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For Medicine Shoppe owner Nagy Wassef, Tuesday promises to be the start of a new and much-needed service to customers struggling to pay for their prescriptions.
Finally, he hopes, he and his staff will be able to offer them some help.
"There are a lot of people who aren't getting their medicines because they can't pay for it, who aren't filling their prescriptions when they're discharged from the hospital," Wassef said.
He recently sent one of his New London pharmacy technicians, Sarah Derosa, for 40 hours of training as an Access Health CT assister, to enable her to help people sign up through the state's new online health insurance marketplace. The site is scheduled to become active on Tuesday.
Derosa and the 1,000 other trained assisters in the state have each been issued a dedicated laptop computer they will use to guide the state's 344,000 uninsured residents to purchase health insurance as the federal Affordable Care Act moves toward full implementation. They also will be looking for lower-cost or more comprehensive options for those seeking better coverage.
"We're in a low-income area, so we see people all the time without health insurance," said Lisa Scronce, pharmacy technician and store manager at Greenville Drug Store in Norwich, who also completed the training. "I decided to pursue the training because it seemed like a good way of getting people into health care. We're committed to this 100 percent."
Across the state, 29 pharmacies answered the request of the Connecticut Pharmacists Association to send staff for training, said Ellen Zappo, communications director for the group. Leading customers through the online site to choose the best plans for them is an expansion of pharmacists' traditional responsibilities, she said, but one that makes sense.
"Pharmacists are in a unique position to help people who are uninsured or under-insured," she said. "It's a little outside the box for some of them, but the majority have really embraced this."
Kevin Counihan, executive director of Access Health CT, said a $136 million federal grant is funding the quasi-public agency through 2014, so ongoing debates in Washington about defunding the Affordable Care Act will have no impact on the new state marketplace's readiness to accept customers as scheduled, though, he said, the rancor is "adding to the massive confusion."
He hopes Connecticut residents will focus their attention on what's happening in their own state and check out the new Access Health CT online marketplace to comparison shop. For individuals and families, three companies are each offering three-tiered plans through the marketplace. Three companies also are offering three-tiered plans for small businesses.
"It's a lot like Travelocity," Counihan said, referring to the online travel website.
According to typical scenerios described by Access Health CT, an average policy in the marketplace for a family of four will cost about $395 to $814 per month. That would include a tax credit available to individuals with annual incomes of up to $46,000 and couples with incomes up to $94,200, about 72 percent of the state's uninsured. Fines for not having insurance will be 1 percent of household income in 2014 but not less than $95, rising to 2.5 percent of income in 2016 but not less than $695.
While the new health insurance mandate is kicking in as scheduled for individuals and families, it's been delayed a year for small businesses. Still, Counihan said, it should be attractive for small businesses to sign up for 2014, given that they will be eligible for tax credits of up to 50 percent of the cost of providing coverage to their workers.
"This is the biggest expansion of health insurance access in 50 years," he said.
When the system goes live on Tuesday, residents will be able to start purchasing insurance through the exchange on their own computers, through the Access Health CT call center, which opened this month, and at storefronts planned for New Britain, New Haven, Hartford, Bridgeport, Stamford and Waterbury. A seventh storefront is in the works for eastern Connecticut, possibly in Willimantic or Norwich. Counihan doesn't expect a big rush of business on the first day or even the first few weeks, because the coverage wouldn't start until Jan. 1.
"We think October is going to be a kicking-the-tires month," he said. "We're expecting the vast number of people to sign up during the last week of November and the first two weeks of December."
Lt. Gov. Nancy Wyman, who's been overseeing the implementation of the Affordable Care Act in Connecticut, said 80,000 to 100,000 residents are expected to sign up in the first year. Access Health CT's advertising campaign has included traditional and social media as well as sending its orange-shirted outreach workers to fairs, concerts, churches "and every place we can get where people are," Wyman said. Also key are the network of 1,000 community-based assisters, she said.
