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Massachusetts health care — wonky, with a healthy dose of reality

National Health Reform is Good For Massachusetts: Helping Pam

National Health Reform is Good For Massachusetts: Helping Pam

March 16, 2010

HCFA’s HelpLine is on track to field more than 40,000 calls this year. Every day we hear from HelpLine callers who tell us that were it not for our help, they would be stuck without access to health care. National health care reform would ensure access to health care coverage for millions of Americans by including funding for consumer assistance programs. The story below demonstrates the importance of consumer assistance programs like our HelpLine. – Kate Bicego

Pam (not her real name) called the HelpLine because her employer stopped helping her to pay for her health insurance coverage. She was earning about $30,000 annually and said there was no way she could afford almost $500 each month for the employer’s health insurance. The HelpLine Counselor she spoke to helped her to apply for a subsidized health insurance option by filling out an application over-the-phone and explaining the necessary documentation.

After going through the initial application process, Pam received a notice saying that she would be ineligible for subsidized coverage due to her offer of insurance through her job. Pam called the HelpLine Counselor again, scared that she now had no affordable health care option. The counselor eased Pam’s mind by explaining that she only needed to fill out a form; then she helped her to fill it out, and send it in to the correct place.

The form was processed and Pam was able to get onto the health care coverage program because of the counselor’s assistance. But Pam still had questions like, ‘How do I choose a health plan?, What plan should I choose?, and What does the plan cover?’ Once again the HelpLine Counselor was able to answer all of Pam’s questions and ensure that she understood how to use her new health care coverage.

A year later, when it came time for Pam’s annual renewal period for her health insurance, the Helpline Counselor gave Pam a call. The counselor helped Pam to complete the form over the phone and gave her instructions for submitting it complete so that she didn’t experience any gap in coverage. Pam remarked she wouldn’t have known where to turn to for assistance was it not for the HelpLine.
-Hannah Frigand