For Maine consumers who are enrolling in a health care plan for the first time — or for those who are changing plans — Dec. 15 is an important day.
It’s the deadline to sign up for coverage on the Individual Health Insurance Market, in order for the policy to be in effect on Jan. 1. The open enrollment period continues through Feb. 15 of next year; however, for coverage to take effect on New Year’s Day, new enrollees must be signed up by the end of the day on Dec. 15.
Maine Insurance Superintendent Eric Cioppa says individuals and families who signed up for a plan this year will be renewed automatically for 2015 if they are making payments and do not opt for any changes.
“However, we encourage everyone, even those with existing coverage, to review their options during the open enrollment period,” Cioppa said in a news release late last week.
People who have health insurance — whether through a plan in existence before the Affordable Care Act created the marketplace or by a plan purchased on or off the Marketplace — might save money, find a better provider network or get improved coverage by shopping around now.
For individuals without health insurance, the open enrollment period is the only time to buy health insurance from the federally-facilitated marketplace. The only exceptions to this enrollment period are special circumstances such as losing a job, marriage or divorce, birth or adoption or termination by the insurance company (for reasons other than nonpayment of premiums).
Anthem, Harvard Pilgrim Health Care/HPHC and Maine Community Health Options all sold plans this year and will sell both on and off the marketplace in 2015. Aetna will join the individual market in Maine this year, selling only off the marketplace.
A total of 49 plans will be available from the four companies. Comparing terms and rates could seem like a daunting task, but help is available from your insurance broker or agent or a marketplace navigator.
Cioppa says the Bureau of Insurance can help as well; you can visit its website (www.maine.gov/insurance) or call someone at the bureau’s Consumer Health Care Division at 1-800-300-5000 (within Maine).
There’s a lot of information at the state’s health insurance website, www.enroll207.com, and you can find out how to get free help from a navigator there. You can also visit the federal government’s website, www.healthcare.gov.
Be careful of “navigator scams” around the web. You cannot be charged for the help a bona fide navigator provides. Read about the scams at www.consumer.ftc.gov/articles/0394-suspect-health-care-scam.
Qualifying individuals can receive a tax credit, but only if they purchase coverage through the marketplace. A tax penalty of $395 per adult up to $885 or two percent of household income will be levied at tax time for those who do not have “minimal essential health coverage,” unless the individual or family is eligible for a “hardship exemption.”
Consumer Forum is a collaboration of the Bangor Daily News and Northeast CONTACT, Maine’s all-volunteer, nonprofit consumer organization. For assistance with consumer-related issues, including consumer fraud and identity theft, or for information, write Consumer Forum, P.O. Box 486, Brewer, ME 04412, visit http://necontact.wordpress.com or email email@example.com.