Navigating the Confusing World of Medical Insurance

By Amy Schmidt

For some, November means blaze orange and antlers. For others, it means drawing up the guest list for Thanksgiving and ordering the turkey. For Erin Watson, Mnsure navigator at Sawtooth Mountain Clinic, it means open enrollment for the Mnsure program has begun.

116346Open from Nov. 1 until Jan. 31, 2017, Mnsure’s open enrollment period is for all Minnesota residence who either need to change an existing insurance plan or sign up for the first time. Because all U.S. citizens and legal residents are required to have health insurance coverage (unless you qualify for an exemption or are willing to pay a penalty), the Mnsure open enrollment period is worth paying attention to. Only those who qualify for Medical Assistance or MinnesotaCare, those who have experienced a qualifying event (such as the birth of a child or a job change) or members of a federally recognized American Indian tribe can apply for insurance outside the three month window. Otherwise, if you need insurance, you must apply during the open enrollment period.

As a Mnsure navigator, Watson is trained to provide free help to anyone looking for coverage in the Mnsure marketplace. Those seeking assistance with the process can start with a phone call to Watson at the clinic.

“We go through some basic questions and then, if needed, set up an appointment to walk through the application process together. In most cases, you will leave our meeting with a start date for your insurance coverage,” said Watson.

While not legally allowed to steer anyone toward a particular plan, a Mnsure navigator can help decipher confusing language and decode the different insurance options.

“It can be an overwhelming process for people,” Watson said. “My job is to make it simpler.”

All patients of Sawtooth Mountain Clinic, Mnsure users or not, should also be aware of the Sliding Fee Scale Program. Available to all those whose income qualifies, the Sliding Fee Scale Program helps off-set the cost of medical care by covering a percentage of certain health services. “It covers things like chiropractic care, dental work, lab tests and physical therapy. And that’s just to name a few,” Watson said.

To help explain the program, here’s an example. Let’s say you are a family of five with a gross income is $48,000/year, qualifying you for Sliding Scale Coverage Level D, 20 percent. You’re seen at Sawtooth Mountain Clinic for an ankle injury and your provider determines you need physical therapy. You make a follow-up appointment, schedule a physical therapy treatment with a qualified therapist and because you’re enrolled in the Sliding Scale program, pay only 20 percent of the treatment’s cost.

“It’s worth it,” Watson said. “It makes getting the care you need more affordable.”

So whether you’re looking for help finding your way around the Mnsure website or curious about the Sliding Fee Scale Program, you’re only a quick phone call away from answers. Call Watson at (218) 387-2330 or visit www.sawtoothmountainclinic.org.

Please follow and like us:


By Amy Schmidt