‘Marketplace’ health care coverage premiums lower

Healthcare coverage through “the Marketplace” is more affordable for more individuals and families now. Southwest Louisiana residents who may have called in previous years and didn’t purchase a plan because it was too expensive, those who failed to call to find out more because they assumed they couldn’t afford the premiums and those who make too much to qualify for Medicaid are encouraged to visit GetCoveredLA.org or call 1-800-435-2432 right away. Saturday, Jan. 15 is the open enrollment deadline.

The Marketplace (Healthcare.org) refers to a program of federally subsidized insurance coverage. Eligibility is expanded and prices are lower because of the American Rescue Act. Insurance coverage is contracted with recognized private insurer brands. Blue Cross Blue Shield of Louisiana, HMO Louisiana, Vantage Health Plan, Christus and United Healthcare offer plans in the Louisiana exchange for 2022. However, plan availability varies from one location to another within the state.

Many consumers who did not qualify for financial assistance in the past will now qualify and premiums are lower, according to Diana Ross, director of community affairs at Southwest Louisiana for Health Services. This could benefit people who own their own businesses, contract employees, people working in the hospitality and entertainment industries and others.

Before federal subsidies last year, the average monthly Louisiana premium was $741. The average premium after Affordable Care Act financial assistance through advance premium tax credits and cost sharing reductions for low and moderate income individuals and families could make premiums as low as $189 per month, according to an example on healthcare.org.

Southwest Louisiana residents who earn as much as 400 percent of the national poverty level may qualify. Poverty guidelines vary according to the number in the household. Here’s an example. For a household of three, annual income of $21,960 is considered the poverty level for 2022. This means that a household receiving four times this amount could still be eligible for more affordable health insurance through the Marketplace.

“Sometimes, I feel like we’re the best kept secret in Louisiana,” said Brian Burton, CEO of the Southwest Louisiana Area Health Education Center. “It’s important that folks know that whether they live in Minden or Morgan City or any community in between, we have a large team of local professionals ready to answer their health insurance questions and get them connected to an affordable, high-quality health plan. When you call us, you’re talking to someone from right here in Louisiana – not from another state or country. And our help is offered absolutely free of charge.”

“Certified Application Counselors never receive a fee; they only assist and guide clients in the selection process to choose a plan and help them understand the application process,’ said Debra Guillory, social services coordinator for Southwest Louisiana Center for Health Services.

Guillory said call volume has been low. She attributes it to COVID and unemployment. She did advise that even though callers have been fewer than expected and phone insurance coverage counselors are patient, knowledgeable and well-trained, the conversation can take from 30 minutes to as much as two hours.

“It just depends on the client’s needs,” she said. “The client has to set up an email address, have tax returns from the previous year and information for the entire household if all need coverage.”

Consumers enrolling in a plan on the Marketplace are guaranteed to receive comprehensive coverage, with no pre-existing condition exclusions or markups. All plans cover essential benefits, including doctor and hospital visits, prescription drugs, mental health treatment, and maternity care. In addition, consumers receive free preventive care services, such as immunizations and health screenings. Testing and treatment of COVID-19 are considered essential health benefits and are covered by all Healthcare.gov plans.

“There has absolutely never been a better time to check out the Federal Health Insurance Marketplace,” said Jacob Schei, Director of Navigators for a Healthy Louisiana.

Health insurance premiums vary from state to state. Louisiana residents with health insurance on the average, including those with employer provided or subsidized coverage and those with coverage from a private insurer pay the fifth highest premiums in the nation, 35 percent higher than the national average, according to Value Penguin, a free source for information and tools that help consumers make spending decisions.

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