Open Enrollment Starts Wednesday for Delaware’s Health Insurance Marketplace

NEW CASTLE (Oct. 31, 2017) – With the open enrollment period for Delaware’s Health Insurance Marketplace cut in half from 12 weeks to six weeks, Delawarean seeking coverage for 2018 are urged to sign up early  beginning Nov. 1 in order to avoid any last-minute rush before the Dec. 15 deadline. Early enrollment is also important because the federal government has announced planned maintenance shutdowns of HealthCare.gov on most Sundays during open enrollment.

The fifth open enrollment period, in which people can renew coverage or sign up for a new plan for 2018, runs from Nov. 1 through Dec. 15, at www.HealthCare.gov. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will be effective Jan. 1.

The state will formally mark the Health Insurance Marketplace’s fifth enrollment period with a press conference at 2 p.m. Nov. 1 at Westside Family Healthcare’s Northeast Wilmington Health Center, 908-B E. 16th St.

“Health insurance is a critical connection to quality health care,” Governor John Carney said. “Since the Affordable Care Act was signed into law, Delaware’s uninsured rate has been reduced significantly and more people are getting the health care they need. For people who don’t have access to health insurance through an employer or another form of coverage, the Health Insurance Marketplace offers them an opportunity to get covered. I urge Delawareans to shop early for a plan, meet with in-person assisters to get help understanding your options and to sign up by December 15th.”

Delaware currently has more than 27,000 people enrolled for coverage through its Health Insurance Marketplace, including 73 percent who re-enrolled for 2017 and 27 percent who were new enrollees.

Earlier this year, Aetna announced it would not sell plans on Delaware’s Health Insurance Marketplace for 2018. Enrollees with Aetna plans for 2017 must choose one of seven Highmark Blue Cross Blue Shield of Delaware plans that are available for purchase in 2018 or they will be automatically enrolled in a similar plan offered by Highmark. Enrollees who currently have coverage through Aetna Health or Aetna Life will be notified in writing as to what steps to take to obtain an alternate plan.

In October, Insurance Commissioner Trinidad Navarro announced that the Department of Insurance had approved an average rate increase of 25 percent for 2018. With the premium increase, Delaware is making an extra effort this enrollment season to make sure residents who do not have employer-sponsored health insurance or who are not eligible for public programs such as Medicare, Medicaid, and the Children’s Health Insurance Program are aware of the federal tax credits available when they buy private plans through the Health Insurance Marketplace, also known as Obamacare. The tax credits can help reduce the cost of their monthly premiums.

“With the uncertainty in Washington, many people may not realize that they can still get coverage through the Marketplace and that there’s still financial help available to help them pay for the plan they choose,” said Dr. Kara Odom Walker, secretary of the Delaware Department of Health and Social Services. “This year, more than 80 percent of Delawareans who have a Marketplace plan are receiving tax credits to lessen the costs of their premiums. It’s important that enrollees with a current Aetna plan go to HealthCare.gov or make an appointment with an assister who can help walk them through their enrollment options. I urge anyone who needs high-quality, affordable health insurance to go to HealthCare.gov to shop for a plan, and I encourage those who are already enrolled to go back to the website, update their information and pick a plan that meets their health needs and budget.”

“Every American ought to have access to quality affordable health care,” said Insurance Commissioner Trinidad Navarro. “Despite the Affordable Care Act’s challenges and the uncertainty in Washington, D.C., consumers should not be discouraged. As a result of Obamacare, more Delawareans are now insured and receiving the health care not only that they need, but that they deserve. Last year Delaware continued its high participation rate on the Marketplace and achieved a 95 percent insured rate throughout the state. Open enrollment is an opportunity to build on these advancements. Because enrollment has been shortened, the Department of Insurance encourages consumers to enroll as early as possible and to consult navigators and other enrollment assisters to select the most cost-efficient plans that offer the greatest quality of services and coverage.”

