Small businesses and self-employed individuals in Maine can begin signing up for the state’s new health insurance program today, Oct. 4, with coverage beginning on Jan. 1.
But people who are unemployed or work for a business that doesn’t offer insurance can’t join DirigoChoice until Feb. 1. Those benefits will become effective April 1.
The staggered enrollment was necessary because DirigoChoice is a complicated program, offering the “only product in the market that is bringing in individuals, sole proprietors and small groups together,” said Karynlee Harrington, executive director of the Dirigo Health agency, which will coordinate DirigoChoice.
Dirigo is a state-private partnership designed to make health care accessible to the state’s 138,000 uninsured residents by 2009.
The 26,500 spots set aside for employees of small businesses are expected to be filled gradually. Participating business owners must find enough employees willing to participate and agree to pay at least 60 percent of their workers’ premiums.
But the 4,500 spots for the self-employed and other individuals will go faster, program coordinators say. Sicker, more expensive patients who face expensive policies on the individual market are expected to be drawn to DirigoChoice, which is priced on ability to pay.
DirigoChoice will be offered through Anthem Blue Cross Blue Shield of Maine and can be purchased only through Anthem-licensed agents. Agents for other insurance companies say that some of their products offer better rates than DirigoChoice.
Dino Joannides, president of the Bridgewater Financial Group Inc., touts an Aetna plan costing up to $150 a month for a single employee and up to $400 for family coverage. It allows for three office visits for each insured person per year at $25 each. A $3,000 deductible applies to any hospital stay.
DirigoChoice monthly premiums may be higher than some competing plans, but have richer benefits such as free preventive care, said Adam Thompson of the Governor’s Office of Health Policy and Finance.
The program extends discounts to people who make up to three times the federal poverty level — $27,930 for a single person, $56,550 for a family of four. Income decides what deductibles and discounts are available.
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