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Riverstone roundtable

Physician Mike Geurin, right, speaks during a round-table discussion involving local, state and national health care advocates on the Affordable Care Act at RiverStone Health Center Thursday in Billings. Other participants, from left to right, include Barbara Schneeman, Kim Gillan, Kathy Kelker, Laura Packard and Stacy Anderson.

If you or members of your family need health insurance for 2019, now’s the time to sign up.

The federal marketplace that provides tax credits to reduce out-of-pocket costs for private health insurance is accepting renewals and new enrollments only until Dec. 15.

Most Montanans (and most Americans) get their health coverage through employee group plans or through a government program, such as Medicare, Medicaid or the Children’s Health Insurance Plan. Those who must purchase their plans on the individual market have long faced higher costs. The marketplace created by the federal Affordable Care Act was intended to make comprehensive, individual health care coverage affordable.

At the start of 2018, 62,000 Montanans were among the 8.7 million Americans enrolled in individual marketplace policies. About 49,000 of those Montanans received tax credits that reduce their monthly out-of-pocket costs for the private insurance premiums, according to a report prepared for the Montana Health Care Foundation.

Jeannie Gates, a certified application counselor at RiverStone Health, is in her fourth season of helping people enroll in the marketplace health plans. In Billings, RiverStone, Billings Clinic, St. Vincent Healthcare and the Montana Migrant Council each offer certified counselors to assist people in selecting a plan that suits their needs.

Insurance shoppers may phone to make appointments with Gates or another counselor. They can call to get answers to general questions. Or shoppers may simply go to covermt.org (a website of the Montana Primary Care Association) or healthcare.gov (the U.S. Department of Health and Human Services website) to get information and enroll online. Typing in a zip code at either site will bring up a list of nearby enrollment counselors’ contact information.

The same three companies are again offering marketplace policies in Montana: Blue Cross and Blue Shield, PacificSource and the Montana Health Care Co-op.

Gates advises shoppers to make sure their preferred hospital is part of the plan they choose. Those who take expensive prescription medicine will want to make sure that medication is covered.

Out-of-pocket costs will vary depending on the plan and the amount of tax credit the buyer receives.

In the first two weeks of open enrollment this month, Gates has seen more people select plans with zero premiums. These are basically catastrophic plans that have no premium after the tax credit, but have deductibles and out-of-pocket maximums that can add up to nearly $10,000 for the year. It can be a good deal for healthy people who expect to stay healthy.

The highest monthly out-of-pocket premium Gates recalled was about $350.

Overall, there’s little change in premiums and deductibles for Montana marketplace plans in 2019.

Shoppers may be eligible for tax credits to reduce their monthly premium payments if their annual 2019 income will be less than $48,560 for a single person or less than $83,120 for a family of three. Applicants with income of less than 138 percent of poverty (about $16,000 for a single person) will be offered Medicaid coverage instead of marketplace tax credits.

People already enrolled in marketplace plans should receive automatic re-enrollment notices from their insurance company. If they don’t want to make any change, their coverage should continue automatically.

Now that you know, check out your options before Dec. 15 and get enrolled. Don’t delay, go to covermt.org and get the information you need to protect your health and pocketbook in 2019.

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