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Chicagoans is a first-person account from off the beaten track, as told to Anne Ford. This week's Chicagoan is Lauren Angeles, Get Covered Illinois "navigator."
"A 'navigator' is an in-person counselor who helps consumers navigate the health insurance enrollment process—everything from when you first come in my door to the final step of getting coverage. February 15 is the open enrollment deadline for coverage starting in 2015. I get a mix of Spanish-speaking consumers and also people from the African-American community. I'm bilingual, but I've never had to say 'copay' in Spanish before now. It's a little interesting.
"It helps to kind of warm up to someone and say, 'Hello, how are you? How's your day going?' before prying into their personal life. For the Spanish-speaking community, it's always the immigration questions that are sensitive, because you do have to be a citizen or a resident to take part in the new ACA [Affordable Care Act] services. I don't like to start off by saying, 'What's your legal permanent status in the U.S.?' That's always the last question I ask, because it's the most uncomfortable for some people.
"At first I felt really horrible when I had to say to someone who wasn't documented, 'We have nothing to offer you.' But we do have other resources that we share with that community, so at least that helps. There are the federal qualified health clinics that people can go to, and those clinics work on a sliding scale.
"I always hear 'I don't remember the last time I went to the doctor.' And I get this a lot from young people: 'Well, I already know I'm not going to be able to afford [health insurance].' I think they just have it in their heads that they can't afford it, even without knowing how any of this works. My favorite thing to say is 'Let me at least try and prove you wrong. Let me at least show you what your options look like.'
"I always use the example of a friend of mine whose income is around $18,000. I helped him enroll, and he opted for a plan with a little more coverage, so he paid a little extra, and even with that, he ended up with the silver plan, which was around $80 a month.
"Some people have never had health insurance. You have to teach them, 'OK, you have health insurance—now what?' It's kind of like explaining to someone how to go to the doctor. If they've never done that before, how do you explain that? We've found ways.
"We turn a little bit into caseworkers. The very first person that I worked with was a cancer patient, and he had been relying on donations and hospital charity programs. So I signed him up, and I made sure his medical card got to him within a week, because obviously he wasn't someone who could just wait and see. For someone in his situation, you can have those applications expedited. If you were to do this on your own, without a navigator, you might not know that.
"The first time someone got emotional, it threw me off guard. Now I just let them talk it out. I tell them it's normal to feel all those emotions, now that you have a say in what happens with your health. I just let them know that it's perfectly normal to feel everything that you're feeling."