As we all prepare for the holidays, it is important to remember that it’s open enrollment time. If you need health coverage, you should know that this year, individuals have a shorter period of time to enroll and select their plans — and fewer options to choose from. The open enrollment period this year is only six weeks — half as long as last year. The enrollment deadline is Dec. 15 for coverage that takes effect Jan. 1. Maine residents who want individual health insurance must go online soon and shop for the plan that best fits their needs and the needs of their family.
It has been widely reported that premiums are going up around the country, and unfortunately, this is also true of Maine. The cost of health care services continues to rise, and recent administrative and legislative decisions made in Washington have directly led to increasing insurance premiums.
Fortunately, most Maine residents purchasing on the exchange will be protected from these increases. While premiums are going up, many Mainers will also see their premium subsidy increase. These subsidies, known as the advanced premium tax credit, offset the cost of health insurance and will allow some residents to purchase health insurance with either very low or zero monthly premiums, depending on their income.
Additionally, certain eligible individuals will also find that another federal subsidy, called cost-sharing reduction subsidies, will dramatically reduce their deductibles, co-pays and other out-of-pocket expenses. These cost-sharing reduction subsidies, however, are available only for so-called “Silver” plans, which may have slightly higher monthly premiums. While you may have read that funding for this subsidy has been ended by actions in Washington, these affordable and attractive plans are still offered on the exchange.
Therefore, this year more than ever, it is extremely important that consumers carefully consider all the costs associated with a health insurance plan, including the premium, deductibles, co-payments, coinsurance and any other out-of-pocket expenses. If individuals have questions about the health plans available on Healthcare.gov, they should know that there are health navigators and certified assisters throughout the state of Maine who can help them with their concerns. These trained professionals have an extensive background in health care and can be reached online at enroll207.com or toll-free by phone at 800-965-7476. Consumers can also contact a licensed broker or even call a health plan directly.
Lastly, consumers will also notice that this year there will be fewer health insurers participating on the exchange through Healthcare.gov, so individuals will find fewer choices than in previous years. Health insurer participation rates around the country have declined, but in Maine, consumers will still find options from two quality health insurers, including Harvard Pilgrim, and be able to choose from several health insurance plans.
In Maine, much credit for the survival of the public health exchange is due to the leadership of the Maine Bureau of Insurance. Amid indecision from Washington about whether or not the cost-sharing reduction payments would be funded, Maine Insurance Superintendent Eric Cioppa was fair and decisive in his approach to regulating the marketplace for 2018. His foresight ensured that residents both had the opportunity to voice their concerns during the process and that Mainers would have a choice in health plans for 2018.
Harvard Pilgrim is proud to have participated in the Maine health insurance exchange for the past three years. As a company celebrating our 50th anniversary, and with over 20 years of serving Maine residents, our commitment to the state of Maine goes well beyond our role as an insurance provider – we hope to be a strong corporate citizen, in line with our not-for-profit mission and our core values.
So, before you get too caught up in the hustle and bustle of the holiday season, please take the time to review your individual health insurance options for 2018 at Healthcare.gov. Dec. 15 and the end of open enrollment are right around the corner.
Edward Kane is Maine vice president for Harvard Pilgrim Health Care.
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