Medicare Assistance Bureau Shares Resources in Advance of Open Enrollment

Free one-on-one counseling and information available to residents; Bureau earns federal grant

The Delaware Medicare Assistance Bureau (DMAB), a division of the Delaware Department of Insurance, is encouraging residents to get ready for Medicare Open Enrollment. DMAB, which provides free, one-on-one Medicare counseling, offers a myriad of virtual appointment options for residents, as well as video tutorials and other guides that can assist in beneficiaries’ preparation. DMAB has provided more than 3,000 counseling sessions so far this year, saving beneficiaries more than $372,438 in premiums through application help.

DMAB will engage in thousands of counseling sessions during Medicare Open Enrollment, which takes place October 15 through December 7. During this time, beneficiaries can make changes to their health and drug coverage and review existing coverage against other options. DMAB will offer virtual appointments throughout this period, available via Webex, Duo, and Microsoft Teams, as well as by phone. Residents are encouraged to register for a MyMedicare.gov account prior to their counseling session so that DMAB can generate personalized plan comparisons.

“Our DMAB team works to increase residents’ understanding of the complex Medicare system and can even help save you money. I encourage the community to reach out to our team for Medicare assistance and information,” said Insurance Commissioner Trinidad Navarro.

A Virtual Medicare Seminar, which DMAB began to offer in 2020, is available on-demand online, and educates participants on topics including Medicare benefits, supplemental insurance policies, Medicare Advantage plans, prescription drug coverage and details on signing up. While specifically created for new or soon-to-be eligible beneficiaries, the informative series can be helpful for all Medicare participants.

“Many people have questions about Medicare and don’t know where to start, and COVID-19 has only increased the stress of choosing the right healthcare plans. We are here to help people in Delaware deal with the complex and often confusing health insurance system,” said DMAB Director Lakia Turner, “and, we’re more accessible than ever through our new virtual programs.”

As Medicare Open Enrollment approaches, the Department of Insurance reminds residents to scrutinize any contact during the open enrollment period to ensure it is from a known, credible source. The most frequent fraudulent contact occurs by phone, but residents should review all communications carefully.

“If you are receiving contact regarding Medicare that you did not initiate, or contact not from one of your healthcare providers, it could be fraudulent,” said Commissioner Navarro. “Protect your Medicare Number like you do your Social Security number or bank account information, and never give it out to unknown or unexpected callers.”

DMAB has been awarded a Medicare Improvement for Patients and Providers Act (MIPPA) 2021 Grant from the federal government, which will provide the bureau $71,943. The annual MIPPA grant has and will assist the bureau’s outreach, education, and one-on-one beneficiary assistance programs over the next year by assisting those beneficiaries who are likely to be eligible for the Low-Income Subsidy program (also called “Extra Help”) or Medicare Savings Programs.

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1-(800) 336-9500 or (302) 674-7364 to set up a free, confidential session. Counselors can assist with Medicare, Medicaid, Medigap (Medicare supplement insurance), long term care insurance, billing issues, prescription savings, and much more.

 View DMAB’s 2021 Open Enrollment Flyer


Medicare Assistance Bureau Innovates to Serve Residents During COVID-19

More ways to receive Medicare counseling and information as Open Enrollment approaches, Bureau earns federal grants to support efforts

When COVID-19 required cancellation of the Department of Insurance Delaware Medicare Assistance Bureau series of statewide Welcome to Medicare in-person events, the team responded rapidly, engaging with residents in new ways and offering their free, one-on-one Medicare counseling remotely. The Delaware Medicare Assistance Bureau (DMAB) has provided more than 2,930 counseling sessions so far this year, saving beneficiaries more than $192,000 in premiums through application assistance.

“We are all facing new challenges due to COVID-19, and I’m proud that our DMAB team has found ways to communicate with Medicare beneficiaries and made Medicare education and empowerment more accessible despite the inability to offer in-person events,” said Insurance Commissioner Trinidad Navarro.

DMAB will engage in thousands of counseling sessions in the coming months, as Medicare Open Enrollment takes place October 15 through December 7. During this time, beneficiaries can make changes to their health insurance coverage and review existing coverage against other options. DMAB will offer virtual Open Enrollment appointments throughout this period, available via Webex, Duo, and Skype, as well as by phone. Residents are encouraged to register for a MyMedicare.gov account prior to their counseling session so that DMAB can generate personalized plan comparisons.

“Many people have questions about Medicare and don’t know where to start, and COVID-19 has only increased the stress of choosing the right healthcare plans. We are here to help people in Delaware deal with the complex and often confusing health insurance system,” said DMAB Director Lakia Turner, “and, we’re more accessible than ever through our new virtual programs.”

