Looking into health insurance on Marketplace? Help is available to navigate new rules, plans

Looking into health insurance on Marketplace? Help is available to navigate new rules & plans

Karen Dandurant | Fosters Daily Democrat
Read the full article on Fosters Daily Democrat

PORTSMOUTH – It is open enrollment time for people seeking health insurance for themselves and their families through the Affordable Care Act (ACA) and while the paperwork seems daunting, there are people standing by who are ready to help.

Mary Moynihan of Goodwin Health and Susan Turner of Families First are certified application counselors whose job it is to know about and understand any changes this year that are important to those seeking health insurance through The Marketplace (healthcare.gov). The two agencies are part of Greater Seacoast Community Health, and are ready and willing to help both patients of the health care group and anyone else in the general public who might be feeling overwhelmed.

Open enrollment for the federal marketplace goes through Jan. 15, 2023, but people need to enroll by Dec. 12, 2022 if they want coverage starting on the first of the year. They can still enroll after, but their coverage will begin later, depending on when they enroll.

The two counselors also want to remind people who are already enrolled that it is important to take time every year to evaluate the offerings for the coming year and see if a different plan might be better for you or less expensive.

“Mary and I have been doing ACA enrollments since the program began 10 years ago,” Turner said. “We are seeing a lot of rollovers. But prior to reenrolling, it’s important for people to take a look at their coverage and make sure it is still correct for them. The tax credits they get can lower their premiums.”

Moynihan said the plan a person signed up for in 2022 may not be exactly the same plan this year and that’s why it is important to look at the plans every year.

“It is the same as your insurance if you get it through your work,” said Moynihan. “People tend to just let it roll over and they really should review it each year. We do that for you and it can help. We look at everything. For example, Anthem is coming in very aggressively this year. If assisted by an advocate, you have better chances of getting the coverage you need, at the best price.”

Those looking for ACA coverage can apply at healthcare gov. Maine residents have to go through the state marketplace at coverme.gov. Each site also offers enrollment advocates to assist with applications.

One of the biggest changes this year that people need to be aware of is the “family glitch” has been fixed, which will lower the cost of insurance for many and more people will qualify for ACA insurance.

This year, for the first time, family members of an employee who gets their health insurance through their employer may be able to choose a federally subsidized Affordable Care Act Marketplace plan instead. To be eligible, the cost of an employer’s family plan must be more than 9.1 percent of the family’s household income. Before this year, eligibility was based on the cost of an employer’s individual plan, which is often less expensive than a family plan.

“What that glitch meant in the past was this: If a person was getting health insurance through their employer, who could offer a family plan, then the person could not go on healthcare.gov and get tax credits,” Turner said. “If they were self employed, they had to meet eligibility requirements to put their family on their plan. People need this to be able to go to the doctor or get vaccines. This is a right that should be for everyone.”

Turner said the fix for this will result in potentially large savings for people hurt by this former problem.

“We can help people find out if this can help their family,” Moynihan said. “This is a huge piece this year, one of the things we can go to the ACA to compare. We all know adding family to insurance plans is ridiculously expensive, so if we can find savings for someone, that’s what we are passionate about, that we want to do for you. The tax credits can make family plans affordable. Even if you are not sure you qualify, come talk to us.”

Moynihan said they will help anyone who comes to them. She said they are seeing a big need among the immigrant and refugee populations, many who do not have a primary care doctor to advise them.

“Health insurance is complicated and we can help educate those who do not understand what is available to them.” said Turner.

Turner can be reached at Families First at 603-422-8208, ext. 3188. Moynihan, at Goodwin, can be reached at 603-516-2556. They are waiting for your call.


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