With last-minute help signing up for insurance, Philly mom hopes to no longer ration meds

Sunday marks the deadline to sign up for insurance through the Affordable Care Act this year. Federal officials estimate that, so far, about 230,000 people in the Philadelphia region have selected plans for the first time or re-enrolled in coverage.

But, like last year, many are waiting until the last minute to sign up.

A Philadelphia help line received 1,000 calls in the last three days. Volume is up 60 percent compared with this time last year at the customer service office for the region’s largest insurer.

And, with just days left before enrollment closes for the year, people including 54-year-old Karen Randall have been seeking out in-person assistance at enrollment events around the region.

“I need health coverage, and I’ve been trying for forever and a day,” said Randall at an Enroll America sign-up blitz inside the lower level of Jefferson Station on Saturday.

Randall, a Philadelphia school bus driver and single mom, said she keeps encountering problems when trying enroll on her own. When an outreach worker contacted her about setting up an appointment, she welcomed the help.

Without insurance, Randall said it’s been difficult to afford medication for her high blood pressure, a condition that brought her to the ER. But she takes it every other week rather than every day.

“It’s feed my daughter or take your medicine. And the type of mother I am, my child comes first. So I’m just going to feed my daughter and ration my medicine,” she said.  “A lot of people have to do that these days, and it’s sad. We shouldn’t have to do that.”

After meeting with a counselor at the event, Randall was able to sign up for a silver-level marketplace plan. It has a monthly premium of $85 dollars, following income-based federal discounts.

“My prescriptions will be $5 instead of $90. My co-pay will be $10 instead of me worrying about a bill that’s hanging over my head,” she says. “I’m relieved. It’s one less worry over my head.”

Her coverage kicks in March 1.

Many experts warn that the real affordability of having coverage rests in the details of the plans. Beyond monthly premium amounts, that includes the deductible (the amount a subscriber must pay out of pocket before insurance kicks in); what providers, drugs and services are covered; and the level of any co-insurance.   

Health officials are also encouraging those who had coverage last year to review and update their plans, as the details may have changed. 

The deadline to sign up for Marketplace insurance is Sunday.

Those who experience certain life events, such as a divorce or job change, can qualify for a special enrollment period.

Those who remain uninsured and don’t qualify for an exemption could face a tax penalty.