DMAB began to offer virtual Welcome to Medicare seminars in May, engaging 150 residents. The Virtual Medicare Seminar, which is now available on-demand online, educates participants on topics including Medicare benefits, supplemental insurance policies, Medicare Advantage plans, prescription drug coverage and details on signing up.

As Medicare Open Enrollment approaches, the department reminds residents to assess any contact during the open enrollment period to ensure it is from a known, credible source. The most frequent fraudulent contact occurs by phone, but residents should review communications carefully.

“If you are receiving contact regarding Medicare that you did not initiate, or contact not from one of your healthcare providers, it could be fraudulent,” said Commissioner Navarro. “Protect your Medicare Number like you do your Social Security number or bank account information, and never give it out to unknown or unexpected callers.”

DMAB has been awarded two significant grants during 2020. The 2020 State Health Insurance Assistance Program Base Grant provides $234,293 in federal funds to DMAB. This is a five-year grant, with annually awards in April. It is a primary source of funding for marketing and outreach, counseling, developing and training the volunteer network, and other strategic efforts. The MIPPA 2020 Grant awarded the bureau $43,270, which has and will assist the bureau’s outreach, education, and one-on-one beneficiary assistance programs over the next year for those beneficiaries who are likely to be eligible for the Low-Income Subsidy program (also called “Extra Help”) or Medicare Savings Programs.

The Delaware Medicare Assistance Bureau provides free one-on-one health insurance counseling for people eligible for Medicare. Residents can call DMAB at 1-(800) 336-9500 or (302) 674-7364 to set up a free confidential session. Counselors can assist with Medicare, Medicaid, Medigap (Medicare supplement insurance), long term care insurance, billing issues, prescription savings, and much more.


GOV. CARNEY OP-ED: We Can Build on Health Care Progress

Governor John Carney published an op-ed about progress made in Delaware to get more Delawareans health insurance coverage, and reminds Delawareans the ACA health insurance marketplace enrollment period ends December 15. 

 

Ten years ago, before President Obama signed the Affordable Care Act into law, it was legal for insurance companies to deny Delawareans health coverage because they had diabetes or another pre-existing condition.

Across our state, more than 11 percent of Delawareans went without insurance. They skipped preventive visits to their doctors. And they accepted that a health crisis could also mean losing all their savings, or worse.

In the years since, we have made substantial progress in reducing the number of uninsured Delawareans.

With federal assistance, we have expanded our Medicaid program to provide quality health insurance coverage for Delaware families who need it the most. And more than 22,000 Delawareans have signed up for a health plan under the ACA health insurance marketplace.

Since implementation of the ACA, we have nearly cut our uninsured population in half in Delaware. And here’s some good news this year: rates on the ACA health insurance marketplace are down almost 20 percent, which we hope will encourage more Delawareans to get covered.

This is because, working with the General Assembly, we passed House Bill 193 into law, creating a reinsurance program which helped drive down the cost of coverage on the ACA marketplace.

In addition, some people will qualify for premium assistance, making the plans even more affordable.

That’s a really big deal. And as we near this year’s deadline of open enrollment on the ACA health insurance marketplace, we want to make sure even more Delawareans get covered.

For Delawareans who don’t have coverage through their employers, and for those who already have insurance through the ACA marketplace, I want to remind you and urge you to shop and compare ACA marketplace plans.

If you don’t have coverage, you need to act quickly. Enrollment on the ACA marketplace is open through December 15. Visit ChooseHealthDE.com to review your options and enroll at healthcare.gov.

If you’re not sure if can afford coverage on the marketplace, Westside Family Healthcare has health care navigators to help walk you through your options, including whether you and your family are eligible for financial assistance.

To make an appointment with a marketplace navigator, call Westside Family Healthcare at 302-472-8655 in New Castle County or 302-678-2205 in Kent and Sussex counties. Or visit ChooseHealthDE.com.

We know that we still have a lot of hard work to make health care more affordable for Delawareans and Delaware families. That’s why – working with members of the General Assembly – we created the new reinsurance program.

And that’s why we are working with health care providers on an initiative to bring transparency to health care prices and give Delaware consumers more information when they are making decision on where to get care.

Our overall goals are to reduce health care costs costs, and improve affordability and health outcomes for Delawareans across our state.

Our overall goals are to reduce health care costs and to improve affordability and health outcomes for Delawareans across our state. To do this, we need to build on the foundation of the ACA until all Delawareans are able to get the quality health care they deserve.

John Carney is the 74th Governor of the State of Delaware.