"A lot of the people we're trying to reach don't have their own computers," she said.
'We'll actually have some answers'
In southeastern Connecticut, a dozen nonprofit organizations also have sent staff for training as assisters, each receiving $6,000 to pay the salaries through the initial signup period ending in March. For all of them, having in-house health insurance agents on staff expands the array of services they offer to their clients and the larger community.
"We get calls from people all the time asking us about how they can get health insurance, and now we'll actually have some answers," said Jennifer Muggeo, supervisor of health education and community outreach for the Ledge Light Health District, which sent its health program coordinator, Stephanye Clark, to the training.
Ledge Light, the public health agency for East Lyme, Groton, Ledyard, New London and Waterford, has committed to getting Clark out into the community with her services, Muggeo said. She'll be taking her Health Access CT laptop to health fairs, public housing complexes, churches and other venues.
Uncas Health District, which serves seven towns including Norwich and Montville, plans to incorporate the services of newly trained assister Connie Capacchione, a health educator, into services the agency already provides, said Patrick McCormack, Uncas' director of health. She'll work with the uninsured at the agency's offices, as well as meet with people one-on-one at smoking cessation classes, blood pressure screenings and other events.
"We figured this service could be well integrated into what we already do around prevention," McCormack said.
Cathy Zall, executive director of the New London Homeless Hospitality Center, said Greg Graves, the case worker who completed the assister training, will work both with current and former residents of the shelter. Having someone on staff who can get people signed up for health insurance is particularly valuable with the high turnover rates at the shelter, she said.
"We get new people coming in all the time," she said. "We want to make this program as accessible as possible."
Graves also will be working with past shelter residents, she said, and will make his services available at visits to the community meal center on Montauk Avenue and free Saturday lunches at local churches.
"We have people who've transitioned out of the shelter, but cycle back to us because they know us, and feel comfortable with us," she said.
The Thames Valley Council for Community Action sent two staff members for assister training. Having in-house assisters will provide more comprehensive help to people already tapping the agency's services, including approximately 2,000 of its clients who are uninsured, said David Yovaisis, chief development officer at TVCCA.
"When somebody comes in and they have needs, we try to offer as much as we can," TVCCA executive director Deborah Monahan said. "This will improve our customer service."
The Child & Family Agency of Southeastern Connecticut also sent two staff members for training, hoping to reach out to its current base of clients using the Child Guidance Clinic, its network of school-based health centers and its child care centers, said JoAnn Eaccarino, associate director of school-based programs. The two assisters, community worker Sheila Perry and family resource center teacher Sadhana Joglekar, she said, are already well-known in the community, enhancing their ability to be effective at getting people signed up for health insurance.
The pair are also planning to offer services at flu shot clinics scheduled for this fall in New London, Pawcatuck and Groton, as well as other locations.
"We expect them to be fanning out in the community," Eaccarino said. On Tuesday, she added, "they will be ready to hit the ground running."
• Child & Family Agency of Southeastern Connecticut
• Ledge Light Health District
• Mashantucket Pequot Tribal Health Services
• NAACP of Norwich
• Uncas Health District
• Safe Futures in New London
• Thames Valley Council for Community Action
• New London Homeless Hospitality Center
• Old Saybrook Social Services Department
• Medicine Shoppe, New London
• Greenville Drug Store, Norwich
For more information, visit www.AccessHealthCT.com. An online calculator on the site will estimate how much people can expect to pay and the amount of tax credit they will receive.
The call center can be reached at (855) 805-4325.
Estimates of health insurance costs
These estimates factor in tax credits through the Access Health CT marketplace. Actual costs would depend on the company and level of coverage chosen.
• Family of four, annual income of $80,000: $395 to $814 per month.
• Couple with annual income of $70,000 whose two children are covered by HUSKY: $256 to $694 per month.
• Single female, age 32, annual income of $30,000: $122 to $288 per month.
• Single male, age 32, annual income of $30,000: $127 to $257.