As you may know, it is currently Open Enrollment for state health insurance exchanges. The state of Maryland’s marketplace (Maryland Health Connection) is the only place where qualified Maryland residents can receive federal tax subsidies to alleviate the burden of monthly premium costs (Advanced Premium Tax Credit) and the Cost-Sharing Reduction (CSR). In order to be considered for financial assistance, one must create an account and submit an application via Maryland Health Connection. After inputting factors such as income and household composition, the system will determine if you are eligible for Medicaid, a Qualified Health Plan with financial assistance, or a Qualified Health Plan without financial assistance.
If you are found eligible for Medicaid, you will not be selecting a plan at the end of your application. You will have the opportunity to select a Managed Care Organization (i.e. Priority Partners) by mail or by calling HealthChoice. It may take up to 3 weeks for your application to be processed. However, any expenses you have accrued from the first of the month of application submission, you can send those bills to Medicaid to be reimbursed on a fee-for-service basis. It is important to note that you must reapply each year to ensure you meet the qualifications for Medicaid. Be sure to look out for redetermination notices in the mail at the address listed on your application. You can apply for Medical Assistance at any time of the year.
If you are found eligible for a QHP, you will have the opportunity to select a plan that same day. Plans are listed from lowest to highest based on premium amounts. In the past, we have worked with consumers who purchased a plan with the lowest premium, the seemingly “cheapest plan.” Yet, the plan did not best cover their health care needs, and they ended up paying large amounts out-of-pocket. To avoid this situation, we have created a checklist that gives behavioral health consumers things to consider before choosing a plan and resources after plan selection. If you are currently planning to purchase health insurance, be sure to think about your current health care specialists, prescriptions, and cost-associated (premium, deductible, co-pay) with coverage. On the back of the checklist is a worksheet to help you understand how to compute plan costs.
Health insurance can be complicated to understand. For that reason, the Mental Health Association of Maryland has a Certified Navigator that can help you apply and enroll into a plan that best meets your needs. Plans and their prices have changed, so we encourage that you shop on Maryland Health Connection to ensure you have the best plan that suits your needs. You may contact Shalesha Lake at (443) 901-1588 to assist you in choosing a plan that meets your needs.