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Cover Oregon expert knows facts - and frustration

Donna Medica finds enthusiastic audience in Forest Grove, where she'll return Saturday

Hillsboro and Beaverton residents have been slow to show interest, but folks in Forest Grove are lining up for information about Cover Oregon, Oregon’s version of Obamacare.

So says Donna Medica, a Community Partner Enrollment Assister for the Affordable Care Act. Medica has been hosting educational seminars in Washington County since November — even as she has had her own personal struggles with Cover Oregon while attempting to sign up for insurance.

In western Washington County, people can get information from Medica this Saturday at 2 p.m. when she offers another Cover Oregon presentation in Forest Grove.

“The people who do come learn a lot and are very grateful,” said Medica, who spends most of her time explaining how to use the Cover Oregon website, which provides information on plans and costs but is still unable to accept online applications.

The site was originally scheduled to be fully operational by Oct. 1, but officials have stopped estimating when it will be ready.

Medica is disappointed that Oregon didn’t create a simple site for the first year and pledge to add other options later. “[Health and Human Services] knew in May that this was not going to be up and running,” she said.

With time running out, people want to know how to apply fast and get health insurance coverage immediately, Medica said.

The deadline to apply has been extended to March 31. Oregon residents must apply by the 15th of each month to get coverage for that month.

If they’re Medicaid eligible, the coverage starts as soon as the application is processed, said Medica, who can tell people about tax credits, Medicaid eligibility, how to find an insurance company and how plans are priced based on income levels.

Medica also speaks from personal experience — as a participant in Cover Oregon. Her grant-funded “enrollment assister” position has not made her experience any easier.

For one thing, the system somehow overstated her income level when she applied, disqualifying her for cost sharing.

Medica quickly tried to correct the error by calling the toll free number for Cover Oregon (1-855-268-3767) and encountered a 20- to 30-minute hold time.

“I’ve called five times, and talked to at least two people each time. When I get to the people who fix mistakes, I get different answers each time,” said a frustrated Medica. “I have been very nice, but I will start getting nasty.”

In addition, she has not received a bill yet, nor an insurance card, although she applied well before the deadline.

She hopes that will happen in time to make her Jan. 15 payment (to Kaiser Permanente).

“You do have to pay the bill by January 15 in order to be covered in January,” said Medica.

Although she has dealt with difficulties with the system, Medica still believes in the concept. And in the end, she thinks she’ll have a good deal on health insurance.

“My deductible and co-pay comes to $16,500 this year,” Medica said. But if her income is correctly calculated, it should be $2,250 with the right plan.

“I am still thankful that we have this new Affordable Care Act,” she said. “I’m still positive. I still tell people, ‘Apply as soon as you can.’ It’s urgent not to procrastinate and to get the applications in.”

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