Seniors attend the 26th annual Prime Time 50+ Expo hosted by Blue Cross Blue Shield of New Mexico. The event, held Oct. 11 at the Embassy Suites Hotel, is a free health fair that included information on Medicare offerings. Open enrollment for Medicare began Oct. 15 and runs through Dec. 7. Open enrollment for beWellnm, New Mexico’s state exchange, runs Nov. 1 through Jan. 15. (Chancey Bush/Journal)
Inflation has increased costs across many industries, including the medical sector.
Yet many New Mexicans enrolling for health care coverage through beWellnm this year will see lower medical costs than they have in previous years, thanks to both new federal and state legislation.
“Putting more money in the pockets of New Mexicans at a time where things are uncertain, I think, is a really positive aspect of these programs coming into play right now,” said Colin Baillio, director of coverage affordability and expansion for the New Mexico Office of the Superintendent of Insurance, which regulates various types of insurance in the state.
Established under the Affordable Care Act, beWellnm is the place where people can shop for health care insurance plans. It helps individuals and families see how much financial assistance is available and decide which plan is for them.
The options found on beWellnm are available to all New Mexico residents who don’t get insurance through an employer, Medicare or Medicaid. People happy with their existing coverage through beWellnm do not need to reenroll to get coverage for 2023. But those wishing to make a change must pick a plan during the open enrollment period which runs from Nov. 1 until Jan. 15. Newly qualifying people and those experiencing an eligible life event — like losing health coverage, getting married, having a baby or becoming a U. S. citizen — are the only people allowed to make changes outside of the enrollment period and only if they take action within 60 days of the event.
Financial assistance
Health care through beWellnm is made affordable through several different means of support, said Maureen Manring, the organization’s director of communication and outreach. When shopping for health care on beWellnm, New Mexicans enter information about their income and household size. This data is used to determine the financial assistance for which they’re eligible.
Some New Mexico residents qualify for a tax credit, for example, that could be used to lower their monthly health insurance premium. Under the federal Inflation Reduction Act signed in August, this premium tax credit may be even larger in 2023 than it was in 2021 and 2022.
Help also comes from state initiatives. Last year, beWellnm moved from a federally supported state-based exchange to a fully state-run program. The change means beWellnm has more flexibility to take advantage of local legislation and deliver additional coverage and financial support.
“It’s really given us a lot of new tools to be able to lower costs for New Mexicans who shop on beWellnm,” Baillio said.
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One of those tools is Turquoise Plans. This is a brand-new type of plan that features low monthly premium payments in addition to reduced out-of-pocket costs. It was created as a result of legislation passed in 2021 in the state. New Mexico is one of only a few states rolling out a plan like this, Baillio said.
Turquoise Plans lower deductibles, copayments and coinsurance and are available for individuals and families with income up to 300% of the poverty level that also qualify for the federal premium tax credit. The plans will automatically be shown to beWellnm shoppers that meet the criteria.
Another feature resulting from last year’s legislative session addresses mental health. Starting this year and continuing into 2023, there is no out-of-pocket cost for mental health services for people with a health care plan through beWellnm.
“This is part of an initiative of the legislature and the governor to really make mental health services more accessible to people,” Baillio said.
Providers
Health care plans on beWellnm for 2023 will be provided by Ambetter from Western Sky Community Care, Blue Cross Blue Shield of New Mexico, Molina Healthcare and Presbyterian Health Plan. BEST Life is providing dental insurance.
In an effort to support the entire state, providers are required to offer plans in all 33 counties of New Mexico. That’s something that doesn’t necessarily happen in other states, Manring said.
The New Mexico Office of the Superintendent of Insurance reviews all plans on the site, Baillio said, to make sure they’re in compliance with the Affordable Care Act and that the rates are fair and actuarially sound.
Choosing a plan
Starting Oct. 17, consumers can start looking at options in preparation for the open enrollment period. BeWellnm’s shop-and-compare online tool is anonymous and helps people see the premiums and the savings that different plans offer.
For those interested in interacting with a person for help, beWellnm has a team of certified enrollment counselors, agents and brokers available to explain health insurance options. By Nov. 1, the beWellnm website will have a tool in place that allows New Mexicans to schedule appointments. Folks can also call 833-862-3935 (TTY 711). Assistance from these experts is always free.
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