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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Open Enrollment Starts Tuesday for Delaware’s Health Insurance Marketplace

NEWS FROM THE DELAWARE DEPARTMENT OF HEALTH AND SOCIAL SERVICES

Open Enrollment Starts Tuesday
for Delaware’s Health Insurance Marketplace
Delawareans who seek coverage through HealthCare.gov are urged
to take advantage of subsidies to offset rise in premium costs

NEW CASTLE (Oct. 31, 2016) – The fourth open enrollment period for Delaware’s Health Insurance Marketplace starts Tuesday as the state prepares to build on the progress of the last three years, in which more than 28,000 Delawareans signed up for coverage and the state’s uninsured rate dropped an estimated 35 percent.

The open enrollment period, in which people can renew current coverage or sign up for a new plan for 2017, runs from Nov. 1 through Jan. 31, 2017, at www.HealthCare.gov. Individuals must sign up by Dec. 15 for their coverage to be effective Jan. 1.

The state will formally mark the Health Insurance Marketplace’s fourth enrollment period with a press conference at 1 p.m. Nov. 10 at Westside Family Healthcare’s Bear office, 404 Fox Hunt Drive in the Fox Run Shopping Center off U.S. 40.

In the face of increased cost of premiums, 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 subsidies available when they buy private plans through the Health Insurance Marketplace, also known as Obamacare.

“Many people still don’t realize they can get financial help paying for their Marketplace coverage,” said Rita Landgraf, secretary of the state 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. 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.”

Consumers can go to HealthCare.gov now to check out their options for 2017. Individuals who need help enrolling in coverage will again 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 http://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:

• Sixty-three percent of Delawareans who now have Marketplace coverage could get 2017 coverage for a monthly premium of $100 or less after tax credits, 55 percent could get coverage for $75 or less, and 45 percent could get coverage for $50 or less.

• Sixty-three percent of current Marketplace enrollees whose annual household incomes are between 100 percent and 250 percent of the federal poverty limit (from $11,880 to $29,700 for one person and from $24,300 to $60,750 for a family of four) are receiving financial assistance. Financial help is available for individuals with annual incomes up to $47,520; for a family of four the income limit is $97,200.

• The median annual income of Marketplace enrollees in Delaware is about $25,000 for one person and $51,400 for a family of four.

As in previous years, three insurers will offer Marketplace medical plans in Delaware for 2017: Highmark Blue Cross Blue Shield of Delaware, Aetna Health, and Aetna Life Insurance Company. Across the insurers, they will offer a total of 21 plans for individuals and 11 SHOP plans for small businesses. Two insurers – Delta Dental and Dominion Dental – will offer a collective 15 stand-alone dental plans, 10 for individuals and five for small businesses.

Rates in 2017 will increase an average of 32.5 percent for Highmark plans, 23.6 percent for Aetna Health and 22.8 percent for Aetna Life.

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.

Medical plans will be available in three metal-level categories – bronze, silver and gold – 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 $6,350 for an individual and $12,700 for a family.

In Delaware in 2017, the average monthly premium for a second-lowest cost silver plan for a 27-year-old non-tobacco user will be $347 before tax credits based on eligibility are applied.

Consumers who pick silver plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance.

Penalty for going without coverage

Individuals who can afford coverage but who choose not to buy it will pay a fee equal to the higher of these amounts: 2.5% of your annual household income or $695 per person ($347.50 per child under 18). The maximum penalty will not exceed $2,085 per household or the total yearly premium for the national average price of a bronze-level plan sold through the Marketplace. 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 congressman urged uninsured Delawareans to find out what’s available for them on the Marketplace.

“Over the last several years, I’ve had a chance to meet with Delawareans who found affordable health care and peace of mind through the Health Insurance Marketplace,” Sen. Tom Carper said. “With open enrollment about to begin, I strongly urge all uninsured individuals to go to ChooseHealthDE.com to get information about the various health insurance plans available and potential financial assistance they may qualify for to reduce their insurance costs. And because enrolling in health insurance can be overwhelming, there is free, in-person assistance available to help individuals and families. Every Delaware family deserves access to the quality health care they need, and the Marketplace is making that a reality for thousands of Delawareans for the first time.”

“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. “I would encourage both the uninsured and insured to visit the Marketplace 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 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.”

Added Congressman John Carney: “Starting Tuesday, Delawareans will have another chance to purchase quality health care coverage for themselves and their families. While we still have work to do to bring down the cost of health care, the Marketplace has made it much easier for many Delawareans to access the care they need. I encourage everyone to take advantage of open enrollment and see what their options are.”

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 83,000 in 2013 to 54,000 in 2015, 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 Landgraf said. “Through the Delaware Center for Health Innovation, we are striving to ensure that our health care system delivers quality care, produces better health outcomes, reduces costs and enhances the experience of health care providers. Those goals are at the heart of the Affordable Care Act.”

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For more information, contact Jill Fredel, Director of Communications, (302) 255-9047 (office) or (302) 357-7498 (cell).

Delaware 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.