Did you miss the 2020 open enrollment for health insurance? Do you still need coverage? A second open enrollment period is now open through May 15. If you do not have health insurance through your job or are not covered by Medicare or another plan, the Health Insurance Marketplace can help you find coverage.
There are many health insurance coverage websites, but HealthCare.gov is the only website where you may be able to get premium tax credits. Premium tax credits provide financial assistance for monthly premium costs. At HealthCare.gov, you can get a clear picture of the cost, compare plans based on your health needs, and choose the combination of price and coverage best for you and your family.
Enrolled tribal members can apply anytime throughout the year for Health Insurance Marketplace coverage. Depending on their income, members of federally recognized tribes may be eligible for a zero cost-sharing plan. This means that there are no additional out-of-pocket costs other than possibly a monthly premium. Enrolled tribal members (both enrolled members and descendants) who are eligible for Montana Medicaid will not have premiums or copays and will have access to a full range of health coverage.
Enrolled tribal members or descendants who are eligible for Indian Health Service, a tribal program, or an urban Indian health program, may qualify for a health insurance plan with limited out-of-pocket costs, or cost-sharing reductions. Using your health insurance in coordination with IHS, tribal health or an urban Indian health center may help increase your health care options and save you money. If you need to see a specialist or someone outside of your local tribal health or IHS Service Unit, make sure that your benefits coordinator knows that you have Montana Medicaid or private insurance.
Through HealthCare.gov, you can also find out if you qualify for the Montana HELP Plan. In 2015, the Montana Legislature expanded Medicaid to create the HELP plan for Montanans who didn’t otherwise qualify for Medicaid but whose income is too low to buy Marketplace insurance. This plan is open to adults ages 19-64, depending on income and family size.
Once you get health insurance, it is important to know how to use it wisely. Your insurance should work to keep you healthy, not just help pay for treatment when you are sick. A good first step is establishing a trusting, ongoing relationship with a primary care provider who can take care of your basic needs in non-emergency situations. Make sure to pay attention to healthcare providers “in-network”. In-network providers will usually cost you less than out-of-network providers. If you have questions about your coverage, call the member service number on your insurance card.
Once open enrollment ends on May 15, you can only get Marketplace coverage if you qualify for a special enrollment period based on life changes. Qualifying changes include loss of health insurance coverage due to a job change, or a change in income, household size or marital status. If you are an enrolled tribal member, you may enroll in coverage at any time.
RiverStone Health Clinic, doesn’t sell insurance, but we have Certified Application Counselors to help you compare your Marketplace options. To schedule an in-person enrollment assistance appointment, please call 406-651-6540.
J.“Scooter” Gates, Care Manager Team coordinator at RiverStone Health, can be reached at 406-651-6540.