A coalition of health-care groups, the state and private insurers have launched a big push to help Montanans who need health insurance find coverage through policies financed by the federal Affordable Care Act.
The ranks of the uninsured have inched upward during the Covid-19 pandemic, as people may have lost employer-linked coverage, because they’ve lost their job or reduced their hours, said Olivia Riutta of the Montana Primary Care Association.
“So I think we have more folks who are uninsured and eligible for (ACA) coverage,” she told MTN News. “We also have folks who have never done this before … So we have a lot of people in Montana who need to take advantage of open enrollment.”
Cover Montana, a project of the Primary Care Association, has embarked on an ambitious public-education program to encourage people to apply for ACA-financed policies or coverage during “open enrollment,” which ends Dec. 15.
With the help of federal Covid-19 relief funds, Cover Montana will be sending mail directly to more than 160,000 Montanans who’ve filed for unemployment benefits this year.
The mailer and an advertising campaign already under way will be telling people to call Cover Montana’s toll-free number, 844-682-6837, where they can be directed to a local “enrollment assister” who can walk them through the application process.
“These are Montanans who’ve been doing this work for a long time, they’re based in communities across the state, their help is free, it’s confidential and they’re trained and certified,” said Riutta, the outreach engagement and population health manager for the Primary Care Association.
During open enrollment, anyone can apply for health-care plans through www.healthcare.gov, the online portal created by the ACA, also known as “Obamacare.” Policies purchased now take effect Jan. 1.
The policies, sold by three private insurers, are for people who don’t have access to health insurance through their employer. Most Montanans buying these policies also qualify for a federal subsidy to offset the cost.
Nearly 50,000 Montanans have these individual policies now.
Riutta said when someone applies for coverage through www.healthcare.gov, they’ll see a range of plans they can purchase, be told if they’re eligible for a subsidy, and find out if they or their children may qualify for other government-financed coverage, such as Medicaid.
Enrollment assisters can help people through the process, she said.
Richard Miltenberger, CEO at Mountain Health Co-op, one of the companies selling the policies in Montana, also said that buyers can use independent insurance agents to help them negotiate the process. About one-third of the buyers use an agent, he said.
“On healthcare.gov, they ask about 25 questions that you don’t need to answer if you go through an agent,” he said. “It’s just a simpler process.”
The subsidies apply to most people earning up to 400 percent of the federal poverty level, or about $51,000 of annual income for a single person or almost $87,000 for a family of three.
The other companies selling the policies are Blue Cross and Blue Shield of Montana and PacificSource.
Riutta and Miltenberger also said consumers should be wary of short-term insurance plans being pitched on-line mostly by out-of-state companies. These policies usually have less coverage, may exempt coverage of pre-existing conditions, and are not subsidized by the ACA, they said.
“I’ve seen people get caught in this,” he said. “They’ll say `Look, your premium is $1,000 on health care.gov, but we can give you this six-month policy that’s only $300 a month.’ Well, the reality is if you go through the process, most of our policyholders are paying about $60 to $80 a month after the subsidies.”
