Are You Changing Health Plans For 2014?

Nov 19, 2013

You might be, if:

- Your individual plan through a private insurer (such as United Healthcare) was canceled because it didn't meet the requirements for coverage under Obamacare, Rhode Island has declined the option to allow people to keep those canceled plans for a year. But the plans you can now buy on HealthSource RI cover all of Obamacare's "essential health benefits," and while they may be more expensive, they'll definitely provide more comprehensive coverage.

- You're one of about 6500 parents of a child in RIte Care, Rhode Island's Medicaid program, who make more than 138% of the Federal Poverty Level, which means you're about to be dropped from RIte Care and expected to find a health plan on HealthSource RI. I questioned the affordability of some of those plans for these 6500 and others here; we first reported on the RIte Care move here. The General Assembly may make some funds available to help parents pay for premiums, co-pays, or deductibles.

- You're one of about 28,000 so-called "dual eligibles" (meaning you qualify for Medicare and Medicaid), now being enrolled in Rhode Island's Integrated Care Initiative (which I wrote about here)

- Your employer-sponsored health insurance costs more than 9.5% of your income, which means you can shop for a plan on the state's health insurance exchange, HealthSource RI

- It's not technically changing, but you might be signing up a for a new plan if you haven't had one, because most people are required to have health insurance as of January 1st, under Obamacare

That's a lot of transition, lots of new doctor-patient relationships about to be forged, lots of new membership cards about to be printed and mails, and the potential for lots of confusion about what to do if you fall into one of these groups. We'll know more about how smoothly the transition went in early 2014.

There's help out there for you, though, if you need it. Call the HealthSource RI contact center, find a local navigator, or check with your insurer or your employer. Or, post a question here and I'll do my best to find an answer.