(C) Daily Montanan This story was originally published by Daily Montanan and is unaltered. . . . . . . . . . . More savings, more family options for marketplace insurance during open enrollment – Daily Montanan [1] ['Darrell Ehrlick', 'More From Author', '- November'] Date: 2022-11-01 Healthcare navigators want Montanans to remember that there’s a reason it’s called the “Affordable Care Act.” It’s not just a clever naming convention. This year, as open enrollment begins on Tuesday, premium costs for insurance plans on the Montana marketplace have mostly lowered, thanks to tax credits from Congress as parts of the American Rescue Plan and the Inflation Reduction Act. Olivia Riutta, the director of special populations at the Montana Primary Care Association, is tasked with helping residents navigate through the application and marketplace. Last year, saw a 14% increase in utilizing the marketplace with 51,134 Montanans enrolled. And nearly 9-out-of-10 enrollees qualify for tax credits to make their monthly premiums more affordable. Generally speaking, rising healthcare premiums have been a source of economic stress for many families, but Riutta pointed to several changes, including the tax credits, which mean that many Montanans will see a drop in the premium price. She said that more than a quarter of all those enrolled qualified for extra financial assistance that reduces the out-of-pocket costs when going to a doctor. Montana has three insurance carriers on its state exchange and the plans offered must include 10 essential coverage areas, too. Open enrollment runs Nov. through Jan 15. However, Dec. 15 is the deadline for Jan. 1 coverage. Otherwise, enrollment between Dec.15 and Jan. 15 will go into effect on Feb. 1, 2023. More options for families One of the largest differences has been the correction of family plans, sometimes referred to as “the family glitch.” Previously, if one member of the family was offered a work-based insurance plan that was considered “affordable” and there was also an option for a family plan, regardless of costs or income, the family had to use the employer-provided plan. In many cases, Riutta explained, employers would cover the premium for the employee, which would make it “affordable,” but coverage for other family members was often prohibitive – yet, families would not be able to purchase a plan on the marketplace exchange. Now, Riutta said families can shop for plans even if one is offered through a workplace. An estimated 5 million Americans are impacted by that change. “No matter how much that premium was for a family, that was their option,” she said. “It’s called the ‘family glitch’ because that was not intended when it was passed.” Open enrollment Open enrollment begins on Nov. 1 and runs through Jan. 15, 2023 (although Dec. 15 is the deadline for coverage that begins on Jan. 1, 2023). One application allows people to find out if they’re eligible for Montana Medicaid, Healthy Montana Kids or a Health Insurance Marketplace plan. Free enrollment help is available through the Cover Montana Help Line at 1-844-682-6837 Cover Montana navigators can provide in-person enrollment assistance in many communities across Montana. To find local help, visit: https://covermt.org/find-local-help/ Then, search by ZIP code. In many communities, residents can sign up for an enrollment appointment. Phone, virtual and in-person appointments are available. Also, the application process is a one-stop shop for several programs, Riutta said. One application allows people to find out if they are eligible for Montana Medicaid, Health Montana Kids or a Health Insurance Marketplace plan. Once an application is filled out, it is directed to the right agency, Riutta said. “It’s done automatically and you don’t have to know what all you qualify for,” Riutta said. “You don’t have to exist in different programs.” Plans are required to have no-cost preventative visits and are comprehensive, covering doctor’s visits, prescription drugs, emergencies, hospitalizations and more. “The reason most people still don’t have insurance is because most people can’t afford it,” Riutta said. “Most people really want to get covered and they’re able to afford it with a bit of help.” She said it’s important to enroll and check out the options yearly. There are options for auto-renewal for those who like their insurance, but she said it’s vital to check to see what may have changed and if you qualify for more assistance. “Usually we’re able to shop for a plan that fits a monthly budget and healthcare needs, but healthcare plans, as we all know, changes,” Riutta said. For example, Montanans who want to see a doctor in particular network may want to shop those plans that have that doctor or clinic in-network. And, Riutta said it’s often helpful to know what medications are needed, or if someone needs more attention from a specialist or more routinely sees their primary care doctor. “So the promise of the exchange was to make it an apples-to-apples comparison and with standardized plans following the same structure, it’s a true apples-to-apples comparison,” Riutta said. “Each cover all the areas but the difference is how much before a deductible or a copay.” [END] --- [1] Url: https://dailymontanan.com/2022/11/01/more-savings-more-family-options-for-marketplace-insurance-during-open-enrollment/ Published and (C) by Daily Montanan Content appears here under this condition or license: Creative Commons CC BY-NC-ND 4.0. via Magical.Fish Gopher News Feeds: gopher://magical.fish/1/feeds/news/montanan/