Help available to navigate Maine’s new health insurance marketplace

This year, the state has launched its own health insurance marketplace for Mainers to sign up for coverage under the Affordable Care Act.Until now, Maine had relied on the federal marketplace.Experts want Mainers to know there is help available to navigate the new system.”This is great. Finally, finally a state-based exchange. I’ve been telling folks, we get to drive the bus instead of the fed driving the bus,” said Helen Roy, of Maine Consumers for Affordable Health Care.Maine Consumers for Affordable Health Care is an advocacy group that helps Mainers sign up for health care coverage.Roy helped retired lobsterman Bruce McGowen, of Topsham, look through plans available on the state’s marketplace website CoverME.gov. His wife, Bonnie McGowen, is already covered through Medicare.”We successfully enrolled Mr. McGowen in a plan that’s going to work for him for 2022. It feels really good I gotta say. I wish I could take this off because of my smile,” Roy said.McGowen, 63, has two more years until he qualifies for Medicare. He had been getting his insurance through the federal marketplace for the past two years.”You really need to check out the different plans because they’re not all good,” McGowen.McGowen said he is happy with the plan he selected through the state’s marketplace that has premiums that won’t break the bank.”I really think people are not getting the correct message on you really need to talk to somebody because is it affordable. It really is. People, I really think, they haven’t been told the right information,” McGowen said.For anyone seeking help signing up for coverage under CoverME.gov, the website has a section that allows people to find help to navigate the system.Mainers can click on the “Find Help Near You” tab, type in their ZIP code, and they will be provided with a list of insurance brokers and health care navigators, such as Roy.”The message is coverage is affordable. Coverage is affordable. Thanks to Congress and the American Rescue Plan, the tax credits are enhanced so the tax credits are greater, so premiums are lower,” Roy said.Tina Riley, a former state legislator, said she recently enrolled and found affordable coverage.”If you don’t make much money, you can get coverage for as little as $2 a month,” Riley said.Riley said that coverage can make a difference.”For that $2 a month, you have coverage that’s going to pay for the most expensive treatments that you might need and it’s going to limit how much you get hit with for a bill,” Riley said.Even though Riley has a high deductible, she said she feels a sense of relief after signing up for a plan.”I’d much rather get hit with a total annual out-of-pocket of $5,000 than to have a catastrophic diagnosis and end up paying $200,00. It’s a peace of mind thing, in a lot of ways,” Riley said.Riley pointed to a family member’s cost for prescription medication.”It costs about $7 a month for him to get that prescription, and if he didn’t have the insurance, that same prescription, the company, the pharmacy would be billing us $137 dollars for that,” Riley said.The open enrollment deadline has been extended through Jan. 15, but for coverage to kick in on Jan. 1, people need to enroll by Dec. 15.

This year, the state has launched its own health insurance marketplace for Mainers to sign up for coverage under the Affordable Care Act.

Until now, Maine had relied on the federal marketplace.

Experts want Mainers to know there is help available to navigate the new system.

“This is great. Finally, finally a state-based exchange. I’ve been telling folks, we get to drive the bus instead of the fed driving the bus,” said Helen Roy, of Maine Consumers for Affordable Health Care.

Maine Consumers for Affordable Health Care is an advocacy group that helps Mainers sign up for health care coverage.

Roy helped retired lobsterman Bruce McGowen, of Topsham, look through plans available on the state’s marketplace website CoverME.gov. His wife, Bonnie McGowen, is already covered through Medicare.

“We successfully enrolled Mr. McGowen in a plan that’s going to work for him for 2022. It feels really good I gotta say. I wish I could take this off because of my smile,” Roy said.

McGowen, 63, has two more years until he qualifies for Medicare. He had been getting his insurance through the federal marketplace for the past two years.

“You really need to check out the different plans because they’re not all good,” McGowen.

McGowen said he is happy with the plan he selected through the state’s marketplace that has premiums that won’t break the bank.

“I really think people are not getting the correct message on you really need to talk to somebody because is it affordable. It really is. People, I really think, they haven’t been told the right information,” McGowen said.

For anyone seeking help signing up for coverage under CoverME.gov, the website has a section that allows people to find help to navigate the system.

Mainers can click on the “Find Help Near You” tab, type in their ZIP code, and they will be provided with a list of insurance brokers and health care navigators, such as Roy.

“The message is coverage is affordable. Coverage is affordable. Thanks to Congress and the American Rescue Plan, the tax credits are enhanced so the tax credits are greater, so premiums are lower,” Roy said.

Tina Riley, a former state legislator, said she recently enrolled and found affordable coverage.

“If you don’t make much money, you can get coverage for as little as $2 a month,” Riley said.

Riley said that coverage can make a difference.

“For that $2 a month, you have coverage that’s going to pay for the most expensive treatments that you might need and it’s going to limit how much you get hit with for a bill,” Riley said.

Even though Riley has a high deductible, she said she feels a sense of relief after signing up for a plan.

“I’d much rather get hit with a total annual out-of-pocket of $5,000 than to have a catastrophic diagnosis and end up paying $200,00. It’s a peace of mind thing, in a lot of ways,” Riley said.

Riley pointed to a family member’s cost for prescription medication.

“It costs about $7 a month for him to get that prescription, and if he didn’t have the insurance, that same prescription, the company, the pharmacy would be billing us $137 dollars for that,” Riley said.

The open enrollment deadline has been extended through Jan. 15, but for coverage to kick in on Jan. 1, people need to enroll by Dec. 15.

https://www.wmtw.com/article/maine-health-insurance-coverme-marketplace-help/38209704

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