Health care en­roll­ment is now un­der­way

For most peo­ple, pre­mi­ums will be ‘fairly sta­ble’

The Calvert Recorder - - Front Page - By DAN­DAN ZOU dzou@somd­

Open en­roll­ment in Mary­land started Nov. 1 for health plans un­der the Af­ford­able Care Act. Health of­fi­cials ad­vise those in need of cov­er­age to re­view the plans and shop around in the next 45 days.

There are talks about rates in­creas­ing, but the rates for most peo­ple in­sured un­der the ACA are go­ing to be “fairly sta­ble,” said Dr. Laurence Pol­sky, Calvert County’s health of­fi­cer. “Peo­ple should not be dis­suaded from sign­ing up or look­ing at the poli­cies.”

The two in­sur­ers that are of­fer­ing plans in 2018

in the state — CareFirst BlueCross BlueShield and Kaiser Per­ma­nente — will be rais­ing some of their health care pre­mi­ums next year. The in­crease is tied to the White House’s de­ci­sion to stop fund­ing cost-shar­ing re­duc­tions, namely pay­ments that re­im­burse in­sur­ers for low­er­ing de­ductibles and co­pays for lower-in­come en­rollees.

Pol­sky asks peo­ple in South­ern Mary­land not to make as­sump­tions about their rates be­cause of the re­cent change from the fed­eral govern­ment.

The cost-shar­ing sub­sidy change only af­fects peo­ple with sil­ver plans, he said. Also, those af­fected by the change may qual­ify for in­creased fi­nan­cial as­sis­tance to off­set some of their out-of­pocket cost.

Lisa Mil­burn, field man­ager of Seedco’s South­ern Re­gion that cov­ers the tri-county area, said peo­ple should know that al­though pre­mi­ums have in­creased, that doesn’t nec­es­sar­ily mean an in­di­vid­ual or a fam­ily will pay more out of pocket. Seedco, a na­tional non­profit agency, part­nered with Mary­land to help peo­ple nav­i­gate its health care ex­change in sev­eral coun­ties, in­clud­ing St. Mary’s.

As pre­mi­ums rise, some may be el­i­gi­ble for more tax cred­its, which would off­set some of the plan cost, she said. Af­ter fac­tor­ing in the in­creased fi­nan­cial as­sis­tance, there may be “not that a big dif­fer­ence” in terms of the fi­nal cost.

Another change that peo­ple should keep in mind is that the en­roll­ment sea­son this year is cut in half from three months to the 45 days from Nov. 1 to Dec. 15.

In pre­vi­ous years, peo­ple could en­roll un­til the end of Jan­uary, Pol­sky said. This year, how­ever, “if they wait be­yond Dec. 15, they won’t be able to en­roll or re-en­roll.”

For those who are el­i­gi­ble for Med­i­caid, they can en­roll year-round.

Pol­sky said about a third of peo­ple who get in­sur­ance through ACA are small-busi­ness em­ploy­ers buy­ing in­sur­ance for their em­ploy­ees. One third are in­sured un­der Med­i­caid.

The rest pur­chase in­di­vid­ual plans through Mary­land Health Con­nec­tions, the state’s health­care ex­change. For this group, Pol­sky said about one out of five may see their pre­mi­ums

go up about 30 per­cent.

But the ma­jor­ity of en­rollees will not see a sig­nif­i­cant in­crease, he said. If they look into the plans, they may find a new plan com­pa­ra­ble or even cheaper than a year ago.

“The plans may change. Plans of­fered last year may not be of­fered this year,” Mil­burn said. “You never know.”

If the pol­i­cy­holder does noth­ing, they will be au­to­mat­i­cally re-en­rolled in

their cur­rent plan or tran­si­tioned into a dif­fer­ent plan if the cur­rent plan no longer ex­ists, she said. Now is the time for peo­ple to re­view their plans and make sure they are up to date on any likely changes com­ing up.

“We al­ways en­cour­age peo­ple to come back so noth­ing is a sur­prise,” Mil­burn said. On av­er­age, an ap­point­ment takes about one hour.

Last year, peo­ple from

the tri-county area made 22,278 en­roll­ments, in­clud­ing any new or re­peated en­roll­ments that were com­pleted on­line, over the phone, with an in­sur­ance bro­ker or an agency worker, ac­cord­ing to Mil­burn.

Con­sumers in the re­gion are en­cour­aged to con­tact Seedco at 855339-3007 to sched­ule a free, in-per­son ap­point­ment with a nav­i­ga­tor to shop or re­visit their

plans. St. Mary’s res­i­dents can also visit the county’s health depart­ment in Leonard­town, or ei­ther of the St. Mary’s County Depart­ment of So­cial Ser­vices of­fices in Leonard­town or Lex­ing­ton Park for as­sis­tance.

Peo­ple can en­roll on the state ex­change’s web­site at www.mary­land­health­con­nec­ or down­load a free mo­bile app called En­roll MHC.

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