New open enrollment period for health insurance begins today

349px-Seal_of_DelawareNEW CASTLE — The fourth open enrollment period for Delaware’s Health Insurance Marketplace starts today as the state prepares to build on the last three years, in which more than 28,000 Delawareans signed up for coverage and the state’s uninsured rate dropped an estimated 35 percent.

The open enrollment period, in which people can renew current coverage or sign up for a new plan for 2017, runs from Nov. 1 through Jan. 31, 2017, at www.HealthCare.gov. Individuals must sign up by Dec. 15 for their coverage to be effective Jan. 1.

In the face of increased cost of premiums, according to the Department of Health and Social Services, Delaware is making an extra effort this enrollment season to make sure residents who do not have employer-sponsored health insurance or who are not eligible for public programs such as Medicare, Medicaid and the Children’s Health Insurance Program are aware of the federal subsidies available when they buy private plans through the Health Insurance Marketplace, also known as Obamacare.

“Many people still don’t realize they can get financial help paying for their Marketplace coverage,” DHSS Secretary Rita Landgraf said. “This year, more than 80 percent of Delawareans who have a Marketplace plan are receiving tax credits to lessen the costs of their premiums. I urge anyone who needs high-quality, affordable health insurance to go to HealthCare.gov to shop for a plan, and I encourage those who are already enrolled to go back to the website, update their information and pick a plan that meets their health needs and budget.”

Consumers can go to HealthCare.gov now to check out options for 2017. Individuals who need help enrolling in coverage will again have access to free in-person assistance from federally funded and trained specialists at several Delaware organizations, including Westside Family Healthcare, Chatman LLC, Henrietta Johnson Medical Center and La Red Health Center.

State-licensed insurance agents and brokers are also available to help individuals re-enroll and to help employers update their coverage, at no extra charge.

For more information, go to www.ChooseHealthDE.com. You can enroll in marketplace coverage at www.HealthCare.gov or by calling (800) 318-2596 (TTY: 1 855 889-4325).

By the numbers

According to the U.S. Department of Health and Human Services:

• Sixty-three percent of Delawareans who now have Marketplace coverage could get 2017 coverage for a monthly premium of $100 or less after tax credits, 55 percent could get coverage for $75 or less, and 45 percent could get coverage for $50 or less.

• Sixty-three percent of current Marketplace enrollees whose annual household incomes are between 100 percent and 250 percent of the federal poverty limit (from $11,880 to $29,700 for one person and from $24,300 to $60,750 for a family of four) are receiving financial assistance. Financial help is available for individuals with annual incomes up to $47,520; for a family of four the income limit is $97,200.

• The median annual income of Marketplace enrollees in Delaware is about $25,000 for one person and $51,400 for a family of four.

As in previous years, three insurers will offer Marketplace medical plans in Delaware for 2017: Highmark Blue Cross Blue Shield of Delaware, Aetna Health and Aetna Life Insurance Co. Across the insurers, they will offer a total of 21 plans for individuals and 11 SHOP plans for small businesses. Two insurers — Delta Dental and Dominion Dental — will offer a collective 15 stand-alone dental plans, 10 for individuals and five for small businesses.

Rates in 2017 will increase an average of 32.5 percent for Highmark plans, 23.6 percent for Aetna Health and 22.8 percent for Aetna Life.

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.

Medical plans will be available in three metal-level categories — bronze, silver and gold — based on how enrollees choose to split the costs of care with their insurance company. Bronze plans have low monthly premiums but high costs when you need care; gold plans have high premiums but lower costs when you need 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 $6,350 for an individual and $12,700 for a family.

In Delaware in 2017, the average monthly premium for a second-lowest cost silver plan for a 27-year-old non-tobacco user will be $347 before tax credits based on eligibility are applied.

Consumers who pick silver plans might also qualify for additional savings through discounts on deductibles, co-payments, and coinsurance.

No coverage penalties

Individuals who can afford coverage but who choose not to buy it will pay a fee equal to the higher of these amounts: 2.5 percent of your annual household income or $695 per person ($347.50 per child younger than 18). The maximum penalty will not exceed $2,085 per household or the total yearly premium for the national average price of a bronze-level plan sold through the Marketplace. In addition to the penalty, consumers will be responsible for the total cost of health expenses they incur.

Consumers can estimate their penalty using the penalty calculator available on ChooseHealthDE.com.

Businesses with 50 employees or less can offer plans to their employees starting any month of the year through the Small Business Health Options Program. Go to HealthCare.gov or call (800) 706-7893 (TTY: 711).

Expanded Medicaid program

In addition to the Health Insurance Marketplace, some residents might be eligible for coverage though Delaware’s expanded Medicaid program, which is open year-round. More than 10,000 Delawareans have received coverage under the Medicaid expansion. To be screened for or to apply for Medicaid benefits, go to Delaware ASSIST.

Delaware’s uninsured population decreased from 83,000 in 2013 to 54,000 in 2015, according to a recent Census Bureau report. That decline includes Delawareans who could not get coverage before the Affordable Care Act because of pre-existing conditions. Increasing access to health care coverage is the first step toward a healthier Delaware, Secretary Landgraf said.

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

You are encouraged to leave relevant comments but engaging in personal attacks, threats, online bullying or commercial spam will not be allowed. All comments should remain within the bounds of fair play and civility. (You can disagree with others courteously, without being disagreeable.) Feel free to express yourself but keep an open mind toward finding value in what others say. To report abuse or spam, click the X in the upper right corner of the comment box.