Here are some things you may want to think about when shopping for health insurance during open enrollment:
Make sure you are shopping from official sources!
Fall means open enrollment for health insurance coverage is quickly approaching for many employers, the Maryland Health Benefit Exchange, and public benefit programs. While the specific dates will vary, open enrollment is the one time a year when people can sign up for coverage for the first time, or make changes to their current coverage, even if they do not have a qualifying event.
During open enrollment, consumers may come across websites, companies, and health coverage products that are not what they appear to be. Knowing where to shop and understanding what you are buying can help protect you from unexpected costs and coverage gaps.
When you are shopping for a health benefit plan provided by an employer, the employer will generally provide information about open enrollment, including a summary of benefits for each plan and information on how to access your online portal. It is important to note that these types of health benefit plans should include all of the health benefits required by Maryland law and the Affordable Care Act (ACA).
But if you do not get health insurance through an employer and need to shop for health insurance from an insurer, or are signing up for Medicaid, a good place to start is with the official Maryland Health Connection website: marylandhealthconnection.gov. The private insurer plans offered through the Maryland Health Connection will also include all of the health benefits required by Maryland law.
You can also search online for health insurance - just be aware that this space isn't as tightly regulated as the official marketplace. Searches for terms like “cheap health insurance" or “Obamacare plans," can lead you to websites that are not insurers or official government marketplaces. Scammers may, for example, also create websites with names that look very similar to the official Maryland Health Connection site. When looking for the Maryland Health Connection website, or another governmental website, one way to protect yourself is to check the website address to be sure it ends in “.gov." before entering personal or financial information.
Some of the search results may include websites that are “lead generators." These websites exist to collect your information and sell it to insurance producers (agents or brokers). You may then receive calls, texts, or emails from people trying to sell you coverage. Generally, if you receive an unexpected call about health insurance, it is safest to hang up right away. If you choose to speak with the caller, you can ask for their name and phone number, and then contact the Maryland Insurance Administration at 800-492-6116 to verify that they are licensed to sell health insurance in Maryland.
If you need help enrolling through the Maryland Health Connection, remember that you have the right to ask to see a photo ID and State of Maryland certification from anyone assisting you. All services through Maryland Health Connection are free and available at marylandhealthconnection.gov/find-help.
If someone says they are with the Maryland Health Connection, and asks for payment or advertises a fee to help you enroll, report it immediately to the Maryland Health Connection Compliance Hotline at 410-547-6862, or visit their website to learn more. Make sure that you understand what you are buying
There are several types of health insurance products available in Maryland that are not required to include all of the mandatory benefits that, for example, an employer sponsored health benefit plan or Maryland Health Connection policy provides. These plans are called limited benefit plans or “excepted benefit plans".
Since the benefits vary by plan/product, before purchasing a limited benefit plan, it is a good idea to make sure you understand exactly what it covers and what it does not cover. Insurance producers may emphasize features such as low premiums, no deductibles, or no copays. However, these products may not provide the coverages you want or need. For example, some limited benefit plans may not include coverage for specific types of medical care, such as mental health services, maternity care, prescription drugs, or treatment for pre-existing conditions. Some products may combine several different types of coverage, making it hard to understand what you are actually purchasing.
Fixed indemnity plans are one example of a limited benefit plan. These plans do not include all of the legally required benefits that must be included in a health benefit plan. Instead, a fixed indemnity plan pays a specific dollar amount for certain covered services. For example, the plan might pay $100 for a doctor's visit. You are responsible for the difference between what the plan pays and what your medical provider charges, as well as the full cost of any services or treatments that are not covered under the policy.
When shopping for health care coverage, consumers may also encounter Health Care Sharing Ministries (HCSMs) and similar arrangements. HCSMs are organizations whose members voluntarily contribute money to help pay for certain health care expenses of other members. These arrangements are not health insurance, and payment of your health care expenses is not guaranteed.
Be cautious if you feel pressured to purchase a plan because you are told that premiums could change quickly or that you need to act fast. Take the time to understand what you are buying, what it will pay, and what you could be responsible for paying yourself.
To learn more about limited benefit health plans and Health Sharing Ministries, click below:Watch out for unauthorized health insurance plans
The Maryland Insurance Administration has identified several entities that are not authorized to sell or issue insurance products in Maryland, or which are offering unauthorized or illegal health insurance plans. In most cases, it is against the law to sell an unauthorized insurance policy in the State of Maryland. 