In 2014, Brad and Lacey Mertz’s daughter was born prematurely and placed in the Neonatal Intensive Care Unit (NICU) for an extended time. Needing to be with her daughter, Lacey used her FMLA and eventually lost her job. As the family's insurance carrier, the Mertzes lost their insurance coverage when Lacey lost her job, which only added to the stress of the situation. With a baby in the NICU and no insurance, Brad and Lacey weren’t sure what to do next.
Then Brad’s mom suggested the couple contact Brightpoint to see if they could help.
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The Metz FamilyAs a community action agency,
Brightpoint has been focused on removing the causes and conditions of poverty in Northeast Indiana for 59 years. One of the many programs they use to do so is the
Health Coverage Assistance program, which provides free help from certified Indiana Navigators to understand and enroll in state and federal health insurance programs including Hoosier Healthwise, the Healthy Indiana Plan, and the Health Insurance Marketplace. Brightpoint is part of the
statewide Covering Kids & Families network.
With just under
two million Indiana residents enrolled in state and federal insurance programs as of August 2024 there’s a large demand for the coverage.
Brightpoint introduced the program in 2008. As the program’s manager, Temecula Nelson says the program's goal is to help reduce barriers to attaining and maintaining health coverage. Several obstacles can stand between people and health coverage– language barriers, internet access, confusing terminology, and complex applications are just the tip of the iceberg.
Enrollment issues aren’t limited to just Indiana residents; policies and resources vary greatly from state to state. Even with the changes in
The Affordable Care Act, some states chose not to expand their Medicaid programs, affecting who qualifies. As of April 2024, it is estimated that 1.6 million adults in the United States are in the
Medicaid coverage gap.
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Temecula Nelson, manager of the Health Coverage Assistance program“The biggest struggle many people face with insurance is navigating the complexity of the system,” Nelson says. “This includes understanding coverage options, determining eligibility, deciphering confusing terms and conditions, and managing the required documentation.”
Part of the confusion stems from the ever-changing criteria and policies for health coverage. Health coverage programs have specific eligibility criteria based on income, household size, age, and health conditions. It can be difficult for residents to stay current on the requirements and documentation needed for enrollment.
“Gathering these documents and ensuring they’re accurate can be difficult, particularly for those in unstable housing or employment situations,” says Nelson.
The Health Coverage Assistance program also provides individual hands-on assistance with interpreters in 22 languages, and personalized support through in-person, phone, and virtual services, with a dedicated 24-hour appointment line. Nelson says they understand that every person and situation is unique.
“Brightpoint aims to ensure that uninsured and underinsured individuals in Northeast Indiana are aware of their eligibility for public health insurance programs and understand how to navigate the enrollment process,” she explains.
As a Brightpoint employee, Brad’s mom, Veronica Metz, knew this program could alleviate some of the stress the couple was feeling as they navigated having a premature baby in the NICU with no insurance. Brad says once he reached out, it felt like a step in the right direction for his family.
“Once we contacted Brightpoint, they knew we were dealing with a situation that was white gloves and tender care and all those things and that we were stressed,” he says. “They literally just took it into their own hands…they took care of us and then they kept us in the loop as every step went.”
After setting up an initial meeting and providing some documents Brighpoint was able to get the Metz family health coverage while their daughter was still in the hospital. Brad says they were even able to go back a couple of days on her health coverage to cover more of her stay in the NICU.
“They literally did everything in their power to make sure we got great coverage as fast as we could possibly get it,” he says.
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Gabe SeligA Brightpoint Health Coverage Navigator helping a client.As part of this program, Brightpoint employs state-certified Healthcare Navigators and federal Certified Application Counselors. Nelson says these counselors undergo extensive training to fully understand the enrollment process, helping consumers navigate their insurance options effectively.
“We believe that once enrolled, consumers will be equipped to use and maintain their health coverage benefits to access local health and mental health services,” Nelson says. “By raising community awareness of state and federally-sponsored health coverage programs, Brightpoint strives to reduce the number of uninsured residents, contributing to a healthier community.”
The program isn’t just for insurance enrollment; team members can also help you find a primary care doctor, update changes in personal information, know when and where to make insurance payments, and other health coverage-related questions.
Despite first using Brightpoint’s program in 2014, it’s still a resource the Metz family utilizes today and one they’ve recommended to their family and friends.
“Even for the last 10 years, they have still helped me get coverage for my wife, myself and my children and they helped us understand marketplace insurance,” Brad says.
The experience with the Health Coverage Assistance Program altered his perspective on health coverage.
“One, it let me know how important health insurance is for everyone and it also let me understand very quickly how your life can change without it,” he says.
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Health Coverage AssistanceOpen enrollment for the Health Insurance Marketplace is from November 1 to December 15.
To learn more about Brightpoint’s Health Coverage program,
visit their website.
This story is made possible by Brightpoint.