Consumers can go to HealthCare.gov now to check out their options for 2018. Individuals who need help enrolling in coverage will have access to free in-person assistance from federally funded and trained specialists at several Delaware organizations, including Westside Family Healthcare, Chatman LLC, Henrietta Johnson Medical Center and La Red Health Center.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

For more information, go to www.ChooseHealthDE.com. You can enroll in marketplace coverage at www.HealthCare.gov or by calling 1 (800) 318-2596 (TTY: 1 855 889-4325).

According to the U.S. Department of Health and Human Services:

• Eight-one percent of Delaware’s current Marketplace enrollees receive financial assistance to help pay their monthly premiums and/or deductibles and co-pays.
• The current average monthly premium in Delaware is $569, with an average tax credit among all enrollees of $338 per month. For the 81 percent of Delawareans who currently receive financial assistance, the average premium after tax credit is $162 per month.
• Among the more than 27,000 current enrollees, 73 percent are re-enrollees and 27 percent are new enrollees for 2017.
• Financial help is available for individuals with annual incomes up to $47,520; for a family of four the income limit is $97,200.
• More than half of all current Delaware enrollees signed up during two weeks in 2017, Dec. 11-17 and Dec. 18-24.

For 2018, Highmark Blue Cross Blue Shield of Delaware will offer a total of seven plans for individuals – one gold plan, three silver, two bronze and one catastrophic. Two insurers – Delta Dental of Delaware, Inc. and Dominion Dental Services, Inc. – will offer a collective 12 stand-alone dental plans, six with a low actuarial level (70 percent) and six with a high actuarial level (85 percent).

All plans cover essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, and pediatric services.

The three metal-level categories – bronze, silver and gold – are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need care.

Tax credits are especially beneficial to consumers who pick the second-lowest cost silver plan, since the credits adjust to match any changes in premium. In a silver plan, the insurer pays about 70 percent of medical costs and the consumer pays about 30 percent, up to a maximum annual out-of-pocket cap of $7,350 for an individual and $14,700 for a family.

Consumers who pick silver plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 45 percent of current enrollees qualify for cost-sharing reductions.

Penalty for going without coverage

Individuals who can afford coverage but who choose not to buy are expected to pay a penalty equal to the higher of these amounts: 2.5% of your annual household income or $695 per person ($347.50 per child under 18). For 2017, the maximum penalty will not exceed $2,085 per household. In addition to the penalty, consumers will be responsible for the total cost of health expenses they incur.

Consumers can estimate their penalty using the penalty calculator available on ChooseHealthDE.com.

Delaware’s senators and U.S. representative urged uninsured Delawareans to find out what’s available for them on the Marketplace.

“I encourage everyone to use the Marketplace open enrollment period to get their free help from navigators up and down the state and review their options for coverage in 2018,” said U.S. Sen. Tom Carper. “Tax credits are available to help cover the cost of the premium, and some may find out they are eligible for Medicaid. Despite partisan politics down in Washington, the Affordable Care Act is still the law of the land, so don’t delay in getting covered.”

“Open enrollment is a great opportunity for Delaware families to shop around in the Health Insurance Marketplace and find a plan that works best for them,” Sen. Chris Coons said. “Whether you have insurance already or not, I encourage all Delawareans to visit HealthCare.gov and explore plans and financial assistance that may be available to them. While we have more work ahead to improve the ACA and bring down overall health care costs, open enrollment is an important opportunity for families to get the comprehensive health care they need, regardless of age, background, or pre-existing conditions.”

“As families budget for 2018, the beginning of health care open enrollment marks the time to shop around, research what discounts may be available, and select coverage for the upcoming year,” said Rep. Lisa Blunt Rochester. “The health care exchanges are a valuable resource for all families in accessing quality care, and a number of Delaware families may qualify for financial assistance in meeting their insurance costs. With a shortened open enrollment period this year, I recommend all Delawareans visit ChooseHealthDE.com to get more information about what plans are available to meet their family’s needs and to find out how to take advantage of free, in-person help to navigate the health care marketplace.”

Businesses with 50 employees or fewer can offer plans to their employees starting any month of the year through the Small Business Health Options Program (SHOP). Go to HealthCare.gov or call 1 (800) 706-7893 (TTY: 711).

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage though Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST.

