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Eyewitness News Takes An Inside Look At Affordable Care Act

The Affordable Care Act has caused major problems nationally which has led to many concerns and questions here at home. But Central New York patient navigators, those who help folks sign-up, say they've seen nothing but success in the program. Eyewitness News reporter Rachel Polansky meets with a patient navigator and walks us through the health care process. Sarah Sipley is a patient navigator at ACR Health in Utica. Since the new insurance exchange launched October 1st, she says ACR has enrolled 100 people. Sipley says it's a quick and easy process.
The Affordable Care Act has caused major problems nationally which has led to many concerns and questions here at home. But Central New York patient navigators, those who help folks sign-up, say they've seen nothing but success in the program. Eyewitness News reporter Rachel Polansky meets with a patient navigator and walks us through the health care process.

Sarah Sipley is a patient navigator at ACR Health in Utica. Since the new insurance exchange launched October 1st, she says ACR has enrolled 100 people. Sipley says it's a quick and easy process.

"Put in all their personal information and as a result we'll see what Affordable Plan is available for them to pick in the NYS Market Place," says Sarah Shipley, patient navigator ACR Health.

How do these plans work? There are 4: Bronze, Silver, Gold, and Platinum. The money you spend out of pocket and the money insurance covers is based on the amount of coverage you want.

"It depends on your income and where you fall on the federal poverty line. This is where reductions come in. You may be eligible to have your deductible reduced down, your co-pays reduced down so that is appealing to a lot of people," says Shipley.


Plan Level                         What the Plan Spends                 What you Spend
Bronze                                          60%                                         40%
Silver                                            70%                                         30%
Gold                                              80%                                         20%
Platinum                                       90%                                         10%

The chart shows how the different plans pay for your health costs, not including premiums. But you do want to keep in mind, the lower the amount of coverage, the lower the premium you pay to maintain that coverage. Bronze has the lowest premiums, but also the lowest level of coverage.

What kind of people would be interested in the plan?

"Bronze: possibly someone who doesn't frequently visit doctors, not having surgery coming up," says Sipley.

As the plans increase from Bronze to Platinum, the monthly premium increases too. That means you'll pay a higher premium for a Platinum plan but you'll pay less for each doctor visit or health care service. Who might be interested in Platinum?

"Might be someone who is gonna have a surgery, or has an illness that has to go to the doctors several times," says Sipley.

If this sounds confusing, navigators say that's okay, that's where they come in.

"Call us. We're more than willing to help out, whenever, wherever, to get you the best coverage available," says Sipley.

We do want to mention that not everyone qualifies. People on Medicaid or Medicare may not qualify. And people employed that have employer offered insurance are only eligible on the Marketplace if they spend more than 9.5% of their gross income. Plans also may change depending if you are single or have a family.

For more information, you can call ACR Health at 1-800-475-2430. Meeting with patient navigators are free.
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