Health care open enrollment starts today, runs for six weeks

DOVER — Open enrollment for Delaware’s Health Insurance Marketplace opens today and runs through Dec. 15.

The marketplace, created through the Affordable Care Act, aka Obamacare, allows individuals who do not have health insurance to purchase coverage.

Individuals can sign up or renew coverage at www.HealthCare.gov. Coverage for enrollees who sign up by Dec. 15 and pay their first month’s premium will be effective Jan. 1.

Eight Highmark Blue Cross Blue Shield of Delaware plans are available for purchase. The plans will see an average rate increase of 3 percent for 2019, although that varies between options. Federal tax credits are available for those whose household income is between 138 percent and 400 percent of the Federal Poverty Level.

For 2018, that’s between $16,753 and $48,560 for an individual or between $34,638 and $100,400 for a family of four. In 2018, about 82 percent of enrollees in Delaware were eligible for tax credits that help reduce the cost of monthly premiums.

Plans are placed in one of five categories — bronze, silver, gold, platinum and catastrophic — and are based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums, but high costs for care, while gold plans have high premiums but lower costs of care.

In a silver plan, the insurer pays about 70 percent of medical costs and the consumer pays about 30 percent, up to a maximum annual out-of-pocket cap of $7,350 for an individual and $14,700 for a family.

Available in 2019 are one gold gold, three silver plans, two bronze plans, one platinum plan and one catastrophic plan.

Consumers who pick silver plans might also qualify for additional savings through discounts on deductibles, copayments, and coinsurance. In Delaware, about 45 percent of current enrollees qualify for cost-sharing reductions. Silver plans will see the largest premium increases in 2019.

All plans cover essential health benefits such as coverage of pre-existing conditions, outpatient care, emergency services, hospitalization, prescription drugs, mental health and substance use disorder services, lab services, and pediatric services.

Delta Dental of Delaware Inc. and Dominion Dental Services Inc. are offering a collective 11 stand-alone dental plans.

“For Delawareans who don’t have access to health insurance through an employer or another form of coverage, the Health Insurance Marketplace offers them an opportunity to get covered,” Gov. John Carney said in a statement. “The availability of insurance through the marketplace is also one of the reasons that Delaware’s uninsured rate has been reduced to 5.4 percent. I urge people to shop early for a plan on the marketplace, meet with in-person assisters to explore your options and to sign up before the Dec. 15 deadline.”

Delaware currently has about 24,500 people enrolled for coverage through its Health Insurance Marketplace. About 23 percent of those were new enrollees in 2018.

There no longer will be a federal tax penalty for individuals who choose not to buy coverage in 2019. For 2018, the penalty is the greater of 2.5 percent of annual household income or $695 per person ($347.50 per child under 18). The maximum penalty will not exceed $2,085 per household.

Delawareans who need help enrolling in coverage can receive free in-person assistance from federally funded and trained specialists at Westside Family Healthcare, which has offices in several locations around the state, and from certified applications counselors at Henrietta Johnson Medical Center in Wilmington and La Red Health Center in Georgetown.

For more information, go to www.ChooseHealthDE.com.

 

Reach the Delaware State News newsroom at newsroom@newszap.com

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