Got Health Insurance?
By: Source: AARP.org Date Posted: 2007-03-02 16:26:43.923584-05:00
AARP Goes One-on-One with Jon Kingsdale
The landmark health care reform, signed into law on April 12, 2006, made Massachusetts the first state in the nation to attempt to cover all residents with health insurance. The reform subsidizes coverage for the uninsured with lower incomes, provides incentives for employers to offer health insurance, reduces non-group insurance premiums, and increases individual choice of health plans.
As part of this law, the Commonwealth Health Insurance Connector Authority ("the Connector") was established to promote health care coverage of the uninsured and to manage "Commonwealth Care" and "Commonwealth Choice," new insurance options for individuals in the Bay State.
AARP Massachusetts asked Jon Kingsdale, executive director of the Connector, to outline the basic information that consumers need to know about the health care reform law, Commonwealth Care and Commonwealth Choice.
Q: Who can sign up for health insurance through the Connector?
A: The Connector offers two different programs of insurance: Commonwealth Care for low-income uninsured individuals, while Commonwealth Choice is an unsubsidized plan for small employers and individuals.
Commonwealth Care is subsidized insurance, intended for uninsured adults earning less than 300 percent of the federal poverty level (FPL)—$29,400 for an individual and $60,000 for a family of four—who are ineligible for Medicare, Medicaid or an employer's program.
The first phase of the rollout occurred October 1, 2006 for those earning 100 percent or less of FPL. The second phase starts January 1, 2007 for those earning between 101 and 300 percent of FPL.
Q: What insurance options are available?
A: Commonwealth Care plans are offered through four managed care organizations - Network Health, HealthNet, Fallon Community Health Plan and Neighborhood Health Plan.
All of them offer outpatient and inpatient care, prescription drugs, inpatient and outpatient mental health and substance abuse services, rehabilitation services and a variety of other benefits, without a deductible or coinsurance, and with relatively modest co-payments.
The Connector's customer service representatives stand by ready to help answer any questions Monday through Friday from 8 a.m. to 5 p.m. at 1-877-623-6765 or 1-877-623-7723 for people with hearing loss.
Q: Do all Massachusetts residents without health insurance have to sign up for Commonwealth Care or Commonwealth Choice?
A: All adults in Massachusetts will be required to have health insurance starting July 1, 2007, with the exception of those individuals granted a waiver by the Connector because affordable options are not available to them. However, the Connector is not for everyone. Some uninsured will acquire plans through the Connector 's Commonwealth Choice, others directly from commercial carriers or through their employers' plan, and still others qualify for government-subsidized programs, such as Medicare, MassHealth or Commonwealth Care.
Making affordable plans available to so many in the Commonwealth is a wonderful opportunity for people to have health insurance for the first time.
AARP Massachusetts thanks Jon Kingsdale for taking the time to answer our questions.
This article was originally published in the AARP Massachusetts Update newsletter, Winter 2007.
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