By: Colin Baillo (Central NM Apprentice- Health Action NM)

The open enrollment period for purchasing individual or family coverage through the NM Health Insurance Exchange has arrived!  Beginning November 15, 2014 the exchange, www.bewellnm.com, will once again be available for those seeking coverage, this time without the technical difficulties that plagued the website during the last enrollment season.  The enrollment period is only three months long, ending February 15, 2015.  Here are some important things to keep in mind if you intend to purchase or renew coverage on the exchange:

Before shopping on the exchange, see if you are eligible for Medicaid

You can visit https://www.yes.state.nm.us to sign up for Medicaid.

Medicaid is a public health coverage program that provides cost-free insurance to low income Americans.  Individuals making less than $16,105 a year and families of four making less than $32,913 a year are eligible for Medicaid.  Medicaid is available throughout the year, unlike plans acquired on the exchange, which can only be purchased during the open enrollment period.  If you are 1) between the ages 19-64 and 2) are a U.S. citizen or lawfully present immigrant and meet household income requirements, you may be eligible for free health insurance.

Visit http://kff.org/interactive/subsidy-calculator/ to see if you qualify for Medicaid.  You will need to provide your zip code, annual income, and the number of people in your family. 

You can also use the chart below to determine whether you and your family qualify for Medicaid:

 

Household Size	Income per Month/Year
1 person	Less than $1,342/$16,105
2 people	Less than $1,809/$21,707
3 people	Less than $2,276/$27,310
4 people	Less than $2,743/$32,913
5 people	Less than $3,210/$38,516
6 people	Less than $3,677/$44,119

 

Is this your first time buying health insurance? 

If you don’t qualify for Medicaid, the next step is to visit http://www.bewellnm.com, where you can shop for health coverage.  It is important to keep in mind that the window for obtaining coverage through the exchange is limited, lasting from November 15, 2014 to February 15, 2015.  Shopping for insurance can be a daunting task.  Luckily there are experts available to help you find the plan that is right for you. 

The New Mexico Health Insurance Exchange Enrollment Assistance Center is offering free assistance and advice on finding appropriate coverage, tax credits, and more.  You can even purchase coverage on site.  The enrollment center is in Albuquerque, located at 2301 San Pedro NE near Indian School.

Visit http://bewellnm.com/find-an-hcg/ to find a Health Care Guide near you.

You can also contact New Mexico’s consumer hotline by calling 1-855-99-NMHIX.

You may be eligible for a tax credit that acts as a discount on your insurance premiums and out-of-pocket costs.  You will need to know your household income to determine your eligibility.  Check out the Kaiser Family Foundation’s subsidy calculator to see how much you can save on your health plan. Right now, you can view price estimates for plans that you can purchase that factor in tax credits at https://www.healthcare.gov/see-plans/.  Insurance lingo can often be confusing.  If you run in to any terminology that you are unfamiliar with, check out BeWell NM’s healthcare glossary.

Shop around before renewing your health plan

If you purchased a plan on the exchange last year then you will be re-enrolled in to the same plan for 2015 unless your insurance company stops offering your plan or you choose to purchase a new plan.  If you like the coverage you received you should still be sure to review your plan before renewing it, as the premiums, co-pays, and other aspects of your plan’s cost may have changed.  In other words, you may pay more than you did last year for the same plan, so be sure to review your plan and shop around.  There may also be new plans offered on the exchange that are more affordable or better suit you and your family’s needs.

Sign up by December 15th if you want your coverage to start January 1st

While the enrollment period lasts through February 15th, you can start using your coverage at the beginning of 2015 if you sign up by December 15th.  If you wait until the end of the enrollment period to sign up for coverage, your insurance will kick in on March 1st, 2015.

Premiums in New Mexico are lower than they were last year

New Mexico has announced that premiums on the exchange will be lower than last year’s, which is great news for state residents shopping on the exchange.  According to the Albuquerque Journal, “premiums will drop on average by 7 percent at Molina Healthcare, 1.5 percent at New Mexico Health Connections and 1 percent at Blue Cross and Blue Shield of New Mexico.  Premiums will be unchanged at Presbyterian Health Plan.”  A new insurance company, Christus Health Plan, has entered the marketplace this year.

The penalty for lacking insurance is higher than it was last year

If you don’t obtain some form of health coverage, you may have to pay a shared responsibility fee.  The penalty was the greater of $95 per adult or 1% of income in 2014.  This year the penalty has increased to the greater of $325 per adult or 2% of income.  You can avoid the penalty by finding health coverage.

A hardship exemption exists for those who truly cannot afford insurance.  To see if you qualify for a hardship exemption, visit https://www.healthcare.gov/fees-exemptions/exemptions-from-the-fee/.

89% of uninsured Americans don’t know about the upcoming open enrollment period… so spread the word!

It is crucial that the uninsured know about the limited window of opportunity to obtain health insurance through the exchange.  According to a survey conducted by the Kaiser Family Foundation, 89% of the uninsured population doesn’t know about the upcoming enrollment period.  Be sure to do your part by telling everyone you know and care about that coverage is available to them and that they may be eligible to receive discounted insurance premiums.  It is estimated that, so far, 28 million Americans gained health insurance as a result of the ACA.  Tens of millions stand to gain from the law this year as well.  We are approaching another historic moment in which Americans are finally able to obtain the security of meaningful, affordable, and non-discriminatory health insurance.  Let’s do all we can to make sure that moment is realized.

Health Action