MIDDLEBURY — Those seeking to obtain insurance through Vermont Health Connect (VHC) or who want to modify the plan in which they are currently enrolled have to act fast.
That’s because state and federal officials have cut this year’s VHC “open enrollment period” in half, from 12 weeks to a six-week period that began on Nov. 1 and will end on Dec. 15.
At stake is health care coverage for 2018 — Vermonters who miss the Dec. 15 deadline might have to wait until 2019 to get their coverage, according to state officials.
“It means squeezing in more people in a shorter period of time,” said Melanie Clark of Middlebury’s Open Door Clinic.
Clark is one of the most experienced in a shrinking number of part-time health care “navigators” tasked each year with helping people find the best VHC plan for them.
Open Door Clinic officials have been spending the past few weeks letting their uninsured and underinsured clients know about the shorter enrollment window and recent changes in VHC coverage options.
“We really want to bring attention to that,” said Christiane Kokubo, the clinic’s communications specialist. “With all the talk in the media these days about repealing and replacing Obamacare, it can be hard for the average consumer to understand how the health care debate is going to affect this year’s open enrollment.”
CHANGES, PRICES
Among the notable changes for VHC clients in 2018 are four new “bronze” plans available to purchase, while rates and plan details have changed for existing plans. Consumers should review the plans available for purchase in 2018 to ensure they are enrolling in the option that best meets their needs at the best available price, officials said.
Most Vermonters will find 24 options for qualified health plans from Blue Cross and Blue Shield of Vermont and MVP, as well as a dental plan from Northeast Delta Dental.
Vermonters younger than 30 years old have the option of choosing a catastrophic plan from either carrier in addition to the 24 other options.
Most current members will be able to find a 2018 health plan at the same level they had in 2017 for about the same, or less, premium that they paid in 2017, according to Vermont Department of Vermont Health Access officials. But they emphasized customers should carefully evaluate their plan options before making a switch.
“Plans do change year to year, and along with that, is the price of the plans and what is covered,” Clark said. “I always encourage people to come in each year and meet with me to see if the plan they are in right now is really the best plan for them.”
For instance, Blue Cross-Blue Shield offered the cheapest health insurance option in 2016 with its “Silver” plan, so most people enrolled in that. But in 2017, MVP came out with a cheaper plan, according to Clark.
“So people who didn’t bother to look at the plans just rolled back into a plan that was $50 more expensive than what could have been a comparable MVP plan,” she said.
What about 2018?
“In 2018, MVP’s rates are much lower than Blue Cross-Blue Shield’s rates,” Clark said. “So if people haven’t taken a look at them, they really should.”
Some of Addison County’s VHC clients have become so confident in Clark’s knowledge and advice that they seek her out each year — just in case.
“I have people who call me, without fail every day on Nov. 1, to say, ‘I want to come in and talk about my plan for next year,’” she said. “Those people occupy a lot of my time, and those are people I’ve already met with who just want to check in and see ‘Is this still the best plan for me, or should I move to a different plan?’”
CUTS HURTS OUTREACH
Meanwhile, outreach and advertising related to VHC enrollment and Obamacare have been cut at both the state and federal level. At the same time, the number of in-person “assistors” available to help the general public has decreased.
Those seeking help with enrolling in a health plan, or changing plans, should schedule their appointments as soon as possible in order to ensure they can be seen before the Dec. 15 deadline.
As reported by the Addison Independent this past August, Middlebury’s Open Door Clinic is trying to fill a $62,000 budget shortfall for next year, one that could have a dramatic impact on the nonprofit’s efforts to extend medical care to migrant farm workers and connect some Addison County residents to health insurance.
The $62,000 shortfall includes the loss of $12,000 in state funding for the clinic’s part-time health care “navigator,” who helps uninsured and under-insured Addison County residents find coverage through VHC. That navigator, Clark, assists residents who find it difficult to negotiate the VHC options and enrollment process online (VermontHealthConnect.gov), or by phone (toll-free: 1-855-899-9600).
Clark ends up helping a lot of people who have tried to sign up for plans online or by phone, but who need personal aid due to language, hearing, illiteracy or other reasons.
Clark works about 20 hours per week providing navigator services to clinic clients. Typically, she’s at the clinic on Mondays, Tuesdays and Thursdays.
The state has been gradually reducing its navigator grants as more people have become integrated into the state’s health care system. In 2013, there were four full- and part-time navigators in Addison County.
State funding for health care navigators was initially $24,000 per year, a sum that decreased to $12,000 last year and was completely phased out this past June 30, according to Clark.
Open Door Clinic leadership has earmarked some of its limited resources to keep Clark in her navigator role, figuring her loss could result in some area residents losing out on health care.
The state has sought to replace navigators with “certified application counselors,” who receive no state funding and are primarily staffers of local health care organizations and have assumed this extra role to help their patients find quality health insurance.
The message to VHC clients is clear: Those who need help with open enrollment this year should soon call 989-6872 to book an appointment with Clark.
“I’m very busy, and we’re not even advertising anywhere,” Clark said. “We have a limited amount of hours we can dedicate to this right now.”
Reporter John Flowers is at [email protected].