CONCORD – Open enrollment in the Individual Health Insurance Marketplace started Nov. 1 and runs through Dec. 15.
During open enrollment, the New Hampshire Insurance Department is offering information and resources for the approximately 54,000 state residents who will purchase health insurance in the individual market for 2019 coverage.
“We are encouraging New Hampshire residents who are buying a plan on Healthcare.gov to update their applications and actively compare plan options,” said New Hampshire Insurance Commissioner John Elias. “Buying insurance is signing a contract. Once you lock in coverage, your rates and cost-sharing amounts will stay the same all year. But if you don’t sign up now, you will not have another chance to enroll until next year – unless you have a qualifying life event.”
Eireann Aspell, outreach coordinator for the New Hampshire Insurance Commission said life events include marriage or the birth of a child.
In 2019, three insurance companies will offer individual plans on the New Hampshire Marketplace: Anthem, Ambetter from NH Healthy Families, and Harvard Pilgrim Health Care.
“All three of the state approved plans include coverage for pre-existing conditions,” said Aspell. “They also covered the 10 basic tenants of health care including previous conditions, maternity, hospitalization and prescription drug coverage.”
For coverage to begin on Jan. 1, 2019, people must enroll by Dec. 15, 2018. Residents can enroll in an individual insurance plan outside of the open enrollment period only if they qualify for a special enrollment period of 60 days following qualifying life events. You will need to pay your first premium by your insurance company’s due date before your 2019 coverage will take effect.
“It is important to pay the initial premium by the deadline of Dec. 31, to assure coverage will begin on Jan. 1,” said Aspell. “Then keep paying the premiums on schedule to avoid a lapse in coverage or a cancellation. If that happens, the person is not eligible to enroll until the next on period.”
Even for those who want to keep the plan they have now, Aspell said they should compare their plan with this year’s, even if the name remains the same.
“Insurance plans can change,” said Aspell. “People should be sure the same coverage they expect is still in this year’s plan. Verify doctors, local hospitals and that the prescription drugs you need are still in the plan.”
To receive federal financial assistance to pay for a plan, you will need to enroll through the Marketplace (HealthCare.gov). An insurance agent or enrollment assister can help you with this process. If you are enrolled in Marketplace coverage for 2018, you will receive renewal information from your insurance company and the Marketplace.
“There are a number of factors to qualify for assistance,” said Aspell. “Finances are considered, but so also is the number of people in your tax household and dependents. Even if you think your neighbor is similar to your circumstance it does not mean they or you qualify for the same assistance. For example, there are cost sharing reductions, but they are only available on the silver plan.”
You can buy a plan outside of the federal Marketplace – through an insurance agent or directly from an insurance company – and it will cover the same essential services as a Marketplace plan. If you are enrolled in the New Hampshire Health Protection Program, you will receive information from the New Hampshire Department of Health and Human Services about how to select a plan for 2019 under the new New Hampshire Granite Advantage Program.
“There are some federal changes that offer parts of the country new plans like the associate plan and a short-term plan,” said Aspell. “Those are not yet available in New Hampshire. We are convening a working group to draft legislation on how those plans should look in our state. The earliest those might be available are in April. One short-term plan, through Everest, is available here.”
Depending on your income level, you may qualify for financial assistance for paying premiums and/or out-of-pocket costs for a health insurance plan bought through the Marketplace, or for no-cost or low-cost coverage under the New Hampshire Granite Advantage Program. All these subsidies are available for 2019 plans, so long as you sign up during open enrollment.
When you complete an application on www.HealthCare.gov, you will be prompted to enter your “tax household” size and financial information. After completing the application, you will be notified if you qualify for financial assistance for a Marketplace plan or for coverage through the New Hampshire Granite Advantage Program.
For a more detailed look at the networks available through the 2019 Marketplace: https://www.nh.gov/insurance/consumers/documents/2019-network-adequacy-public-infopresentation.pdf.
• The Insurance Department website can help you find an enrollment assister to walk you through how to use the Marketplace or a licensed agent or broker who can help you select a plan: http://www.nh.gov/insurance/consumers/mp_plans.htm.
• More information on the Granite Advantage Health Care Program is available from the NH Department of Health and Human Services: https://www.dhhs.nh.gov/medicaid/granite/index.htm.
The New Hampshire Insurance Department Can Help:
“I want the New Hampshire residents to know that the Insurance Department is here as a resource: Our Consumer Services staff is available to assist with issues that arise after enrolling in coverage,” said Commissioner Elias.
Questions about or issues with using the Marketplace and obtaining coverage can be obtained by calling the federal government at (800) 318-2596. Once you have coverage, contact the Insurance Department with questions or concerns, at 1-800-852-3416 or (603) 271-2261, or by email at firstname.lastname@example.org
To compare the available plans, visit https://www.nh.gov/insurance/consumers/documents/py2019plancompare.pdf
The New Hampshire hospital quick guide grid is available at https://www.nh.gov/insurance/consumers/documents/py2019nh-hosp-prov_fndr_rx_ref.pdf