LiveSmart: Time to Think About Medical Insurance for 2016

[This piece was written by Rosie Perez, vice president of Mission Services for St. Peter’s Health Partners.]

Approximately 25,000 people in Albany are currently uninsured – now is the time to change that status, with fall open enrollment underway for prescription-drug, Medicare Advantage plans, and the NY State of Health insurance plans.

Open enrollment for prescription-drug and Medicare Advantage plans is currently underway, running through December 7. It’s the best chance individuals on Medicare will have all year to manage their health-insurance costs by comparison shopping and looking at all of their provider options.

The Medicare Rights Center maintains a free telephone hotline (1-800-333-4114) that can walk beneficiaries through differences between traditional Medicare and Advantage plans, and help with selecting Prescription Drug Plans and Advantage plans.

Open enrollment for the NY State of Health, the official health plan marketplace for New York state, opened on November 1 and runs through February 15, 2016. Enrollment completed through the fifteenth of December (12/15) will ensure coverage beginning January 1, 2016.

There is a new plan in 2016, through the marketplace, called the Essential Plan. This plan is for people under the age of 65, not eligible for Medicaid or Child Health Plus, and who make under 200% of Federal Poverty Guidelines.

Eligible participants can enroll in the Essential Plan at any time during the year, but coverage from the beginning of the year is recommended to avoid a penalty. The cost of enrollment in the Essential Plan varies by individual, with no cost for some individuals to no more than $20 a month per person for others. The penalty for not enrolling and having coverage for 2016 is $695 per adult and/or $347.50 per child under 18.

For families that need access to Medicaid or the Children’s Health Insurance Program (CHIP), there is no limited enrollment period, so you can apply at any time. These programs provide free or low-cost coverage to millions of Americans, including some people with limited incomes, families and children, pregnant women, and people with disabilities.

You can apply for Medicaid, CHIP, or Marketplace coverage in the following ways:

The IPA/Navigator program is designed to provide culturally competent, linguistically appropriate, and disability accessible enrollment services. They are available at convenient times, including evenings and weekends, at no cost to enrollees. Visit the website for IPA/Navigator site locations throughout the Capital Region.

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