10-12-2022 PTL - Flipbook - Page 18
18 A Special Advertising Section of Baltimore Sun Media Group | Wednesday, October 12, 2022
INSURANCE
Comparing apples
to apples
Health insurance
plan options
By Margit B. Weisgal, Contributing Writer
W
hen the Patient Protection and Affordable Care Act (also known as names to determine what best meets your
Obamacare) became law in 2010, its purpose was to ensure everyone
had access to health care insurance. Prior to its passing, over 40 million
Americans could not afford it.
In Maryland, the Maryland Health Benefit
Exchange, an independent unit of our state
government, was created in 2011. Working
with the Maryland Department of Health, the
Maryland Department of Human Resources
(DHR), and the Maryland Insurance
Administration, the Maryland Health
Connection (www.marylandhealthconnection.
gov) was formed to enable residents easy
access to health insurance.
MHC, also referred to as the Marketplace
(with a capital M), is where Maryland residents,
who don’t have health insurance through their
employers or spouses, can look at various
health insurance plans, compare rates, and
even figure out if they are eligible for tax credits or other cost reductions, including public
assistance such as Medicaid and Maryland
CHP (Maryland Children’s Health Program).
Individuals and families can apply. There
are also non-group plans and a special section for small groups. You can also investigate
adding dental coverage or buying a policy
separately.
Insurance Enrollment
Open Enrollment occurs from November
1 to December 15 every calendar year. For
a while, during the pandemic, the rules were
ignored, but they are now back. If you want to
secure health insurance for 2023, mark your
calendar with those dates.
It may be worth checking to see if you
qualify for Medicaid. If you do, you can apply
at any time, and you’ll receive free or low-cost
coverage. In addition, even if you don’t qualify, your children may be eligible. There are a
couple links on the MHC home page, one to
see if you qualify and another to get an estimate. You can always speak with someone
who can guide you through the process and
answer any questions you may have.
Another link on the home page can be
used to see if you’re eligible for “Special
Enrollment” to sign up at other times. If your
status changes – you got married, you had a
baby or you turned 26, to name a few – you
can enroll outside of the above-mentioned
enrollment period. Visit the website to see the
complete list of status changes that allow you
to apply at other times.
What helps consumers is you are always
able to compare apples to apples. All plans
offer the same required benefits plus preventive care. You can look at private health plans
and prices offered by companies with familiar
needs and what you can afford. You can then
sign up on the website for the plan you select.
Should you need additional help, there are
always experts – certified insurance brokers –
available by phone to answer your questions.
If you prefer, you may request someone contact you so you’re not sitting on hold; you’ll
receive a call back within 30 minutes.
Essential Health Benefits
No matter which policy you choose, the
following benefits are always included:
• Doctor visits
• Hospitalization
• Emergency care
• Prescriptions
• Mental and behavioral health care
• Maternity and newborn care
• Pediatric care
• Preventive care (wellness visits, shots
and screenings)
Your Options
To make it easier for consumers, every
insurance company on MHC has plans that
range from Bronze – the lowest level and least
expensive, although your out-of-pocket costs
are the most – to Silver, Gold and Platinum.
The Process: Shop, Apply, Get Help
Your journey to health insurance coverage
begins at the MHC website. There is also a
mobile app for both Apple and Android. You
can even apply by phoning 1-855-642-8572.
Start by browsing the site and comparing
options of the different plans. There’s a link on
the home page for you to get an estimate by
entering your personal or family data. Costs
will vary based on the size of your family. And
that ‘get an estimate’ link may alert you if you
qualify for financial assistance. It will also help
you determine how to calculate your income,
which family members to include, and what
documents you will need to complete the
application.
You may want to look at dental plans in
addition to health insurance. If you qualify
for Maryland CHP, it usually includes dental
coverage.
Remember: if, at any time, you want more
assistance, you can call and speak to someone who will answer your questions and walk
you through the options. That person will also
help you figure out what plan will work best
for you.
Once you’ve completed your application and enrolled, your billing will come from
the insurance company you’ve selected:
CareFirst, Kaiser Permanente or United
Healthcare. If you ever have questions, you
can contact that company directly.