Delaware’s uninsured population decreased from 10 percent in 2008 to 5.7 percent in 2016, according to a recent Census Bureau report. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions. Increasing access to health care coverage is the first step toward a healthier Delaware, Secretary Walker said. “Through our work on a health care spending benchmark for Delaware linked to the state’s economy, we are striving to ensure that our health care system delivers quality care, produces better health outcomes, slows the growth of health care spending and enhances the experience of health care providers.”

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The Department of Health and Social Services is committed to improving the quality of the lives of Delaware’s citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.


Open Enrollment Continues through January 31 for Delaware’s Health Insurance Marketplace

DOVER, DE Commissioner Karen Weldin Stewart reminds consumers that the open enrollment period for health insurance plans offered in 2017 through Delaware’s Health Insurance Marketplace ends on January 31, 2017. If you want coverage to begin on January 1, you need to enroll in a plan by December 15.  Delaware residents who are looking for personal assistance with selecting a plan should visit www.choosehealthde.com to connect with health navigators who provide free support. Consumers can select or change plans on their own at www.healthcare.gov.

According to Healthcare.gov, if you had Marketplace health insurance in 2016, you can renew, change, or update your plan for 2017 through January 31, 2017: “Whether you intend to renew or change plans, you must update income and household information on your 2017 application to get the right amount of financial assistance. Your savings depend on your expected household income for the year. Over 8 in 10 people who apply are eligible to save, and most can find plans for between $50 and $100 per month (after accounting for their premium tax credit).”

There are always changes in costs, networks and other details of insurance plans from year to year. Don’t assume that just because a plan worked well for you in 2016 that it will also be the best, or most cost-effective plan, for 2017. All health insurance plans offered through the Marketplace cover the ten Essential Health Benefits, pre-existing conditions and preventive care services.

If you were enrolled in a Marketplace plan in 2016, the federal government reports that “by November 1, 2016, you should receive two letters: one from your current insurance company and one from the Marketplace. Together they explain: any changes in your coverage and financial help; and if you need to send the Marketplace any documents.”  In addition, some plans are being discontinued for plan year 2017.  It’s important that consumers who were enrolled in those plans choose a new plan for next year. If you don’t choose a new plan, you may be automatically enrolled, or “crosswalked,” into a similar plan. Once you’ve enrolled in a plan, check your mail for information from your insurance company. When a welcome packet arrives, be sure to read the information thoroughly and save everything in a secure place. It is very important that you pay your premium on time. If you fail to pay your monthly premiums, your insurance company can cancel your policy. If your policy is cancelled due to non-payment you will likely not qualify for any other coverage until January 1, 2018.

If you don’t have health insurance coverage in 2017 you will have to pay a federal fee at tax time.

After January 31, 2017, you won’t be eligible to enroll in a health insurance plan through the Marketplace for the rest of 2017 unless you qualify for a special enrollment period.

Ready to enroll? Consumers can find more details about the various plans and their related premiums and deductibles, as well as any potential premium subsidies they may be eligible for, at www.healthcare.gov.

Small businesses can apply for coverage for their employees any time, all year.

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The Health Insurance Marketplace Open Enrollment Period Has Passed, But You May Qualify for a Special Enrollment Period

Important Deadline Approaching April 30; Beware of Scams

Dover, DE The open enrollment period for the Health Insurance Marketplace, www.healthcare.gov, ended on February 15; however, some people may qualify for a special enrollment period (SEP) going on right now. If you owe a fee with your taxes for not having qualifying health coverage in 2014, and you don’t yet have health insurance for 2015, you may still be able to get coverage for this year. Time to apply is limited; this special enrollment period ends on April 30.

“If you don’t have health insurance in 2015 you’ll risk having to pay the fee again next year,” said Insurance Commissioner Karen Weldin Stewart. The fee for people who don’t have coverage increases in 2015 to $325 per person or 2% of your household income – whichever is higher. Eighty percent of people who apply for financial assistance received some level of support to help pay for monthly premiums.

