With open enrollment for Maryland’s health insurance marketplace set to open, Access Carroll plans outreach

Carroll County Times (Westminster, MD)

Oct. 30--For anyone who doesn't have health insurance and is not eligible for coverage through a parent's or employer's plan, the time to check out plans available through Maryland's individual insurance marketplace, the Maryland Health Connection, is almost here.

"Open enrollment begins at 5 a.m. this Friday, Nov. 1," said Michele Eberle, executive director of the Maryland Health Benefits Exchange, which operates the Maryland Health Connection. "Between Nov. 1 and Nov. 9, we have more than 20 Get Connected events taking place around the state, and we want people to come in, look at the plans and see if something better meets their needs."

One of the first of those Get Connected events will be held in Westminster. Access Carroll will be hosting one from 9 a.m. to 1 p.m. Saturday, Nov. 2, as an opportunity to sign up for health insurance, or to simply learn more about the plans available, including eligibility for tax credits to bring down the cost of a plan, or even Medicaid eligibility.

"We always encourage people to call if they have questions related either to the current plan they are enrolled in, whether they are shifting plans, or whether they are eligible," said Traci Kodeck, CEO of HealthCare Access Maryland, whose staff will be on hand Saturday to answer questions. "Sometimes it's nice to just walk through that with someone who does it every day."

HealthCare Access Maryland is a nonprofit that functions as the "connector" organization for Carroll County, operating a call center and providing individuals known as navigators who can help answer questions about Medicaid and Maryland Health Connection insurance plans.

"We are the person who can meet face-to-face with those individuals, that will help them walk through either being eligible for free health insurance under Medicaid, or purchasing on the health exchange," Kodeck said. "What are the options? What they will be paying at the end of the day? What's a premium? What does that mean to me? Tax credits -- we can really walk them through what can often be very overwhelming to people."

The Maryland Health Connection is the state marketplace for health insurance set up as part of the federal Affordable Care Act, though for 2020, insurers CareFirst and Kaiser Permanente will be the only insurance providers offering insurance plans through the marketplace.

As in years past, those making below a certain income threshold may be eligible for Medicaid, while others may be eligible for tax credits that reduce the cost of insurance. A family of four making less than $35,532 per year would be eligible for Medicaid, whereas that same family could qualify for a tax credit while making up to $100,400 annually.

More information on plans and tax credit estimates are available on the connection website at www.marylandhealthconnection.gov.

In Carroll County, 3,026 people were enrolled in plans purchased through the Maryland Health Connection in 2019.

According to Eberle, people shopping on the individual marketplace could see opportunities for lower premium plans, as well as lower deductibles compared with 2019 and 2018. Average premiums dropped 13 percent in 2019 compared with 2018, she said, and average premiums are expected to decrease another 10 percent for 2020, a decrease she attributes to Maryland's reinsurance plan.

"What reinsurance is is kind of insurance for insurance," Eberle said, while the state used tax revenue from insurers to set aside a pot of federally matched funds to offset the costs to insurers of covering people who are sicker and use more health care. "That says, 'OK carrier, we will help you with that risk, so now you can lower rates for everybody.' It's been very successful."

How much of an effect that will have may vary from plan to plan. The Maryland Health Connection continues to categorize insurance plans as Bronze, Silver or Gold, with Bronze plans typically having lower premium costs but higher deductibles and other tradeoffs, while Gold plans represent the other end of a continuum with higher premiums and lower deductibles.

According to information provided by Eberle, the monthly premiums for the lowest-cost Silver plans for a 40-year-old person in 2018 were $465 from CareFirst HMO, $686 from CareFirst PPO and $373 from Kaiser Permanente. Those same plans in 2020 will have monthly premiums of $341, $626 and $366, respectively.

Also new this year are mandated "value plans," according to Eberle, which require insurers offer more services without requiring a deductible be met first, although they can charge a co-pay.

"We are now going to require the insurance carriers to offer primary care visits, mental health visits and, in some cases, generic drugs before the deductible," she said. "So it just makes consumers able to use their health plans for more coverage without paying out of pocket."

There will also be a new special enrollment window for women who become pregnant, according to Eberle.

"If a woman becomes pregnant, she will have 35 days from the date her doctor confirms she is pregnant to apply for a health plan that will cover her for the duration of the pregnancy," she said.

Because of the changes to plans, premiums and other benefits, Eberle said the Maryland Health Benefits Exchange is using the Get Connected events to really invite people to check out their options for 2020, even if they have previously been ineligible or did not find a plan that was right for them.

"Anyone who does not have health insurance during open enrollment, we encourage you to put your information in and see if you are eligible," she said.

One group that is not eligible?

"The federal tax credits would not apply to Illegal immigrants," Eberle said. "But that does not mean that if you are here lawfully, and there's a whole list of reasons you could be here lawfully, that you cannot get coverage."

For those who find the process of looking at insurance plans a little daunting, Kodeck's HealthCare Access Maryland navigators will be on hand, and not just at Saturday's Get Connected event. A navigator will be available by appointment 8:30 a.m. to 4:30 p.m. Monday through Friday at the Carroll County Department of Social Services, as well as at Access Carroll. The numbers to call to make an appointment are 410-500-4710 or 855-654-8572.

There will also be ongoing weekend and evening appointment times available at the Access Carroll location.

"Access Carroll does have a great partnership with Health Care Access Maryland as the navigation vendor for the Maryland Health Exchange," Access Carroll executive director Tammy Black wrote in an email. "We have extended evening hours and Saturday openings on Nov. 2, Nov. 9, Nov. 16, Nov. 23, Dec. 7 and Dec. 14."

Open enrollment runs through Dec. 15.

"Making a decisions like this is not one that you want to make on Dec. 15. You want to give yourself time to process it, to make sure the plan you pick has your doctors," Kodeck said. "It's always good to meet with a navigator early."

If you go

What: Get Connected event for open enrollment for insurance plans on the Maryland Health Connection

When: 9 a.m.-1 p.m. Saturday, Nov. 2

Where: Access Carroll, 10 Distillery Drive, Suite 200, Westminster

Cost: Free

Open enrollment runs from Nov. 1 through Dec. 15. To schedule an appointment with a navigator outside the Get Connected event, call 410-500-4710 or 855-654-8572.

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Visit the Carroll County Times (Westminster, Md.) at www.carrollcountytimes.com

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