep their coverage.
Although the public health emergency has been extended 11 times since it was originally declared in January 2020 and is currently extended until January 11, many health professionals expect it to end next year.
“A lot of people are used to getting help through the state program, and as everyone goes back to work and everyone starts working, some people will potentially lose their coverage because they’re over the income limit,” Perry said.
For more information
To make an appointment with a navigator at one of the many agencies, you can use this online tool hosted by Covering Wisconsin.