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Denise McDonough is the president of Anthem Blue Cross and Blue Shield in Maine, based in South Portland.
We all want good health for ourselves and our families. That’s why many of life’s choices are centered around how we can achieve better health or improve our wellness. An important part of that process is ensuring you have the right health plan — one that’s affordable and will help you achieve your goals. The Affordable Care Act’s open enrollment period is a good time to review your options heading into the new year.
ACA open enrollment for individual health insurance began Nov. 1 and runs through Jan. 15, 2023. For coverage that starts Jan. 1, you must enroll by Dec. 15. To ensure you have coverage in 2023, it’s important to start looking now for a plan that meets your family’s needs and your budget.
In addition, the federal public health emergency, which extended eligibility for Medicaid coverage, is expected to end sometime in 2023. Those who may lose eligibility for Medicaid next year will need coverage and an ACA individual plan could fulfill that need.
There are a couple of things to remember when shopping for a health benefits plan. First, there are many options available at various price points, so make sure you take time to find a plan that is right for you. Second, keep in mind that even if your current insurance carrier continues to offer ACA plans, offerings and networks can change from year to year, so it’s important to look at your options again. Taking the time to understand your health insurance options can help create a path to better health and wellness, and potentially save you thousands of dollars.
ACA plans cover essential benefits, including emergency services and prescription drugs. They also offer no-cost preventive health care, meaning you pay nothing for important services such as mammograms, colonoscopies and regular check-ups. This is critical because many potentially life-threatening and costly health issues can often be prevented or managed through these early detection screenings.
In Maine, we have Clear Choice plans, which offer standardized benefits for services like preventive care and prescription drugs. While the core benefits are the same, others vary depending on the insurance carrier, so it’s important to look at your options and find one that meets your needs. For example, not all plans may provide coverage if you need emergency care while traveling out of the country.
If you think selecting a health plan is overwhelming, you don’t have to go it alone — help is out there. There is plenty of assistance available, from navigators to brokers to your current or prospective insurance carrier, all ready to assist you.
CoverME.gov, the state’s marketplace, is a great resource with information about the ACA and how to choose and select a plan. The ACA uses metal levels (gold, silver, and bronze) to categorize plans based on pricing levels, with gold plans offering the most robust benefits and lowest out-of-pocket costs (and as a result have higher premiums), and bronze being the more affordable plans but with higher out-of-pocket costs. CoverME.gov is also where you need to enroll if you qualify for assistance in the form of Advanced Premium Tax Credits, also called subsidies.
With the cost of food, gas and utilities rising, many Mainers are feeling financial pressure and must make tough decisions about their budgets. Choosing to go without health coverage should not be one of them. Don’t assume you can’t afford health insurance because costs for a health plan may be more affordable than you think — and improving your health will ultimately save you money in the long run.
The recent Inflation Reduction Act provides enhanced federal subsidies through 2025 to help keep costs down for those buying plans on the health exchange, making high-quality plans more affordable. If you haven’t qualified previously for a subsidy, check again as you may now qualify, especially if your circumstances have changed.
Anthem Blue Cross and Blue Shield in Maine has been serving Mainers’ health needs for 84 years. We are here to help answer any questions you might have about choosing the best plan for you.
Taking action now will help you build a strong foundation for good health.