NM’s health exchange reaches out to tribal communities
By Colleen Keane
Special to the Times
After breaking her ankle while hiking at Sandia Crest, Juliet Yazzie thanks her lucky stars that she purchased health insurance through beWellnm, the New Mexico Health Insurance Exchange.
“It’s a good thing I did because I would have been stuck with all those bills out of my own pocket. It’s a very good thing to have health insurance because you never know what can happen,” she said.
Now, Yazzie, Diné, works for beWellnm as the Native American liaison manager tasked with outreach and education to tribal communities. She’s been in the position for the past five years.
You may recognize Yazzie from the many events where she’s handed out information under a blue-canopied table. Her handouts are about the benefits of health insurance and zero- or low-cost plans.
“We visited many health fairs and conferences and set up tables,” she said. “We also set up enrollment days across the state – Gallup, Farmington, Mescalero and Jicarilla.”
Lately, she’s been busy spreading the message of the current enrollment period for the general public. It opened in this month and closes May 15.
While Native Americans can sign up any time on the marketplace for health insurance plans, CEO Jeffery Bustamante said that the organization is reaching out to tribal communities to join open enrollment.
“There are about 10,000 Native Americans who would qualify for some sort of assistance (in New Mexico),” he said.
“(BeWellnm) is the place where individuals can go who don’t get employment insurance and are not covered by Medicaid,” noted Bustamante.
Based on income
Describing the discounted health plans, Yazzie pointed out “they’re based on your income level and family size.”
Two cost-sharing plans are highlighted on a beWellnm promotional flyer.
With a zero-cost-sharing plan, you don’t have copayments, deductibles or coinsurance when getting care from an Indian health care provider or health benefits from a health exchange plan. And you don’t need a referral.
For a limited cost-sharing plan, there are no copays, deductibles or coinsurance when receiving care from an Indian health care provider. But, you do need a referral to avoid charges.
Premium amounts are discounted through a tax credit. Yazzie gave an example of an individual earning $28,000 a year. She said they would receive a $130 credit and pay as low as $78 a month.
To look up your eligibility and potential costs, there’s an income chart on the organization’s website.
“This is a great opportunity for folks to get enrolled,” Yazzie said. “We strongly encourage the Native American population to look into (the health insurance exchange). A lot of times individuals are usually surprised at how affordable the plans can be.”
Health insurance companies offering plans on the exchange are Ambetter from Western Sky Community, Blue Cross and Blue Shield of New Mexico, Friday Health Plans, Molina Health Care of New Mexico and True Health New Mexico.
There’s a plan comparison tool describing a network of doctors and specialists on beWellnm’s website.
What about treaty rights?
A federal advisory at healthcare.org states that health care is a treaty obligation but Congress approves only about half of the U.S. Indian Health Service’s costs for American Indians and Alaska Natives annually, leaving a huge gap in needed services.
The advisory also notes that IHS is not health insurance.
“(IHS) delivers health care to (tribal members) and provides funds for tribal and urban Indian health programs, while health insurance pays for health care covered by a plan (addressing specific needs),” the advisory said.
According to the beWellnm website, plans offer health benefits for ambulatory, maternity/newborn, mental health and emergency care, hospitalization, rehabilitation, laboratory, wellness and preventative services and prescription drugs. Acupuncture and chiropractic services are also covered.
Yazzie said that you can check out the health exchange either virtually or by phone.
“At the virtual appointment, we can walk through the registration and enrollment process and assist in a plan selection,” said Yazzie.
If you don’t have access to the internet, call 833-862-3935 to speak with an enrollment counselor.
A Navajo language speaker is available when needed.
On the phone or at an information table, Yazzie encourages tribal members to look into the health insurance options.
“We would like people to have opportunities,” she said. “A lot of Native Americans qualify for financial assistance that can greatly reduce their premium amount.”