Easing the burden: Lowering costs for those using the NM health exchange this year

Retirees 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 includes information about Medicare offerings. Medicare open enrollment began on October 15th and runs through December 7th. Open enrollment for beWellnm, New Mexico’s state exchange, runs from November 1st through January 15th. (Chancey Bush/Journal)

Inflation has increased costs in many industries, including the medical sector.

Still, many New Mexicans who sign up for health coverage through beWellnm this year will see lower medical costs than in previous years, thanks to both new federal and state legislation.

“I think putting more money in the pockets of New Mexicans at a time when things are uncertain is a really positive aspect of these programs coming into play right now,” said Colin Baillio, director of coverage affordability and expansion for New Mexico Office of the Superintendent of Insurance, which regulates the various types of insurance in the state.

Created under the Affordable Care Act, beWellnm is where people can shop for health insurance plans. It helps people and families see how much financial help is available and decide which plan is right for them.

The options found on beWellnm are available to all New Mexico residents who do not receive insurance through an employer, Medicare or Medicaid. People who are satisfied with their existing coverage through beWellnm do not need to re-enroll to get coverage for 2023. But those who wish to make a change must select a plan during the open enrollment period, which runs from November 1 to January 15. Newly qualified people and those who experience a qualifying life event—such as 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 take action within 60 days of the event.

Financial help

Health care through beWellnm is made available through several different means of support, said Maureen Manring, the organization’s director of communications 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 aid for which they are eligible.

Some New Mexico residents are eligible for a tax credit, for example, that can be used to reduce their monthly health insurance premium. Under the federal Inflation Reduction Act signed into law in August, that premium tax credit could be even larger in 2023 than in 2021 and 2022.

Help also comes from government initiatives. Last year, beWellnm transitioned from a federally supported state exchange to a fully state-run program. The change means beWellnm has more flexibility to take advantage of local legislation and provide 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 at beWellnm,” Baillio said.

One of these tools is Turquoise Plans. This is an entirely new type of plan that includes 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 the few states that has enacted a plan like this, Baio said.

Turquoise plans reduce deductibles, copayments and coinsurance and are available to individuals and families with incomes up to 300% of the poverty level who also qualify for the federal premium tax credit. Plans will automatically be shown to beWellnm buyers who meet the criteria.

Another feature emerging from last year’s legislative session concerns mental health. Starting this year and continuing through 2023, there is no cost for mental health services for people with a health plan through beWellnm.

“This is part of an initiative by the Legislature and the governor to really make mental health services more accessible to people,” Bayo said.

Providers

beWellnm health plans for 2023 will be provided by Ambetter of Western Sky Community Care, Blue Cross Blue Shield of New Mexico, Molina Healthcare and Presbyterian Health Plan. BEST Life provides dental insurance.

In an effort to support the entire state, providers are required to offer plans in all 33 New Mexico counties. That’s something that doesn’t necessarily happen in other states, Manring said.

New Mexico’s Office of the Superintendent of Insurance reviews all plans on the site, Baillio said, to make sure they comply with the Affordable Care Act and that the rates are fair and actuarially sound.

Choose a plan

Starting October 17th, consumers can start looking at options in preparation for the open enrollment period. BeWellnm’s online shopping and comparison tool is anonymous and helps people see the premiums and savings that different plans offer.

For those interested in interacting with a support person, beWellnm has a team of certified enrollment consultants, agents and brokers to explain health insurance options. By November 1, the beWellnm website will have a tool that allows New Mexicans to schedule appointments. People can also call 833-862-3935 (TTY 711). Help from these experts is always free.

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