If you owe the fee for not having qualifying coverage in 2014, you may still be eligible to enroll in 2015 coverage if all of these apply:

  • You didn’t know until after open enrollment ended on February 15, 2015 that the health care law required you and your household to have health coverage, or you didn’t understand how the requirement would impact you and your household;
  • You owe the fee for not having coverage in 2014; and
  • You aren’t already enrolled in 2015 coverage through the Health Insurance Marketplace or outside the Marketplace.

Healthcare.gov states that, “You don’t need to have filed your 2014 taxes before enrolling with this SEP—you just have to owe the fee.” The website further states, “If any person in a household meets the criteria for this SEP, everyone in the household can enroll with it.” Please note: Even if you get 2015 coverage through the SEP, you still owe the fee for 2014.

Other special enrollment periods are available throughout the year if you experience certain life changes, such as having a baby, getting married, or losing your existing health coverage. To see if you qualify, please visit www.choosehealthde.com or www.healthcare.gov.

Small businesses can apply for Small Business Health Options Program (SHOP) coverage for their employees any time, all year long.

Fraud, scams and harassment: If you try to obtain a health insurance policy outside of the open enrollment period which complies with the Affordable Care Act, you will probably find very few options. Nevertheless, within the past week the Department of Insurance’s Consumer Services division has received several complaints about harassing phone calls from callers trying to sell limited benefit plans to consumers, sometimes insinuating that the callers’ plans qualify as full health insurance coverage. It most likely does not comply.

There have also been recent reports of scammers calling and impersonating IRS agents, telling people that they need to pay fines or enroll in a plan immediately. Remember, the IRS does not generally conduct business via telephone and you should never give out personal information to anyone if you are suspicious of the call or feel pressured to “act immediately”. Never provide your social security number or credit card number to anyone who demands it.

If you are contacted by an agent who is selling a legitimate insurance product, he or she is required by law to provide you with the name of the insurance company that the agent is representing, and the agent’s ID number. If you request that information, and the alleged agent will not provide it, then the call is almost certainly a scam. Before you purchase any benefit plan or insurance policy, you are encouraged to call the Delaware DOI Consumer Services division at 1-800-282-8611 to verify that the agent is licensed to sell insurance policies in Delaware. For more information about health insurance topics please visit www.delawareinsurance.gov.

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Contact:  Jerry Grant

(302) 674-7303

 


It’s Time to Think about Your Health Insurance Coverage

It’s Time to Think about Your Health Coverage

Whether you’re covered under Medicare, or don’t have any health insurance at all,
the time to review your health coverage is fast approaching

 

DOVER, DE–If you are unhappy with your health insurance coverage, or don’t have any at all,Delaware Insurance Commissioner Karen Weldin Stewart wants to alert you to two important sets of dates coming up soon.

October 15 through December 7 is the time for Medicare Open Enrollment.  It’s the time when all people with Medicare are encouraged to review their current health and prescription drug coverage, including any changes in costs, coverage, and benefits that will take effect next year.

Call the Delaware Medicare Assistance Bureau, DMAB, at 1-800-336-9500 for help with all of your questions related to Medicare and Medicare prescription drug plans, such as Part D. You can also get information on DMAB’s website, www.delawareinsurance.gov/DMAB. Staff and trained volunteers are available to meet with Medicare recipients at various locations throughout each county to review your current prescriptions and options in-person.

If you want to change your Medicare coverage for next year, this is the time to do it. If you’re satisfied that your current coverage will continue to meet your needs for next year, you don’t need to do anything. Staff members are also able to help with questions about Medicare Advantage plans.

If you are not on Medicare and need health insurance, November 15 through February 15 is the open enrollment period for the Health Insurance Marketplace at www.HealthCare.gov.  If you need to enroll in a plan, or review your current plan and options, visit www.ChooseHealthDE.com to get connected to free, local help from a trained Marketplace Guide. Help is also available by phone at 1-800-318-2596 (this number connects to a national call center).

Many individuals and their families will qualify for federal subsidies to help lower health insurance premiums. Talk to a Marketplace Guide or set up an account on Healthcare.gov to get more information about plans and coverage available, as well as costs and subsidies.

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Know Your Open Enrollment Dates 2014

Delaware Department of Insurance: “Protecting Delawareans through regulation and
education while providing oversight of the insurance industry to best serve the public.”