Will health-care consumers give state exchange another chance?

It’s been one of the big unknowns of the upcoming open-enrollment session: Will consumers burned by a flawed system the first time around give the state exchange another chance?

The answer is important, because the Nevada Health Link marketplace needs to maintain its current enrollment of around 35,000 to begin building a bigger base that will keep it funded.

At least one consumer we profiled said she’s open to sticking with the system.

Las Vegan Laury Phelps, whose troubles we detailed in August, still doesn’t have her situation resolved. But with the second enrollment period underway, Phelps needs insurance for 2015, and she and her broker haven’t ruled out using the state’s insurance exchange.

That’s despite a host of coverage issues Phelps is still having. She has been paying $248 in monthly premiums since January, but through August, she had been receiving form letters telling her she had no policy. Call center representatives kept telling her they needed more information without detailing what else they needed to know. Customer-service reps even told her that her Social Security number didn’t exist. She had to consider stopping her medications, which were costing her more than $800 a month out of pocket.

Phelps wrote us a week after we profiled her to tell us her coverage was finally in place. But a month later, in September, she returned from a trip to find that her insurance card wouldn’t work. Her doctor booked her for a December appointment anyway, but she’s still out thousands of dollars in reimbursements for the medications she paid for herself despite paying for a plan.

Still, Phelps is meeting Tuesday with her broker, Pat Casale, to discuss her 2015 enrollment. She said she “probably” will go through the exchange again.

She asked: “Am I a glutton for punishment?”

Not necessarily, Casale said.

That’s because in this open-enrollment session, brokers and consumers can enroll in an exchange-based plan directly through insurers themselves, rather than tangling with any potential technical issues on the healthcare.gov website, which Nevada Health Link is borrowing for eligibilty and enrollment functions.

“(Health Plan of Nevada) knows how to handle applications and payments,” Casale said. “It should definitely be easier this time around.”

■ We’ve been hit with a slew of reminders from health care providers, insurers and state agencies reminding us to remind you that it’s also open-enrollment season for Medicare — a message that’s easily lost in the flurry of attention targeted at the exchange sign-up session.

Everyone 65 and older is enrolled automatically in the federal insurance program for seniors as soon as they are eligible. But some seniors also buy Medicare Advantage or supplemental plans that pay for services Medicare doesn’t, and in that additional coverage, enrollment ends Dec. 7.

Southern Nevada is home to about 250,000 Medicare recipients, and 40 percent of them are enrolled in a Medicare Advantage Plan, said Dr. Bard Coats, senior vice president of clinical operations for HeathCare Partners Nevada. That’s twice the enrollment rate of markets in, say, the Midwest, where just 20 percent of eligible seniors are signed up. Coats said sign-ups here got a head start because some forwaard-thinking carriers began offering them here in 1990, which means “better benefits, better coordination (of care) and less money out of pocket.”

Still, there’s room to grow: Some markets have as many as 75 perent of their seniors on Medicare Advantage, Coats said. People who sign up get more help covering copays and paying for prescription drugs — vital assistance for people on fixed incomes, Coats said.

So here’s what you need to know.

First, if you already are in a Medicare Advantage plan you like, you don’t need to do anything. Your coverage stays in place.

If you want to sign up, it’s essential that you verify the plan you have chosen is approved by Medicare. Find out by visiting Medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).

If you need help deciding what plan to buy, the State Health Insurance Assistance Program provides information, counseling and assistance to Medicare enrollees through a statewide network of volunteers. Call the agency at 702-486-3478.

The state Insurance Division also has a few ground rules designed to protect consumers.

Any broker who sells plans must be licensed by the division. To check for credentials, visit doi.nv.gov/licensing-search/ or call 888-872-3234.

Remember that insurance agents aren’t allowed to sell unsolicited door to door and can’t visit homes without an appointment. So be leery of people who show up at your front door on a cold call, or who approach you about coverage in a parking lot. Nor can anyone pitch you at a doctor’s office, pharmacy or educational event.

Plus, a salesperson also has to tell you in advance what types of products he will discuss with you, and he can’t try to sell you nonhealth-related plans such as life insurance or annuities. Also off-limits: Free meals at sales events and gifts worth more than $15.