New Charter Oak Health Insurance Plan

The new Charter Oak Health Plan began taking applications on July 1st with coverage to begin in September.

Premiums per person vary between $75 and $279/month with an annual cap on services of $100,000, in addition to the lifetime $1 million cap. Annual deductibles range from $150 to $900 (and up to $1,750 for families) and above that amount, consumers will have to pay 10% of inpatient hospital bills and 20% of outpatient surgery and medical tests. There will also be co-pays on office visits and prescriptions drugs, and there is a $4,000 annual cap on durable medical equipment.

The three participating health plans are Community Health Network, Aetna Better Health and AmeriChoice (UnitedHealth Plan). Charter Oak covers hospital care, doctor or clinic visits, X rays and lab tests, prescriptions, and some mental health and substance abuse treatment. There is no pre-existing condition exclusion and subsidies in premiums and deductibles are based on income.

While Charter Oak is an important new option for CT's uninsured, it may not be right for everyone. As with all insurance, consumers need to do their homework.

Charter Oak may not be right for consumers who:

• Have insurance now - (with some exceptions, you may not be eligible if you've had insurance in the last six months)

• Don't have money in the bank available for health costs ($900 deductibles plus 10% of hospitals stays can get very expensive)

• Have high prescription needs (prescriptions are limited to $7,500/year)

• Need to see a specific doctor (the provider panel is likely to be very limited)

• Need dental or vision care (they are not covered)

• Need mental health or substance abuse treatment (coverage is limited and high cost sharing applies to certain services)

Consumers who want more information or to sign up can go to http://www.charteroakhealthplan.com/ or call 1-877-77CTOAK

(1-877-772-8625).

This information is taken from the CT Alliance for Basic Human Needs (CABHN) June/July 2008 Newsletter and the CT Health Policy Project website http://www.cthealthpolicy.org/

Thank you,
Alicia Woodsby, MSW
Public Policy Director
NAMI-CT