State health exchange concerned about filling coverage gap for 1,300

Hartford — Connecticut’s health insurance exchange is trying to limit any coverage gaps for the approximately 1,300 people who will no longer be eligible for Medicaid starting Sept. 1, exchange officials saidWednesday.

Letters will be sent to recipients later this week informing them about the new changes, said James Michele, director of operations at Access Health CT. They’ll be followed by telephone robocalls informing people about how they can obtain replacement, private insurance coverage through the exchange.

Because people are losing a coverage they already have, the 1,300 theoretically have until Aug. 31 to enroll in a new plan. However, Access Health officials said at Wednesday’s Board of Directors meeting that consumers must enroll in a private plan by Aug. 15 in order to be covered on Sept. 1.

“Our concern is, if they’re not in by the 15th, that may prevent them from getting prescriptions by the first of September,” said Michele. Insurance carriers need at least two weeks to process applications and send out invoices and ID cards, he said.

Vicki Veltri, the state’s health care advocate and a board member, said more work is needed to ensure people have the correct enrollment information.

“There’s definitely confusion about that enrollment “There’s definitely confusion about that enrollment time. I know that people are allowed to stay on their Medicaid coverage through Aug. 31. We don’t want a gap, but we also don’t want to be accidentally sending a message that might be incorrect.” time,” she said. “I know that people are allowed to stay on their Medicaid coverage through Aug. 31. We don’t want a gap, but we also don’t want to be accidentally sending a message that might be incorrect. So I think we should go back and hammer it out.”

The state’s new two- year, $ 40.3 billion budget, which took effect on July 1, reduced the income levels for certain people to qualify for Medicaid in order to help balance Connecticut’s books.

It marked one of the first eligibility changes to the state’s Medicaid program since Connecticut increased its rolls in 2010 by expanding income eligibility.

However, the Department of Social Services said the change does not affect the expansion group, which included low-income adults without dependent children. Rather, the affected group include parents and relative caregivers of children enrolled in the state’s HUSKY health insurance program.

The state’s eligibility threshold is dropping from 201 percent of the federal poverty level to 155 percent of the federal poverty level, or under $24,692 for a family of two and under $37,586 for a family of four. The first group of 1,300 includes parents and caregivers who do not have earned income. Instead, they receive unearned income from sources such as unemployment and child support.

The second group of about 18,000 individuals, whose Medicaid coverage ends next year, includes parents and relative caregivers with earned income.

Access Health has been meeting with insurance brokers, community health centers and others to make sure they’re prepared to assist people with choosing the private plan offered on the exchange that’s best suited for their needs. Jim Wadleigh, CEO of Access Health CT, acknowledged that some customers are purchasing bronze plans because they have a lower premium than silver and gold plans.

However, he said they may not fully understand the coverage, which can have higher deductibles.