Need help with insurance enrollment? You’re not alone.

Looking for a new healthcare plan is a challenge. In a national Kaiser Family Foundation survey, fielded March – April 2020, more than 2,000 individuals were asked about the enrollment process. 18 percent reported that they received professional help finding a new insurance plan that year and 22 percent of those who did not report getting professional that year reported getting help in a previous year. 

Of those who received help in 2020, 62 percent said they sought help because they did not understand their coverage options and 52 percent said the process of applying was too complicated to complete on their own. Others cited limited internet access, technical problems with the website, or needing help in another language. 

Unfortunately, post-pandemic Medicaid redeterminations in Michigan and other states have only made this process more complicated. People who still qualify for Medicaid are losing their coverage due to procedural errors and failure to complete their renewal paperwork and struggle to get their coverage back on their own. Medicaid denial letters–the paper notices people receive when they no longer qualify or are denied coverage–have not included next steps to find alternative health coverage, nor assistance. Without instruction and assistance options, the confusing process of picking the right plan may leave many uninsured.

“People think they should be able to figure it out on their own, and they feel bad when they can’t,” says Meredith Buhalis, a certified health coverage navigator at the nonprofit Washtenaw Health Project in Ypsilanti. The Washtenaw Health Project specializes in helping people access affordable health care; the majority of their staff spend their day meeting with clients to enroll them in health coverage plans and explain how those plans work. They have been seeing the issues with the post-pandemic Medicaid redetermination process firsthand. 

“Health insurance is incredibly complicated,” she continues. “People shouldn’t feel bad if they can’t do it on their own. They should come see us, or work with someone who understands the nuances of all the options so that they can get the best possible outcome.”

Navigators, Assisters, Counselors, Agents, Brokers. What’s the difference?

The Affordable Care Act mandates that states provide navigator programs to help residents apply for coverage. Navigators—also referred to as assisters and counselors—complete training to become federally-certified in helping consumers navigate the health insurance system to find the most affordable coverage that meets their needs. Navigators are required to provide free, unbiased assistance. They help consumers find the best coverage and financial assistance they’re eligible for,complete applications, and connect with medical providers that accept their insurance.

People looking for a new insurance plan can also request help from agents/brokers—licensed professionals who usually represent an insurance company—but that probably isn’t the best option. While brokers can offer specific recommendations, they can be motivated by financial incentives to enroll clients in their company’s insurance plans and can charge for their services. Additionally, data from the Kaiser Family Foundation shows that, compared to marketplace navigators, brokers are less likely to help clients who are uninsured, need help in different languages, or apply for Medicaid. 

Washtenaw County nonprofits are here to help

Hope Clinic and Packard Health help low-income Washtenaw County residents navigate coverage and financial assistance options, and Washtenaw Health Project helps anyone enroll in Medicaid, Marketplace, and Washtenaw Health Plan coverage, as well as financial assistance options, no matter their income.

Packard Health

Individuals can call Packard’s main number (734-971-1073) and request assistance with insurance navigation. They will be offered an appointment with one of Packard’s Patient Resource Specialists. 

Hope Clinic 

Patients who come into the clinic for medical care receive a healthcare navigation evaluation to see what insurance options they may qualify for. Individuals from the community can also schedule a healthcare navigation visit with Hope’s Patient Advocates to apply for Medicaid or receive referrals to other resources.

Both Packard Health and the Hope Clinic refer patients to the Washtenaw Health Project, another area nonprofit, when they’re unable to provide sufficient support. 

“The Washtenaw Health Project is a wonderful resource for clients to receive help navigating insurance, applying for Washtenaw Health Plan coverage, understanding Medicaid application issues, the Marketplace, etc,” says Julie Payne of the Hope Clinic. 

Washtenaw Health Project 

The Washtenaw Health Project (WHP) provides the most robust navigation assistance for Washtenaw County residents and is able to assist in almost all cases. WHP takes referrals from Hope Clinic, Packard Health, Washtenaw County Community Mental Health, hospitals, and other local organizations for clients seeking navigation assistance that have more complicated cases. For example, factors like immigration status, differing eligibility between family members, and income that’s not easily calculated can make selecting a healthcare plan difficult. But WHP navigators work with every client to secure accurate and detailed information on clients’ situations and incomes in order to find the most advantageous plan they’re eligible for.

County residents seeking help with healthcare coverage can walk-in to the WHP office or schedule an appointment to receive in-person assistance. If clients have all their application documents in hand, WHP navigators can enroll them in a planduring their initial appointment. And, because eligibility criteria for health coverage is often the same as other benefit programs, WHP can recommend additional resources at the same time. 

But people don’t need to wait until they have everything ready to reach out to WHP. They can still help. WHP staff can also answer questions over the phone or email if people just have questions about what to do.

“We hold their hand through the whole process, so that by the end of working with us they have coverage, they understand how to use it, and they know where to go for care,” says Anna Leavitt, the communications coordinator for Washtenaw Health Project.

Once enrolled, WHP helps clients connect to medical providers in the area who accept their insurance plan.

“A great day for us is helping 25 people get coverage, and resolving issues that keep people from accessing affordable health care,” says Leavitt. “A lot of people don’t know what help is out there, or they believe it won’t actually help them. It’s great to see the people who came in anxious and panicked leave relieved and excited to tell their friends about us after they see how much we can help.”

To receive over-the-phone assistance, set up an appointment, or receive other healthcare assistance or information, call (734) 544-3030, email, or visit the WHP office at 555 Towner Street in Ypsilanti Monday–Friday, 9:00am to 12:00pm and 1:00 to 4:00pm. In-person assistance is available in English, Spanish, French, and Arabic, and telephone interpretation service is available for 200+ other languages.