The Checkup
9:10 am
Tue September 17, 2013

What You Need To Know About The New Health Insurance Exchange

Today we continue our series The Checkup: How Health Care Is Changing In Maryland. We meet a retiree from Baltimore County, who’s looking for a good deal in health coverage and Karen Pollitz from the Kaiser Family Foundation, who guides us through the soon-to-open online marketplaces for health insurance.

In 2009, when Sherri Casey and her husband sold their beer-importing business, they hadn’t given much thought to health insurance: "Although we were very smart about everything else in selling it, the one thing we weren’t smart about was to make sure I had continuing coverage. It didn’t matter for my husband because he was on Medicare."

She worked for the new owners for a year and got health insurance through the company. When she left, at age 59, still six years away from being eligible for Medicare, she got coverage through COBRA. COBRA is a law that allows former employees to continue on the company health plan, paying the full premium themselves, with no contribution from the employer. Casey’s COBRA coverage lasted 18 months.

"As I started to get towards the end of those 18 months, I realized I better do something," she said.

She asked her health insurance agent about her coverage options. She applied for coverage through CareFirst BlueCross BlueShield, and says she was quoted a premium of $1,800 a month, more than four times the premium she’d been paying for similar coverage on her COBRA plan.

Casey has high blood pressure, a condition that afflicts an estimated one in three adults in the U.S. Insurers could consider it a pre-existing condition and deny her coverage. Her agent suggested she apply for the Maryland Health Insurance Plan, or MHIP, which covers Marylanders with pre-existing conditions. She was accepted and now pays more than $620 a month for coverage that she says is decent.

But, MHIP will eventually end as a result of Obamacare, since insurers will no longer be able to deny coverage or charge more based on pre-existing conditions.

Many of those on MHIP are expected to apply for coverage through the Maryland Health Connection, the state’s online health insurance marketplace, or exchange, which opens in two weeks. Casey will be among them: "I want to go on to the exchange, see what the plans are, see what the coverage is, and see what the costs are. And, I’m hoping that something will cost less and give me at least what I have now if not better."

After we spoke with Sherri Casey last week, we wanted to get a sense of what people like her need to know as they navigate the online marketplace. So, we contacted Karen Pollitz, Senior Fellow at the Kaiser Family Foundation, a nonprofit focused on health policy. We spoke about how the plans will be organized, who will be eligible subsidies, and what families should think about as they apply for coverage.

Listen to previous episodes of The Checkup here.

Calculate what subsidies you might be eligible for on the exchange here.

Learn more about the Maryland Health Connection at their website. Here's a fact sheet on the exchange.

We want to know how Obamacare is shaping your health care. E-mail us at thecheckup@wypr.org. Tell us your story, and leave your name and a number where we can reach you. You can also leave us a message on our voice mail at (410) 881-3162.

Produced by Matt Purdy.

Our series ‘The Checkup: How Health Care Is Changing In Maryland’ is made possible by grants from CareFirst BlueCross BlueShield, the Baltimore Association of Health Underwriters, and HealthCare Access Maryland.