BILLINGS — The complications of signing up for healthcare can prevent patients from receiving the help and treatment they need. That's why RiverStone Health is assisting patients with their Care Management program.
"There is something out there besides just the Medicaid, or not having insurance," said Genie Gates, the Care Management Service Manager at RiverStone Health.
We all know it can be difficult finding reliable, accessible, and affordable healthcare. In fact it can be a headache. And for the 300,000 Montanans who lost Medicaid coverage in 2023, that headache feels more like a migraine.
"One of the barriers to not getting healthcare is insurance. And so individuals that don't have insurance tend to not get the healthcare they need... So, we kind of walk individuals through that to determine what's going to be the best plan for you, that meets your medical needs and is also affordable," Gates said.
From Nov. 1 to Jan. 15, RiverStone Health is holding appointments with patients to help them sign up for Health Insurance Marketplace through the Affordable Care Act.
Different than Medicaid, Marketplace is funded by the Affordable Care Act and works through private insurance companies, such as Blue Cross Blue Shield. There are also fewer qualifications for patients as opposed to Medicaid.
Open Enrollment for Marketplace ends in January, whereas Medicaid has no enrollment period.
In March of 2020, the Biden administration passed the Families First Coronavirus Response Act (FFRCA). One of the functions of this act would ensure that families enrolled in Medicaid would continue to be enrolled until the end of the pandemic.
April 1, 2023, families across the nation had to choose to reapply for Medicaid or choose a different healthcare plan due to the Consolidations Appropriations Act (CAA). The CAA impacted about 10 to 15 million Americans, and over 300,000 Montanans.
So all of the Americans who lost their Medicaid coverage from the FFRCA entered an unwinding period, lasting about 12 months in Montana. Therefore, between April 2023 and November 2024, many lost access to affordable health insurance.
"If someone doesn't have access to insurance at all, people are more likely to stay home instead of going to get care," said Eric Arzubi, a licensed medical psychiatrist and the CEO of Frontier Psychiatry.
Dr. Arzubi says that not having insurance can take both a physical and mental toll on the patient.
"You know, whether you're talking about physical health, or mental health, those two things are really intertwined and you can't really separate one from the other," he said.
That's one of the reasons Dr. Arzubi believes the assistance that RiverStone Health is offering is so important.
"So really, individuals want to look at 'what works for me. Do I just want a high deductible where if I end up hospitalized it'll help me set a limit on what my hospital bill would be? Do I have more health needs and need to be seen on a regular basis? Am I looking to get prescription coverage doctor visits and things covered?' It can be confusing and overwhelming. So to have somebody that's certified and kind of help with that, walk through the system, makes it less painful" Gates said.
Offering help at a time when it's badly needed by so many trying to navigate the complexities of insurance.
Appointments can be made five days a week. Evening and early morning hour appointments are available. For tribal members, the enrollment period doesn't apply. Finally, you can start applying for Marketplace on HealthCare.gov.
