Health experts say you should find the best option before open enrollment

Healthcare

Missourians have a little more than a month until open enrollment for healthcare coverage at healthcare.gov, and medical experts say it’s important to understand your options to get the best plan for your needs.

More than 215,000 Missouri residents are enrolled in coverage.

But Michelle Davis Reed, eligibility and enrollment coordinator with Northwest Health Services based in St. Joseph, said many folks who previously had marketplace plans or no coverage at all will now be eligible for Medicaid – after the courts upheld voter-approved Medicaid expansion over the summer.  “Everybody who has put off their health care, couldn’t find coverage,” said Davis Reed, “we can put them on sliding fee scales all day. But that doesn’t cover pharmacy, that doesn’t cover if they need to go to the hospital. And with Medicaid expansion, everything is going to be covered.”

Roughly 250,000 people who make up to 138% of the poverty level are newly eligible.  Davis Reed noted that prior to expansion, a family of three could not make more than $381 a month and still qualify. Now, they can make a little more than $2,500 and still be eligible.

For those without Medicaid, open enrollment starts on November 1 and runs through December 15.

Dr. Rhonda Randall – chief medical officer for employer and individual plans at UnitedHealthcare – said it’s important to anticipate what your health needs may be, and compare the differences between plan designs if you expect any upcoming health events.  “We have seen an increased interest in mental-health needs lately,” said Randall. “That’s another important thing to check on. Does your employer have an employee assistance program, and does the medical-plan benefits that they’re offering have the mental-health coverage that you’re looking for?”

Randall added that in addition to in-person care, many insurers have expanded their virtual health network of therapists and psychiatrists. She said some health insurers, including UnitedHealthcare, also offer advocacy services to help individuals find the right therapist and type of care.