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Plan now for health insurance coverage

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If you want to sign up for health insurance through the Health Insurance Marketplace, you’ll have to act quickly. The open enrollment period has been shortened for the 2018 coverage year. The sign-up period begins Nov. 1 and ends on Dec. 15, 2017, for insurance coverage that begins Jan. 1, 2018.

While shopping for a plan online at healthcare.gov, you’ll get a clear picture of the cost, compare plans based upon your health needs, and choose the combination of price and coverage that fits you and your family. RiverStone Health’s specially trained application counselors can help you choose a plan, but make your appointment early, since available time slots fill up early.

To get ready to apply for coverage or meet with an application counselor, you’ll need to gather some information about yourself and your household. The checklist includes addresses, birth dates and Social Security numbers for everyone in your household who is applying for coverage. The application may ask about income and other information from tax returns, and any current health coverage through an employer or other source.     

As you shop, keep in mind that the lower your monthly premium cost, the higher the out-of-pocket costs such as co-payment and deductibles. The higher the premium, the lower the out-of-pocket costs. Once you fill out the Health Insurance Marketplace application, you will know immediately if you’re eligible for tax credits to lower the cost on your monthly premiums. If you are uninsured, the only way to get a tax credit to lower your costs is to buy your insurance through healthcare.gov

Through the Marketplace at 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 whose income was too high to qualify for Medicaid and too low to buy Marketplace insurance. The HELP Plan, through Blue Cross Blue Shield, is open to 19-year-olds through 64-year-olds, depending on income and family size. Unlike the Marketplace plans, if you qualify for the Montana HELP Plan, Medicaid, or Healthy Montana Kids, you can enroll at any time of year.

Once you get health insurance, it’s important to know how to use your coverage wisely. Your insurance should work to keep you healthy, not just help pay for treatment when you’re sick. One way to start using your insurance wisely is to establish a trusting, ongoing relationship with a primary care provider who can take care of your basic needs in non-emergency situations. Your health insurance company typically provides information on which providers are in your 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 the open enrollment period ends on Dec. 15, 2017, you can only get coverage through the Health Insurance Marketplace if you qualify for a special enrollment period based on life changes. Some of those qualifying life changes include a recent move to Montana, loss of coverage through a job change, or a change in income or marital status. If you are an enrolled tribal member, you may enroll in coverage at any time.

Thousands more Montanans now have the health coverage and access to medical care they need to live healthier lives thanks to the Affordable Care Act and the Montana HELP Plan.

Jeanne “Scooter” Gates, Care Manager Team Supervisor at RiverStone Health, may be reached at 651-6540 or Scooter.Gat@riverstonehealth.org.

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