November 1st was the first day of open enrollment for 2019 health insurance coverage through the marketplace. The marketplace offers subsidies to families who make between 133% and 400% of the Federal Poverty Level and who are not offered insurance through an employer. These are individuals and families who are over income guidelines for Medicaid but who otherwise may not be able to afford insurance plans.
Sometimes we see people who can still only afford “catastrophic coverage” even with the subsidies. This means that while they have insurance coverage, the deductible is so high that it would only be met by a large medical issue. Some deductibles are well over $10,000! However, we see many patients who work full time and make just over Medicaid guidelines. For these individuals, a marketplace plan can be both affordable and help them to get established with a primary care provider.
As we seek to serve our patients well, one of the services we provide is patient advocacy. A large part of this role is education about insurance. For some that is screening and applying for Medicaid. However, for those whose incomes are over the guidelines for Medicaid their only chance to look at coverage options in the marketplace is for 6 weeks in the fall. After December 15th, a person must have a qualifying event for a special enrollment period such as having a child, moving to another state, or having an increase in income that resulted in losing Medicaid.
At His Hands we want to empower our patients to take an active role in their healthcare. Part of that includes gaining an understanding of the insurance options available and how insurance works. During open enrollment period this fall, we will be busy answering insurance questions and assisting in applying both for our patients and individuals from the community. 2019 will be here before we know it, and we want as many people in our community as possible to ring in the new year with insurance coverage and primary care!