The state is gearing up for open enrollment for the Maryland Health Insurance Exchange

An employee explains the coverage options available on the Maryland Health Exchange to a Prince George’s County resident in 2019. (Maryland Health Exchange)

The Maryland Health Exchange is making it easier for people to see which plans will cost them the least as the exchange opens its annual open enrollment period on Nov. 1.

Open enrollment will continue through Jan. 15 with federal and state funds to reduce health insurance costs for some who don’t have access to affordable employer-provided coverage or who don’t qualify for Medicaid or Medicare.

In March, Gov. Larry Hogan announced that a record 182,861 people had enrolled during the 2022 open enrollment period, which was extended due to the pandemic.

Michele Eberle, executive director of the Maryland Health Benefit Exchange, said the record is due to a number of factors, but especially because Maryland’s offerings are some of the most affordable plans in the nation. The state estimates there are still 300,000 people in Maryland who need insurance, so she hopes to enroll many and reach more.

“We’re trying to make it as easy as possible for people to understand what’s available to them,” Eberle said.

Premiums have gone up this year, but with Maryland’s reinsurance program and the Young Adult Subsidy, as well as federal extended tax credits for three more years, rates are still low, she said.

For example, a 28-year-old Baltimore City resident making about $32,000 a year can be insured for about a $20 per month premium. That resident would be eligible for a $17 monthly premium with a Gold plan to keep out-of-pocket costs low, she said.

People have until Dec. 31 to make a choice to make changes or sign up for a plan that starts Jan. 1.

On the exchange’s website, marylandhealthconnection.gov, interested residents can enter basic information into the Get an Estimate tool and be presented with the lowest-cost overall plan. In recent years, people often chose plans based on the lowest premiums.

This year, the website will help people assess the value of a cost-sharing reduction if they qualify. Cost-sharing reductions are available through the federal Affordable Care Act to reduce out-of-pocket costs for eligible participants who choose silver level plans in the Marketplace.

“It’s much better coverage at a lower cost,” Eberle said.

She said two segments of Maryland’s population could be particularly helped by getting coverage through the exchange: young adults ages 18-35 and people ages 55-65 who are self-employed or retired early but still not yet eligible for Medicare.

More people may be eligible to participate in the exchange this year. To be eligible, people cannot already have access to affordable health insurance. Under a new rule from the Internal Revenue Service, the definition of affordable employer coverage has been changed to take into account whether it’s affordable for the entire family — if the cost of coverage for the entire household exceeds 9.12% of household income, as opposed to the cost of just of individual coverage over 9.12%.

There are also several special enrollment periods throughout the year to reach people who missed open enrollment. This includes people who discover they are eligible for an exchange while filing their taxes and checking a box for easy recording on their state tax return.

And starting July 1, 2022, Maryland residents with incomes below 150% of the federal poverty level ($20,385 for an individual, $41,625 for a family of 4) can enroll in a health plan through Maryland Health Connection year-round , regardless of enrollment periods, as Congress continues to increase tax credits for this population.

There is no longer a limit on the amount of gross household income to receive tax credits, so people are eligible for credits if their health care costs exceed 8.5% of gross household income.

Previously, these credits were not available to people who earned more than 400% of the federal poverty level.

Those who are young often don’t think they need insurance, but Eberle urges those people to consider it for unplanned medical emergencies, as well as the ability to get vaccines and preventive tests covered.

“We hope that newly insured people have already discovered the value of this insurance, and even though their situation may have changed, they will want to continue to have this coverage,” Eberle said.

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