April 2017

AHA is proud to award a Gold Star to the individuals – coverage guides, enrollment specialists, etc. – who spend countless hours helping people in Aurora get the coverage and the care they need. Aurora is lucky to
be served by ACAN – the Aurora Coverage Assistance Network, which coordinates outreach and enrollment among several participating organizations, including Aurora Community Connection and the Asian Pacific Development Center.

During the latest open enrollment period (Oct 2016 to Mar 2017), ACAN helped 1,940 people get enrolled/obtain health insurance coverage. But that number is only a small part of the story. Many of the people who
come in for coverage assistance don’t just need help picking a plan or filling out a form, they are facing complex obstacles in their lives. We asked several enrollment specialists to tell us about one of their most
memorable clients. Here are their stories (clients’ real names are not used).

Sara Maru, Health Coverage Guide, Aurora Coverage Assistance Network (ACAN)

My client is a 50 year old woman who is a refugee and has been in the US less than 5 years, so is not eligible for Medicaid. She lives with her husband and 13 year-old grandson; both adults were working. I helped her obtain a Kaiser insurance policy.

She needed thyroid surgery and to be safe after surgery needed to be isolated from others. The family lived in a very small apartment where isolation would have been impossible, so she called me again to find out what they could do. I helped them contact the hospital to ask if the woman could remain in the hospital an extra 24 hours due to the risk of complications should she return home immediately.

Because of the insurance coverage, she was allowed to stay longer in the hospital, with 70% of the cost covered by insurance. Surgery was successful and this client has returned to good health.

Ivan Sosa, Health Access Program Manager, Aurora Community Connection

Alexis was diagnosed with chronic renal disease 3 years ago and started dialysis, 3 times a week, in addition to taking 5 pills a day. During this time Alexis was uninsured, and owed thousands of dollars by the time he met with me. I was able to get Alexis enrolled in a Kaiser plan.

Discovering that the average wait time to get a transplant was 5-7 years, I suggested to Alexis that his family and friends get tested to see if any of them were a match. His sister was a match and I was able to enroll her in a Kaiser plan as well. The transplant surgery took place 5 months after she was enrolled.

Now Alexis takes 175 pills a week, but says he would much rather take pills than have dialysis. I helped him apply for financial assistance for the $30k he owed and we were able to lower that debt to $500. Now Alexis lives a healthy life, has a full time job, and plays in a soccer league.

Nohemi Burciaga, Family Program Coordinator, Aurora Community Connection

Roberto visited our center in January of 2017, seeking information on how to access health insurance. He was at the time covered through Medicare due to a disability because of kidney failure. Roberto
needs a kidney transplant in order to live beyond the two years doctors have given him.

Medicare is currently covering most of his medical expenses, but does not cover the full cost of a kidney transplant. During the enrollment process, we learned Roberto qualified for the Medicaid Buy-in program. He is now able to supplement the percentage to his treatments and kidney transplant. Today, he is optimistically starting the legal process to bring his brother from Guatemala to begin the treatment for the kidney transplant.

Javier Garcia, Health Program Assistant, Aurora Community Connection

Dolores, a 70 year old woman from Yucatan Mexico, receives retirement funds from Mexico. She came to the US with her children to a sponsor, and does not qualify for Old Age Pension (OAP). She has not worked in the United States but does file income tax returns because she does have an income.

Dolores began experiencing chest pains, but because she had no health insurance she did not seek medical help, until she worried that the pains were serious so she began paying out of pocket for medical care. Someone gave Dolores information about Enroll America, so she made an appointment.

When Dolores arrived at the Aurora Community Connection office she was struggling to receive needed care and confused about the entire health care/insurance process. I helped her purchase an excellent policy, and she followed up with a doctor who determined she needed open heart surgery.

The cost out of pocket would not exceed $2500. Dolores and her family could not believe that she would only have to pay $2,500 for a $150,000 surgery! Surgery was successful and Dolores and her family are again enjoying a happy and healthy life.

Kuang Oo, Community Navigator, Asian Pacific Development Center

A 26-year-old refugee, who recently became a US citizen, had been experiencing severe pain in his back and legs for 2 years. The pain reached a point where he couldn’t stand for more than 5 minutes,
so he couldn’t continue working. This escalated until he finally called an ambulance to take him to the emergency room, was admitted to the hospital, and spent 2 nights there. He later received a bill for approximately $10,000 dollars.

He came to Asian Pacific Center for help. I worked with the hospital and through Colorado Indigent Care Program (CICP) and other negotiations got the bill reduced to $800.00. I also connected this young man to a Kaiser insurance plan through Connect 4 Health. He is insured, able to afford needed medication, and back at work.