Andrea Bryant of Manchester and Barbara Channels of Torrington were two of the first individuals Monday to sign up for the state’s new health insurance plan for uninsured adults.
Bryant, a waitress in Wethersfield, said two years ago after her husband died she was paying $700 a month for health insurance. “My pay didn’t cover it all,” Bryant said. She said she can’t wait to participate in the new Charter Oak Health Plan and hopes the affordable monthly premiums will help her get out of debt. Channels, a medical advocate for her 47-year-old brother, said she is helping him sign up for the plan because he needs major medical treatment in the near future and he doesn’t qualify for any other insurance plans.
The Charter Oak Health Plan does not exclude individuals because they have a pre-existing condition, however, under some circumstances individuals have to be uninsured for six-months before they qualify.
Individual premiums range between $75 to $259 per month depending on income and the annual deductible for individuals ranges from $150 to $900 and families from $300 to $1,750. The three managed care organizations hired by the state to provide the Charter Oak Plan to residents includes, Aetna Better Health, AmeriChoice of Connecticut, and Community Health Providers. The Department of Social Services plans to enroll residents throughout the month of July. The plan will begin on Aug. 1.
Gov. M. Jodi Rell, who first proposed the plan in December 2006, said Monday that “My goal has always been to help the uninsured get the affordable health insurance they need.” The Charter Oak Health Plan for uninsured adults ages 19 to 64 will “change the face of health care in our state,” she said.
Touted as the first-of-its-kind type of plan in the nation, Rell said this plan is not like the one in Massachusetts because it does not place mandates on individuals or employers to purchase health insurance. Rell said she doesn’t support a single-payer system of health care. “I personally don’t think it’s the answer,” she said.
Rell said there were concerns early on that individuals may drop their employer-sponsored health insurance, which is why there is a six-month crowd out provision included in the plan. She said the Charter Oak Plan will help adults who don’t have access to health insurance through their employers.
Tom McAteer of Aetna called Rell’s Charter Oak Plan, “a bold approach” to helping the uninsured. He said by offering a delineated plan to the uninsured the entire health insurance industry is saving money because they’re not paying for the uninsured that walk into the emergency room when they need medical attention.
Don Langer, chief operations officer of AmeriChoice and Lynn Childs, vice president of health services for Community Health Networks said what’s good about the plan is that individuals aren’t paying their premiums based on their medical risk.
But health care advocates like Ellen Andrews executive director of the CT Health Policy Project said consumers need to be careful when deciding to buy into the plan. “Charter Oak Health Plan will be a good option for some, but consumers really need to do their homework, and investigate the health insurance options to make sure that the insurance will make sense for both their finances and their individual health care needs,” Andrews said.
Andrews said deductibles and co-insurance costs may be too high for some consumers. For instance, an individual who makes more than $31,200 and is single would have to pay up to $900 or more out of pocket in addition to premiums. She said while 90 percent of inpatient hospital care is covered after the $900 deductible is met, one heart attack could cost as much as $40,000 leaving an individual with a $4,000 bill after they get out of the hospital.
Not all services require a deductible. Primary care office visits will be a $25 co-pay, specialists will be a $35 co-pay and an emergency room visit is $100 co-pay, which is waived if the visit is deemed an emergency.
There is also a $100,000 annual maximum benefit and a $1 million lifetime maximum benefit.
The legislature approved $11 million for the program in 2007. Department of Social Services Commissioner Michael Starkowski said Monday that he expects between 15,000 and 17,000 individuals to sign up for the plan this fiscal year.
For more information about or to download an application visit the state’s web site: www.charteroakhealthplan.com or call 1-877-772-8625.