Marylanders who need insurance under health reform because they don't have it through their employer or a federal plan will be able to get it from a state exchange. Maryland Insurance Commissioner Therese M. Goldsmith discusses the kinds of plans that are offered on the exchange, called Maryland Health Connection, which opened Tuesday. People shopping for health insurance can compare the specific plans at marylandhealthconnection.gov. Coverage starts in January.
How many plans are offered on the individual exchange?
Consumers will find a wide variety of plans available through Maryland Health Connection. The Maryland Insurance Administration reviewed and approved submissions from nine carriers seeking to offer health plans through the individual exchange. Three companies since withdrew their filings, leaving six carriers offering 47 plans. High-deductible "catastrophic plans" are also available for young adults under age 30 and certain other qualifying individuals.
What will these plans cover and how much will they cost?
All individual and small group plans issued after Jan. 1 will cover, by law, essential health benefits such as emergency services, physician services, hospital care, prescription drugs and maternity care. The cost of a plan will vary depending on a number of factors, including the "metal" level (bronze, silver, gold or platinum) that a consumer purchases.
What is the difference between a gold, bronze and silver plan?
All individual and small group plans issued on after Jan. 1 will be categorized as bronze, silver, gold or platinum, based on how costs are shared between the carrier and the consumer. For example, bronze plans are likely to have lower premiums but higher out-of-pocket costs such as deductibles, co-pays and coinsurance, whereas platinum plans will have higher premiums but lower out-of-pocket costs.
How are these plans different from what is on the market now?
Plans issued in the individual and small group market on or after Jan. 1 will be different in a number of ways from today's plans. They will cover at least the essential health benefits, they have to be issued to anyone regardless of health status, they will no longer contain annual and lifetime dollar limits, they cannot vary in price due to gender, and the plans on Maryland Health Connection may come with financial assistance to consumers through tax credits and cost sharing reductions.
The Baltimore Sun has occasionally run questions and answers on implementation of the Affordable Care Act. See previous questions at baltimoresun.com/healthreform.
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