Health insurance remains a riddle for many in Lynn

LYNN – Today marks the final day for Massachusetts residents to obtain health insurance or apply for a waiver, or they will face tax penalties under the state’s new Health Connector insurance system.With that deadline hanging over the heads of many on the North Shore, local hospitals and clinics are dealing with a flood of concerned patients looking to find out their options and determine which state health program they qualify for.While most Massachusetts residents – the Department of Revenue estimates the number at 95 percent – already have health insurance through an employer or family member, it is the other 5 percent that do not have coverage who must study a complicated and confusing pile of paper work to determine which particular plan they qualify for.The system is so confusing that the Lynn Community Health Center has established a nine-member insurance enrollment department that specializes in sitting down with the uninsured and helping them sift through the paper work to find the right plan for them.”We are still seeing a lot of our clients and patients having to change insurance,” said LCHC Deputy Director Bob Dempkowski. “It is confusing for them, but it is also confusing for all of us that were under the impression that we knew what we were doing.”Dempkowski said most of the confusion comes when dealing with individuals who used to use the state’s free health care pool, which allowed patients who were uninsured and under the poverty level to receive emergency care at clinics or hospitals, which then billed the state.Now, the clinic is left searching for a state program that each individual patient is eligible to sign up for, which requires a tedious review of financial records and state documents.While the process is difficult and confusing for all involved, Dempkowski said just about every patient will end up insured.”All of that transition stuff, particularly those who were in the free care pool, are the ones we are dealing with trying to get insurance for. That was a huge insurer for us,” he said. “For the most part, it looks like most folks should be eligible for something, unless they are undocumented.”For individuals who make too much money to apply for Mass Health or an exemption, the enrollment specialists are left to search for insurance plans that do not have high premiums that patients cannot afford to pay.Overall, while the system is confusing, Dempkowski says it is a huge improvement over the old state system, which did not require everyone to have insurance, and did not cover expensive necessities like ambulance rides.”The plus is that hundreds of people who did not have insurance before will have it now, and who doesn’t need insurance,” he said. “You never know when your appendix is going to decide to burst, and you need to get that care.”While most citizens will not have to worry about this confusion, every Massachusetts resident can expect a slightly different tax form this year because of the insurance changes.According to Department of Revenue Spokesman Robert R. Bliss, in order to ensure that every resident has health insurance, tax forms will have a new section requiring state residents to fill in their health insurance subscription information.For most residents, the health insurance provider will mail this information in early 2008, but some taxpayers with out-of-state insurance may have to contact their insurance companies personally to find out this information.The Department of Revenue will enter the information into a database to confirm its legitimacy, to prevent those without health insurance from slipping through the cracks.Bliss said residents who do not have health insurance should receive a calculator and instructions on how to determine if there are any exemptions or affordable insurance options available to them. Residents who do not receive the calculator and do not have insurance can access the information at www.Mass.gov.